6.1 Describe the impact of intercurrent illness on individuals with diabetes

This guide will help you answer 6.1 Describe the impact of intercurrent illness on individuals with diabetes.

An intercurrent illness is any illness or infection that occurs at the same time as a long-term condition, such as diabetes. This could be something minor like a cold or a more serious problem such as pneumonia or a urinary tract infection. Intercurrent means the new illness happens while the person is already living with another condition.

For people with diabetes, an intercurrent illness can have a powerful effect on their health and day-to-day life. The body reacts differently, and diabetes control becomes more complicated.

How Diabetes Affects the Body

Diabetes affects the way the body handles glucose, the main sugar in the blood. There are two main types:

Type 1 diabetes: The body does not produce insulin.
Type 2 diabetes: The body cannot use insulin well.

Insulin is a hormone that helps glucose move from the blood into the body’s cells, giving them energy. With diabetes, this process is disrupted. Blood sugar levels can go too high (hyperglycaemia) or too low (hypoglycaemia).

Maintaining the right balance is important.

What Happens During an Intercurrent Illness?

When someone with diabetes gets another illness, their body becomes more stressed. The body releases stress hormones such as adrenaline and cortisol. These hormones are designed to help the body cope with illness, but they have an important side effect: they make it harder for insulin to work properly.

As a result, blood sugar levels often rise, sometimes quite sharply.

People might:

Feel thirsty
Go to the toilet more often
Feel tired
Be more at risk of serious diabetes complications

Even simple illnesses like a cold or mild infection can have a significant effect.

Common Intercurrent Illnesses

Some illnesses that often affect people with diabetes include:

Infections (urinary tract, chest, skin)
Flu
Stomach bugs (gastroenteritis)
Tooth abscesses or gum infections

Any infection or illness puts extra strain on the body. The immune system works harder, and blood sugar often goes up.

Effects of High Blood Sugar during Illness

When blood sugar goes high during illness, several problems can follow:

The kidneys try to flush out excess sugar, leading to dehydration.
High blood sugar means white blood cells cannot work well, so infections can be harder to fight.
Wounds or infections can take longer to heal.
There is a higher risk of diabetic ketoacidosis (DKA) in people with Type 1 diabetes. DKA is a dangerous condition where the body starts breaking down fat instead of sugar, making the blood acidic.
Hyperosmolar Hyperglycaemic State (HHS) can happen in Type 2 diabetes. This is a medical emergency marked by very high blood sugar levels and severe dehydration.

The risks are real, and people with diabetes need to take particular care if they are ill.

Difficulties in Diabetes Self-Management

Illness can make it harder for someone with diabetes to look after themselves.

They may have less appetite and eat less food, leading to lower blood sugar. But, if they cannot keep food down, they may struggle with hypoglycaemia if insulin or diabetes tablets are not adjusted.

On the other hand, not adjusting insulin or medication when blood sugar is high from illness can lead to very high blood sugar. Urgent action may be needed.

People with diabetes need to:

Check their blood sugar more often
Adjust medication, sometimes with medical advice
Keep drinking fluids to prevent dehydration

These are called “sick day rules.” Every person with diabetes should know their own plan.

Impact on Physical Health

Intercurrent illness can lead to immediate and longer-term problems.

Short-Term Effects

Increased blood sugar (hyperglycaemia)
Dehydration, making the person feel unwell
Increased risk of diabetes complications, such as infection spread or developing DKA

Longer-Term Effects

If illness is not managed well, it can lead to:

Hospital admission
Poor diabetes control after illness resolves
Higher risk of future complications, such as kidney problems, nerve damage, or sight loss

Stable diabetes control protects the body in the long term. Frequent or severe episodes of high blood sugar caused by repeated illness can lead to more serious health problems.

Emotional Impact

Living with diabetes already involves daily choices and routines. Getting ill on top of this can be overwhelming.

Some people may feel:

Worried or scared about what the illness will do to their diabetes
Confused about how to adjust medications or insulin
Frustrated at feeling unwell and having more to manage
Isolated if family or carers do not understand how much more challenging self-care has become

Emotional support is just as important as physical care. Health and social care staff should be patient and give clear information.

