How can minor illnesses affect a person with diabetes?

In most people with stable diabetes, minor illnesses are not a big deal. You'll be able to weather a cold or flulike problem without too much difficulty. The real issue is recognizing when things are getting to be more than you can safely handle at home and when you need to contact your doctor.

Common sense will tell you the main thing you need to know about being sick with diabetes: you have to monitor yourself much more frequently and be prepared to get help if you're getting worse. When you're sick, your body becomes less responsive to insulin, which means that your blood sugar level is probably going to go higher. If you have pre-diabetes, your blood sugar level may well rise into the clearly diabetic range, and many people first learn that they have diabetes during an illness. If you have diabetes and are on oral medication, you shouldn't take more without talking to your doctor. If you're on insulin, and especially if you have type 1 diabetes, you are probably accustomed to adjusting your insulin doses regularly. When you are sick, you may need a big increase in your insulin dosage, but it's really impossible to predict ahead of time how much more you'll need.

When you're sick and you have diabetes, you're under stress. To deal with this stress, your body releases hormones that help it fight disease. But these hormones have side effects. They raise blood sugar levels and interfere with the blood sugar-lowering effects of insulin.

As a result, when you are sick, it is harder to keep your blood sugar in your target range. Ketoacidosis leading to a diabetic coma can develop, particularly in people with type 1 diabetes. People with type 2 diabetes, especially older people, can develop a similar condition called hyperosmolar hyperglycemic nonketotic coma. Both conditions are dangerous and can be life-threatening.