Diabetes management: Creating your sick-day plan

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Diabetes management: Creating your sick-day plan

Diabetes management includes having a sick-day plan to prevent complications when you're ill.

You don't feel well. Your temperature is high, you're tired and you've lost your appetite. Having diabetes only adds to your concerns.

When you're sick, your body produces hormones to help fight the illness. These hormones raise your blood sugar by preventing insulin from working effectively. In people without diabetes, the additional sugar promotes healing. But when you have diabetes, the fluctuations can result in potentially serious diabetes complications.

To prevent complications, make a sick-day plan part of your diabetes management.

Start with your health care team

Talk to your doctor and other members of your diabetes care team about your sick-day plan. Make sure your sick-day plan includes:

  • What medications to take
  • How often to measure your blood sugar and urine ketones
  • How to adjust your insulin dosage, if you need insulin
  • How to manage any other conditions you may have
  • When to call your doctor

Also identify a loved one or friend who can contact your doctor or help you seek emergency care if you experience diabetes complications.

Diabetes and illness: Sick-day self-care plan (PDF file requiring Adobe Reader)

Keep close track of your blood sugar and urine ketone levels

Continue taking your diabetes medication when you're sick, and remember to test your blood sugar often. You may need to adjust your insulin doses or other medications. Here are some general guidelines:

  • Type 1 diabetes. Check your blood sugar and urine ketone levels every four hours.
  • Type 2 diabetes. Check your blood sugar levels four times a day. If your blood sugar level is higher than 300 mg/dL, check your urine for ketones. Make sure your test strips haven't expired.

Excessively high blood sugar can lead to ketoacidosis, especially in people who have type 1 diabetes. People who have type 2 diabetes — particularly older adults — may develop a similar condition called diabetic hyperosmolar syndrome. Both conditions can cause confusion, difficulty breathing or coma. Sometimes these conditions can be fatal.

Stick to your diabetes meal plan

With a minor illness such as a cold, you may be able to stick to your diabetes meal plan — which will help ensure blood sugar stability. Remember to check the sugar content of any over-the-counter medications you take. Many cough syrups and other liquid cold preparations are high in sugar.

If you have nausea, vomiting or diarrhea, you may not be able to eat your regular foods. But it's still important to get enough carbohydrates. Try these foods, which contain about 10 to 15 grams of carbohydrates each:

  • 1 double-stick frozen fruit pop
  • 1 cup milk
  • 1/2 cup fruit juice
  • 1/2 cup regular (not diet) soda
  • 6 saltine crackers
  • 3 graham crackers
  • 1 slice dry toast
  • 1/2 cup regular (not artificially sweetened) gelatin

In addition to sipping fruit juice or sweetened beverages, drink at least 8 ounces of water or other calorie-free liquid every hour you're awake. If you're not able to keep anything down, it's especially important to monitor your blood sugar closely.

Know when to contact your doctor

Diabetes complications can quickly become dangerous. Contact your doctor if:

  • Your blood sugar level is higher than 300 mg/dL
  • Your blood sugar level is higher than 240 mg/dL for more than 24 hours
  • Your urine ketone level is moderate to high
  • You feel sleepier than usual or can't think clearly
  • You're unable to keep fluids down or vomit for more than six hours
  • You have diarrhea for more than six hours
  • You feel confused and can't think clearly
  • Your lips and tongue appear dry and cracked

Think prevention

High blood sugar can weaken your immune system. This makes you more likely to get a cold or the flu — and more vulnerable to serious effects of common illnesses. To reduce the risk of getting sick, wash your hands often and avoid crowds during flu season. Ask your doctor about vaccination for flu and pneumococcal pneumonia.

If you do get sick, feel confident in your ability to manage your diabetes by following your sick-day plan.

Last Updated: 04/02/2007
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