When you are sick, your blood glucose levels are harder to regulate. Being sick often causes blood glucose levels to rise, which can lead to serious health conditions. It is important to have a plan to manage your sick days, so you are prepared ahead of time. Read on to learn more.

Take Your Diabetes Medicines

Take your insulin or oral diabetes medications even if you aren't eating as much as usual. Your blood glucose goes up when you are sick, so you may need more medication than usual. Your diabetes care team can help you regulate your medications when you are sick.

Check Blood Glucose and Urine Ketones

Check your blood glucose levels more frequently when you are sick. You should measure urine ketones if your blood glucose is higher than 300, or as directed by your health care provider.

Choose the Right Cold Medicine

Some over-the-counter cold and flu medicines can affect blood glucose. Ask your pharmacist or health care provider about the best medication to take. Keep the right medicines on hand so you are prepared in case you get sick.

Eat and Drink

Stick to your regular meal plan if you can. If not, try to get your normal calorie intake by eating foods that are easy on the stomach, such as regular (not diet) gelatin, crackers, soup, or applesauce.

It is critical to drink enough fluids to keep yourself hydrated when you are sick. Drink at least one cup, or 8 ounces, of liquid (alcohol-free and caffeine-free) every hour to stay well hydrated.

Sick Day Foods

Be prepared for sick days by having some of these foods and drinks on hand. Each one contains 10 to 15 grams of carbohydrates.

• 1 double-stick popsicle
• 1 cup sports drink
• 1 cup low-fat milk
• 1 cup soup
• ½ cup fruit juice or regular (not diet) soda
• ½ cup lemonade
• 6 saltine crackers
• 5 vanilla wafers
• 3 graham crackers
• 1 slice toast
• ½ cup cooked cereal
• ½ cup mashed potatoes
• ⅓ cup frozen yogurt
• ½ cup regular ice cream
• ¼ cup sherbet
• ½ cup regular (not diet) gelatin
• ¼ cup regular pudding
• ½ cup sugar-free pudding

When to Call Your Diabetes Team

The American Diabetes Association suggests that you call someone on your diabetes care team immediately if you have any of these symptoms while you are sick:

• You have a high fever
• You have trouble breathing
• You vomit more than once
• You have diarrhea for more than 6 hours
• You have moderate to large amounts of ketones in your urine
• Your glucose levels are higher than 240 even though you've taken the extra insulin your sick-day plan calls for
• You take pills for your diabetes and your blood glucose level climbs to more than 240 before meals and stays there for more than 24 hours
• You have symptoms that might signal ketoacidosis, dehydration, or some other serious condition (for example, your chest hurts, you are having trouble breathing, your breath smells fruity, or your lips or tongue are dry and cracked)
• You aren't certain what to do to take care of yourself

Source: National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2014

For more information, visit:

Resources for People Living with Diabetes: https://www.diabeteseducator.org/living-with-diabetes/how-a-diabetes-educator-can-help-you

UF/IFAS Extension: http://sfyl.ifas.ufl.edu/who-we-are/

American Diabetes Association: https://diabetes.org/healthy-living

Make a Plan

Work with your diabetes care team to make a plan for your sick days.

Diabetes medications for sick days:

How often to measure blood glucose:

How often to measure urine ketones:

Suitable cold or flu medicines:

Meal plan:

Important phone numbers:

References

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2014 February). Take care of your diabetes during sick days and special times. Retrieved on January 12, 2022. https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/sick-days-special-times

University of Washington Medicine Diabetes Institute. (2020 June). 15 gram carbohydrate food list. Retrieved on October 10, 2022. https://uwmdi.org/wp-content/uploads/2020/06/15-Gram-Carbohydrate-Food-List-Revised.pdf