Managing Sick Days with Diabetes

Before diabetes, the usual prescription for a cold or flu was rest, refreshments, and reruns. After a diabetes diagnosis, tending to a cold or flu also includes managing blood sugar levels that may be more difficult to control. 

Managing Diabetes on Sick Days
Take notes. Create a “sick day notebook” to help you keep track of everything when you are sick.

In your notebook, include:

• The doctor’s guidelines including when to call
• Your diabetes care team’s daytime and after-hours phone numbers
• A copy of your insurance card
• Sick-day meal plans to eat
• A list of over-the-counter medicines that don’t interfere with insulin or blood glucose levels
• A record of blood glucose readings, insulin dosages and carbohydrate counts of foods eaten

What to Expect
Our bodies fight disease by releasing hormones. The downside is they can make blood glucose levels go up and hamper the effects of insulin.

When sick:

• Your body is likely to need extra insulin
• Check blood glucose as often as every 2-3 hours
• Check blood or urine ketones as often as every 4 hours
• Drink lots of clear liquids – no caffeine
• Continue taking regular medicine

Contact the doctor if:

• You’ve had a fever for two days
• You’ve been throwing up or having diarrhea for six hours
• Can’t keep any fluids down
• Glucose levels are way over target range (ask your diabetes care team how high) even with additional insulin
• Moderate or large urine ketones
• Any symptoms of dehydration or ketoacidosis including difficulty breathing, chest pains, fruity smelling breath or dry lips

If blood glucose levels get too high, your body will start to produce ketones. High ketone levels that go unchecked can lead to diabetic ketoacidosis or a diabetic coma. If you begin showing signs of ketoacidosis, GO TO THE EMERGENCY ROOM IMMEDIATELY! Take your “sick day notebook” with you so you have all the numbers you need and a copy of your insurance card.

Adapted from: American Diabetes Association

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