endocrinology general-medicine

Diabetes Sick Day Risk Assessment

Sick-day rules for people with diabetes who are unwell. There is no validated points score — the page's tally was not a published method.

Used in: Diabetes & DKA

Result

There is no validated points score for sick-day risk. Sick-day rules: never stop insulin; check blood glucose every 2–4 hours and, in type 1 diabetes or on an SGLT2 inhibitor, blood ketones while unwell. Ketones 0.6–1.5 mmol/L: slightly raised — extra fluids, recheck in 2 hours and ask the diabetes team about extra insulin; 1.6–2.9 mmol/L: high risk of DKA — contact the diabetes team urgently; 3.0 mmol/L or more, vomiting or unable to keep fluids down, drowsiness or confusion, abdominal pain or breathlessness: emergency assessment (DKA/HHS pathway). While dehydrated, pause SGLT2 inhibitors, metformin, ACE inhibitors/ARBs, diuretics, NSAIDs and sulfonylureas, restarting after 24–48 hours of eating and drinking normally.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Hypoglycaemia Severity Classification · Diabetes Management

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

References

Related