CHAPTER 20 — SPECIAL SITUATIONS: ILLNESS, FASTING, TRAVEL, AND HOLIDAYS Daily routines are powerful, but real life includes illness, religious or cultural fasting, travel, celebrations, and holidays. These situations can temporarily disturb glucose levels and habits. This chapter explains simple, practical ways to handle them more safely and calmly. GENERAL PRINCIPLES FOR SPECIAL SITUATIONS Across all special situations, some basic rules remain:
- Protect hydration.
- Avoid very long periods with no calories unless medically guided.
- Keep medication plans clear and checked with a professional.
- Monitor glucose more often when conditions change.
- Return to normal routine as soon as possible after the event.
SPECIAL SITUATION 1: ILLNESS AND INFECTION When the body fights an infection, stress hormones rise and the liver releases more glucose. As a result:
- Blood sugar often increases, even with normal food intake.
- Appetite may fall or change.
- Dehydration risk increases.
Sick day basics:
- Drink small, frequent amounts of water or suitable fluids.
- Try to maintain some carbohydrate intake if using medicines that can cause low blood sugar.
- Continue diabetes medication unless a health professional advises otherwise.
- Check glucose more often than usual.
- Seek medical help if glucose stays very high, you cannot keep fluids down, or you feel unusually drowsy or short of breath.
Food during illness:
- Choose simple foods that are easy to digest and that include some protein if possible.
- If appetite is low, small frequent meals or drinks may be easier than large meals.
- Avoid relying only on sugary drinks and biscuits.
After illness, gradually return to your standard routine. SPECIAL SITUATION 2: RELIGIOUS OR CULTURAL FASTING Some people with Type 2 Diabetes choose to fast for religious or cultural reasons. This needs careful planning with a health professional, especially if medications or insulin are used. Key considerations:
- Type of fasting (daytime only, full day, alternate days).
- Duration of the fast.
- Medication type, dose, and timing.
- Risk of low or very high blood sugar.
General safety ideas (for discussion with a professional):
- Adjusting medication timing for periods with no food.
- Breaking the fast with balanced meals rather than very heavy, sweet foods.
- Drinking enough fluids during allowed hours.
- Checking glucose more often during fasting periods.
- Having a clear plan for when to stop fasting if glucose becomes unsafe.
Fasting without professional guidance is not recommended for people with:
- Significant kidney, heart, or advanced eye disease.
- History of frequent low blood sugar.
- Serious illness or frailty.
- Pregnancy.
SPECIAL SITUATION 3: TRAVEL AND TIME ZONE CHANGES Travel influences meals, sleep, stress, and movement. It can temporarily disturb glucose patterns. Before travel:
- Pack medications, glucose meter or CGM supplies, and snacks in hand luggage.
- Carry a list of medicines and doses.
- Ensure enough medication for the full trip plus a few extra days.
During travel days:
- Avoid large, very high carbohydrate meals.
- Choose protein and vegetables where possible.
- Drink water regularly.
- Stand, stretch, and walk when safe and possible during long journeys.
- If crossing time zones, adjust medication gradually as advised by your health professional.
At destination:
- Rebuild routine as soon as possible: regular meals, movement, and sleep.
- Test how local foods affect glucose using your meter or CGM.
- Use walking to explore and to support glucose control.
SPECIAL SITUATION 4: HOLIDAYS, CELEBRATIONS, AND FEASTS Holidays often bring rich foods, desserts, alcohol, and less structure. The aim is not complete restriction, but sensible boundaries. Helpful strategies: Before events:
- Do not arrive very hungry; eat a small protein based snack if needed.
- Decide in advance which foods you will definitely enjoy and which you can ignore.
- Plan to balance larger meals with lighter meals before or after.
During events:
- Fill part of the plate with vegetables and protein first.
- Have small samples of special foods instead of large portions.
- Drink water between alcoholic or sugary drinks, or avoid sugary drinks completely.
- Eat slowly and notice when you feel comfortably satisfied.
After events:
- Avoid guilt; return to your routine promptly.
- Use walking and balanced meals the next day to stabilise glucose.
- Recognise that one event does not determine long term control.
SPECIAL SITUATION 5: STRESSFUL LIFE EVENTS Events such as job loss, bereavement, family conflict, or financial stress can:
- Raise stress hormones.
- Increase cravings for comfort foods.
- Disturb sleep.
- Reduce motivation for self care.
During high stress periods:
- Focus on a few non negotiable basics such as:
- One balanced meal per day.
- One short walk per day.
- A regular sleep window where possible.
- One simple relaxation practice.
- Lower expectations of perfection.
- Seek emotional and practical support from family, friends, or professionals.
SPECIAL SITUATION 6: SURGERY AND HOSPITAL ADMISSION Surgery or hospital stays require specific planning with the healthcare team. Typical steps:
- Preoperative assessment of glucose and overall health.
- Adjustments to medication on the day before and day of surgery.
- Monitoring during the stay.
- Instructions for returning to usual medications after discharge.
Inform every member of the care team that you have Type 2 Diabetes and list your medicines. Ask for clear written instructions when leaving hospital. RETURNING TO ROUTINE AFTER DISRUPTION After any special situation, it is easy to feel that progress has been lost. In reality:
- The body remembers established habits.
- Returning to routine quickly restores stability.
- One week of disruption does not erase months of good practice.
Simple return plan:
- Reintroduce regular meal times.
- Restart walking and basic movement.
- Reinstate sleep routine.
- Resume glucose monitoring pattern.
KEY POINTS SUMMARISED
- Illness, fasting, travel, holidays, and major life events can temporarily disturb glucose and routine.
- Safety, hydration, and clear medication planning are priorities.
- Glucose monitoring is especially important during these periods.
- With preparation and simple rules, special situations can be managed without losing long term progress.
- The key is to handle the event as safely as possible and then return to established routines as soon as circumstances allow.
This chapter closes the main series on Type 2 Diabetes foundations. The material can be combined into personalised protocols that match individual test results, preferences, cultural context, and medical guidance.