Managing Sick Days With Diabetes: What to Keep on Hand and When to Get Help

People with diabetes get sick like everyone else — and illness can make blood sugar hard to manage. Prepare now, so you know what to do.

Before you get sick

Keep enough insulin, other diabetes medicines, and easy-to-make foods for several weeks or longer. Useful to have at home:

Medicines and supplies: milk of magnesia, anti-diarrhea medicine, an antacid, a pain reliever, a thermometer, and suppositories for vomiting.

Foods: sports drinks, canned soup, fruit juice or regular soda, instant cooked cereals, crackers, instant pudding, unsweetened applesauce.

If you can't eat meals, aim for about 50 grams of carbohydrate every 4 hours — for example 1½ cups of unsweetened applesauce or of fruit juice.

When you're sick

• You may eat and drink less, which affects blood sugar — and the hormones your body releases to fight illness can raise it. If you use insulin, you may need a different amount.
• Your doctor may ask you to test your blood sugar more often.

Even if your blood sugar is in range:

• keep taking insulin and diabetes pills as usual;
• test blood sugar every 4 hours and record the results;
• drink plenty of water;
• try to eat normally;
• weigh yourself daily — losing weight without trying is a sign of high blood sugar;
• check your temperature morning and evening — a fever may mean infection.

Ketones and DKA

Without enough insulin, the body burns fat for fuel, producing ketones. Too many, too fast, can cause diabetic ketoacidosis (DKA) — very serious, and able to cause coma or death. An over-the-counter kit tests urine for ketones; if they're present, call your doctor at once — you'll probably need hospital treatment.

Go to the emergency room if

• you're having trouble breathing;
• you have ketones in your urine;
• you can't keep liquids down for more than 4 hours, or food for more than 24 hours;
• you lose 5 pounds or more while sick;
• your blood sugar is below 60 mg/dl;
• you've had vomiting and/or severe diarrhea for more than 6 hours;
• your temperature has been over 101°F for 24 hours.

Illness and low blood sugar can make you tired or foggy; if needed, have someone else call your doctor or drive you to the emergency room.

Sources

Based on "Managing Sick Days," Centers for Disease Control and Prevention; a work of the United States government in the public domain. The source's stock photograph is not reproduced.