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Sick-Day Guidelines for People With Diabetes - Topic Overview

What happens when you are sick

When you are sick, your body reacts by releasing hormones to fight infection. But these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.

Plan ahead

Work with your doctor or diabetes educator to make a sick-day plan for you or your child who has diabetes. Discuss your target blood sugar goal during an illness, how you should adjust your insulin dose and timing (if you take insulin), and when you need to contact your doctor for help. Also, make sure you know how often to check blood sugar and ketone levels. Keep your plan in a convenient place, and include contact information in case you need to reach your doctor at night or on the weekends.

Steps to take during an illness

Here are some general sick-day guidelines:

  • Continue taking your diabetes medicine even if you are vomiting and having trouble eating or drinking. Your blood sugar may continue to rise because of your illness. If you cannot take your medicines, call your doctor and discuss whether you need to adjust your insulin dose or other medicine.
  • Try to eat your normal types and amounts of food and to drink extra fluids, such as water, broth, carbonated drinks, and fruit juice. Encourage your child to drink extra liquids to prevent dehydration.
    • If your blood sugar level is higher than 240 milligrams per deciliter (mg/dL), or the blood sugar level your doctor recommends, drink extra liquids that do not contain sugar, such as water or sugar-free cola.
    • If you cannot eat the foods in your regular diet, drink extra liquids that contain sugar and salt, such as soup, sports drinks, or milk. You may also try eating foods that are gentle on the stomach, such as crackers, gelatin, or applesauce. Try to eat or drink 50 grams (g) of carbohydrate every 3 to 4 hours. For example, 6 saltine crackers, 1 cup (8 fl oz) of milk, and ½ cup (4 fl oz) of orange juice each contain approximately 15 g of carbohydrate.
  • Check your blood sugar at least every 3 to 4 hours, or more often if it is rising quickly, even through the night. If your blood sugar level rises above 240 mg/dL and your doctor has told you to take an extra insulin dose for high blood sugar levels, take the appropriate amount. If you take insulin and your doctor has not told you to take a specific amount of additional insulin, call him or her for advice.
  • If you take insulin, do a test for ketones, especially if your blood sugar is higher than 300 mg/dL.
  • Weigh yourself and check your temperature, breathing rate, and pulse frequently if your blood sugar is higher than 300 mg/dL. If you are losing weight and your temperature, breathing rate, and pulse are increasing, contact a doctor. You may be getting worse.
  • Don't take any nonprescription medicines without talking with your doctor. Many nonprescription medicines affect your blood sugar level.
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    Normal
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    Your level is currently

    If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

    People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

    Congratulations on taking steps to manage your health.

    However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

    Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

    Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

    One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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