What is a sick day action plan?

A sick day action plan is a personalised plan created by a doctor (usually a GP). It includes key information about what the person with diabetes should do when they are sick in order to properly manage their condition. This includes information such as what to do when they are not eating or drinking, what to do if they are vomiting, how often blood glucose levels should be tested, and when to contact the doctor. Ensure that a sick day action plan is obtained before it is needed.

Taking insulin, taking medications, and checking blood glucose levels when sick

It is important that a person with diabetes continues to take their insulin when sick, even when vomiting or experiencing diarrhoea. When unwell, they may need extra insulin even if they are not eating or drinking as much. Because of this, it is important to check blood glucose levels more than normal (every 2-4 hours). Do this until levels are back in the normal range as recommended by their healthcare professional. If extra insulin is needed, a dose of short-acting insulin would be the best course of action.

Even when sick, those with diabetes should continue to take their medications, with some exceptions. If there are multiple instances of vomiting and/or diarrhoea or if these symptoms last more than a few hours, consult your doctor for advice. The two types of medication the person may need to stop taking in these cases are Metformin or SGLT-2 inhibitors.

Preparation

• If needed (depending on destination), acquire a letter from the doctor stating which medications you are carrying and what they are needed for.
• Discuss how insulin should be carried and stored with the doctor.
• Familiarise yourself with local emergency departments, pharmacy and GP practice, if abroad including the emergency dialing number.
• Discuss the option of purchasing travel insurance.
• Write a list of all stops and breaks, arrival and departure times, and time zone changes (this will help if medication and blood sugar testing times will differ from the usual routine)
• If meals are provided in-flight, discuss with the airline the person’s meal requirements to ensure the correct food and drinks are available.

What to pack

• A copy of the Diabetes Medical Management Plan and Low/High Blood Sugar Plan if required.
• Adequate supply of medications, test strips, insulin, and glucose meter to last the duration of the holiday and extra supply.
• A diary to record blood sugar test times and results, if the person you support has a sliding scale and normally records BGL readings.
• Medication sheet to record time and amount of medication given.
• Carry some sugary snacks and long-acting carbohydrate snacks just in case.
• Letter from the doctor (if required)
• Pack insulin, BGL monitor, hypoglycemia kit and snack foods in a backpack that will be kept under the seat for easy access if required.

If the person is travelling alone, it is highly recommended that the person wears a form of diabetes identification of some sort, such as a bracelet or necklace, especially if they are taking medication or insulin.