How to Handle a Cold or Flu -- With Diabetes

Learn how to manage the disease when you're under the weather.

Medically Reviewed by Brunilda Nazario, MD on September 20, 2015
From the WebMD Archives

You're new to diabetes, but you feel you're keeping it under control. Then, bam! You get sick.

Diabetes can be tricky when you're under the weather. But if you let your blood sugar get out of whack, you'll feel worse.

If you come down with a cold, fever, or flu this winter, you'll be back on your feet sooner with these simple guidelines.

Do I keep taking my medicine? "The biggest mistake people with diabetes make when they're sick is that they think they don't have to take their medicine because they're not eating as much," says Elaine Sullivan, RN, a certified diabetes educator at Joslin Diabetes Center.

It's true that eating less can lower your blood sugar. But lack of physical activity and sickness itself can raise it. So keep taking your meds while you're fighting off a cold or the flu.

What should I eat? It's best to continue your meals as usual. But if you can't eat much, try to get at least 45 to 50 grams of carbohydrate every 3 to 4 hours. Soup, soda crackers, Popsicles, and gelatin might be easier to keep down than your usual staples.

What should I drink? Even a meager diet of soup and crackers might not prevent sick-day sugar spikes. Your body gets rid of extra sugar through your urine, and you can help the process along by drinking plenty of fluids. You could be pretty thirsty anyway: High blood sugar can dehydrate you.

Drink about 8 ounces of zero-calorie fluid every hour -- unless you can't keep food down. "If you can't eat, have no-calorie beverages one hour, then carb-containing fluids the next," Sullivan says. "That could be 8 ounces of juice or regular soda."

Liquids that contain minerals -- like broth or sports drinks -- can help keep you hydrated.

Can I take cough or cold medicine? Take sugar-free medicine if you can. Syrups are more likely than pills to have sugar. But if you need syrup to soothe your throat, go ahead. "The quantity of sugar you're getting from a tablespoon of cough medicine is not enough to really make a difference," Sullivan says.

Some medicines, including aspirin, antibiotics, and decongestants, can raise or lower blood sugar even if they don't contain sugar. If you're not sure how to take these, ask your doctor or pharmacist.

How often should I check my blood sugar levels? You might not notice the symptoms of high blood sugar when you're sick, since you feel pretty crummy anyway, so check your levels every 2 to 4 hours for the first couple of days.

"If your sugars seem pretty normal or they're running under 250, then you don't have to continue to do extra checking," Sullivan says. If they're 250 or higher for one reading, adjust your carbohydrate intake accordingly. Call your doctor if the spike continues for two or more readings.

High Alert

You can manage diabetes when you're sick. But call the doctor if you:

• Have two or more consecutive blood sugar readings of 250 or higher

• Have uncontrollable nausea or diarrhea

• Are vomiting

• Can't keep fluids down

• Have a fever for more than 24 hours

• Have belly pain

• Don't feel confident taking care of yourself

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Elaine Sullivan, MS, RN, CDE, Associate director of clinical education programs, Joslin Diabetes Center, Boston, Mass.

Thomas-Dobersen, D. Clinical Diabetes. Summer 2000.

American Diabetes Association. "When you're sick."

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