Risks During Intercurrent Illness

If blood sugar is not managed carefully, some serious risks increase:

Diabetic Ketoacidosis (DKA)

More common in Type 1 diabetes
Can be triggered by chest infection or stomach bug
Leads to nausea, vomiting, stomach pain, dehydration, trouble breathing
Needs urgent hospital care

Hyperosmolar Hyperglycaemic State (HHS)

More likely with Type 2 diabetes
Caused by very high blood sugar and not enough fluid intake
May cause severe drowsiness, confusion, risk of coma
Also needs urgent hospital care

Other Complications

Infections can become severe or spread, like chest infections turning into pneumonia
Pressure ulcers if the person is bed-bound and too weak to move
Falls or injuries if the person becomes weak, dizzy or confused

Quick recognition and prompt medical support save lives.

Impact on Daily Life and Independence

An intercurrent illness can disrupt a person’s daily routine. This affects their confidence and independence.

People might:

Need to stay in bed or rest more
Miss work, social activities, or even basic tasks
Rely more on carers or family for help with medication, meals or travel to appointments

Maintaining independence is important for self-esteem. Support workers and carers play a big part here.

Social and Practical Considerations

When illness strikes, even small daily chores can feel very hard.

Tasks that become difficult might include:

Preparing food, especially if tired or nauseous
Checking blood sugar frequently
Remembering to take medication
Noticing early symptoms of low or high blood sugar

Clear support plans and regular contact from carers can help people cope better.

Supporting People with Diabetes through Illness

Health and social care workers can make a big difference. Simple steps include:

Reminding the person to eat and drink little and often, even if appetite is poor
Supporting regular blood sugar testing and helping record the results
Watching for signs of dehydration, confusion, or breathlessness
Making sure medication is taken as prescribed
Alerting healthcare professionals if they notice worrying signs

Clear, easy-to-understand information helps people feel in control.

Clear Communication

Good communication matters. Use plain language, without jargon. Check the person understands:

What is happening with their blood sugar
When to seek help
Any changes to their medication or food plan

Encourage questions and listen to worries.

Preventative Steps

Health and social care workers can help people avoid complications. Simple actions include:

Helping to arrange flu and pneumonia vaccinations
Teaching good hand and personal hygiene to prevent infections
Watching for early signs of illness

Prompt treatment of minor illnesses can stop things getting worse.

Importance of Individualised Care

Each person with diabetes is different. Some may notice big changes from even minor illnesses, while others manage well.

A person’s care plan should be individual. It might need to include:

Personal “sick day rules”
Emergency contact numbers
Information about when to contact the GP or diabetes nurse

Keep the plan updated and make sure the person knows where to find it.

Role of Family and Carers

Family members and carers can have an important role, especially during illness. They can:

Offer emotional support
Help monitor for warning signs
Remind the person to eat, drink and check blood sugar
Phone the GP if the person gets worse

Workers can support families with advice or training if needed.

Medicines Management

During intercurrent illness, medication management can become complicated.

Some diabetes medicines may need to be paused or adjusted if the person is vomiting or has diarrhoea. Other medicines, such as antibiotics, might be needed for infections.

Workers should never make changes themselves but always follow a nurse or doctor’s advice. Keeping an up-to-date medicines list helps everyone involved.

Monitoring and Early Action

Spotting problems early is important. Watch for:

Rapid rise or fall in blood sugar
Vomiting, refusal to drink fluids or eat
New confusion, sleepiness or difficulty breathing

Report concerns quickly. Better to alert someone too soon than too late.

Training for Health and Social Care Workers

Ongoing training helps workers:

Recognise early signs of worsening diabetes control
Know how to support people with “sick day rules”
Understand what urgent action to take and who to contact

This keeps everyone safer.

Final Thoughts

Living with diabetes means always being ready for the unexpected. When another illness happens, it changes everything. Blood sugar can rise, routines break down, and both physical and emotional stress increase. Care workers and health professionals can support people to stay as healthy and independent as possible.

Everyone should be aware of the risks, recognise changes quickly, and always act with clear communication and kindness. By staying alert and working together, we can lessen the impact of intercurrent illness for people with diabetes. Giving the right support during these times makes a real difference to health, wellbeing, and quality of life.