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.
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 your blood sugar and your 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.
- If your blood sugar level is higher than the blood sugar level your doctor recommends, for example 240 mg/dL, 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, try to eat or drink 50 grams (g) of carbohydrate every 3 to 4 hours. Some ideas include broth, juice, soup, crackers, gelatin, and applesauce.
- 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 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 when you have high blood sugar.
- Weigh yourself and check your temperature, breathing rate, and pulse frequently. 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.