General guidance:
(1) The patient should continue to take diabetes medications even if food intake is significantly reduced.
(2) The patient should try to avoid dehydration by regularly drinking fluids (from 6 to 8 ounces of liquid every hour while awake).
(3) Blood glucose levels should be monitored regularly (every 3 or 4 hours). If the blood glucose is > 250 mg/dL then additional insulin may be needed.
(4) If significant hyperglycemia is present, then the urine should be tested for ketones.
The healthcare provider should be contacted if:
(1) The hyperglycemia persists or progresses despite insulin therapy.
(2) The patient becomes hypoglycemic.
(3) Moderate to large amounts of ketones are present in the urine.
(4) The patient becomes dehydrated or is at risk of becoming dehydrated (persistent vomiting or diarrhea, inability to maintain fluid intake).
(5) The patient becomes short of breath or is breathing heavily.
(6) There is evidence of a bacterial infection.
(7) The patient shows a change in mental status.
