Sick Day Plan for Diabetes
Blood sugar (glucose) can be difficult to control when you are sick. Common illnesses that can cause problems for people with diabetes (diabetes mellitus) include colds, fever, flu (influenza), nausea, vomiting, and diarrhea.
These illnesses can cause stress and loss of body fluids (dehydration), and those issues can cause blood glucose levels to increase. Because of this, it is very important to take your insulin and diabetes medicines and eat some form of carbohydrate when you are sick.
You should make a plan for days when you are sick (sick day plan) as part of your diabetes management plan. You and your health care provider should make this plan in advance. The following guidelines are intended to help you manage an illness that lasts for about 24 hours or less. Your health care provider may also give you more specific instructions.
What do I need to do to manage my blood glucose?
- Check your blood glucose every 2–4 hours, or as often as told by your health care provider.
- Know your sick day treatment goals. Your target blood glucose levels may be different when you are sick.
- If
you use insulin, take your usual dose.
- If your blood glucose continues to be too high, you may need to take an additional insulin dose as told by your health care provider.
- If you use oral diabetes medicine, you may need to stop taking it if you are not able to eat or drink normally. Ask your health care provider about whether you need to stop taking these medicines while you are sick.
If you use injectable hormone medicines other than insulin to control your diabetes, ask your health care provider about whether you need to stop taking these medicines while you are sick.
What else can I do to manage my diabetes when I am sick?
Check your ketones
- If you have type 1 diabetes, check your urine ketones every 4 hours.
- If you have type 2 diabetes, check your urine ketones as often as told by your health care provider.
Drink fluids
- Drink enough fluid to keep your urine clear or pale yellow. This is especially important if you have a fever, vomiting, or diarrhea. Those symptoms can lead to dehydration.
- Follow
any instructions from your health care provider about beverages to avoid.
- Do notdrink alcohol, caffeine, or drinks that contain a lot of sugar.
Take medicines as directed
- Take-over-the-counter and prescription medicines only as told by your health care provider.
- Check medicine labels for added sugars. Some medicines may contain sugar or types of sugars that can raise your blood glucose level.
What foods can I eat when I am sick?
You need to eat some form of carbohydrates when you are sick. You should eat 45–50 grams (45–50 g) of carbohydrates every 3–4 hours until you feel better.
All of the food choices below contain about 15 g of carbohydrates. Plan ahead and keep some of these foods around so you have them if you get sick.
- 4–6 oz (120–177 mL) carbonated beverage that contains sugar, such as regular ( notdiet) soda. You may be able to drink carbonated beverages more easily if you open the beverage and let it sit at room temperature for a few minutes before drinking.
- ½ of a twin frozen ice pop.
- 4 oz (120 g) regular gelatin.
- 4 oz (120 mL) fruit juice.
- 4 oz (120 g) ice cream or frozen yogurt.
- 2 oz (60 g) sherbet.
- 8 oz (240 mL) clear broth or soup.
- 4 oz (120 g) regular custard.
- 4 oz (120 g) regular pudding.
- 8 oz (240 g) plain yogurt.
- 1 slice bread or toast.
- 6 saltine crackers.
- 5 vanilla wafers.
Questions to ask your health care provider
Consider asking the following questions so you know what to do on days when you are sick:
- Should I adjust my diabetes medicines?
- How often do I need to check my blood glucose?
- What supplies do I need to manage my diabetes at home when I am sick?
- What number can I call if I have questions?
- What foods and drinks should I avoid?
Contact a health care provider if:
- You
develop symptoms of diabetic ketoacidosis, such as:
- Fatigue.
- Weight loss.
- Excessive thirst.
- Light-headedness.
- Fruity or sweet-smelling breath.
- Excessive urination.
- Vision changes.
- Confusion or irritability.
- Nausea.
- Vomiting.
- Rapid breathing.
- Pain in the abdomen.
- Feeling flushed.
- You are unable to drink fluids without vomiting.
- You
have any of the following for more than 6 hours:
- Nausea.
- Vomiting.
- Diarrhea.
- Your blood glucose is at or above 240 mg/dL (13.3 mmol/L), even after you take an additional insulin dose.
- You have a change in how you think, feel, or act (mental status).
- You develop another serious illness.
- You have been sick or have had a fever for 2 days or longer and you are not getting better.
Get help right away if:
- Your blood glucose is lower than 54 mg/dL (3.0 mmol/L).
- You have difficulty breathing.
- You have moderate or high ketone levels in your urine.
- You used emergency glucagon to treat low blood glucose.
Summary
- Blood sugar (glucose) can be difficult to control when you are sick. Common illnesses that can cause problems for people with diabetes (diabetes mellitus) include colds, fever, flu (influenza), nausea, vomiting, and diarrhea.
- Illnesses can cause stress and loss of body fluids (dehydration), and those issues can cause blood glucose levels to increase.
- Make a plan for days when you are sick (sick day plan) as part of your diabetes management plan. You and your health care provider should make this plan in advance.
- It is very important to take your insulin and diabetes medicines and to eat some form of carbohydrate when you are sick.
- Contact your health care provider if have problems managing your blood glucose levels when you are sick, or if you have been sick or had a fever for 2 days or longer and are not getting better.
