Where patients do not administer enough insulin, they could develop hyperglycaemia. Early signs include polydipsia (excessive thirst), polyuria (abnormally large production/passage
of urine), loss of appetite, nausea, vomiting and dry skin.

An example of a patient’s description is: “When I have a high blood sugar, I get sleepy, my brain feels like toffee, I’m lethargic and I can’t concentrate. Sometimes I’m insatiably thirsty as well.”

Patients should contact their diabetes team if they are unsure of what to do during periods of illness. Community pharmacy teams can check their patients’ understanding of how to use their insulin when they are unwell or experiencing higher than usual levels of stress.