People with diabetes need to take special care during times of illness. When you are sick, it is very important to keep a watchful eye on your blood glucose levels, as they may be very unpredictable.
Many illnesses raise blood glucose. This is especially true for those associated with fever. This is caused by the release of stress hormones that cause more glucose to be produced and make it more difficult for the body to use it. On the other hand, illnesses that are associated with vomiting and diarrhea may cause low blood sugar (hypoglycemia). It is important to test your blood glucose levels at least every 2 to 4 hours, day and night, during times of illness.
If you are sick, continue to take your diabetes medications unless otherwise advised by a health care professional. If you take insulin, be sure to check with your health professional about guidelines for insulin adjustment during times of illness. Depending on the type of illness you have, and based on your blood glucose readings, you may have to adjust your insulin up or down. If your blood sugars are elevated, you may need to test your blood for ketones. Develop a "sick day" plan with your diabetes team to help you keep your blood sugars in check during times of illness.
Try to consume 15 g of carbohydrates every hour to maintain your nutrition and avoid hypoglycemia. Avoid caffeinated coffee, tea, and pop since they may cause you to lose extra fluids from your body. If you can't eat according to your normal meal plan, solid foods should be replaced with fluids that contain glucose and electrolytes such as sports drinks and electrolyte mixtures.
You should call your doctor if you have:
- blood sugar levels that stay above 10 mmol/L or below 4.0 mmol/L
- moderate to high ketones
- trouble keeping liquids down
- a fever above 38.3°C (101°F)
- diarrhea or are vomiting
- frequent urination
- extreme thirst
- weakness
- difficulty breathing
Get plenty of rest. If you need to use a cough or cold medication, be sure to ask your pharmacist to help you make the best choice. They can also help you determine which medications to stop or how to adjust your insulin.
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