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How should I take care of myself when I am sick and I have diabetes?

Dr. Jeanne Morrison, PhD
Family Practitioner

Take care of yourself when you're sick. Being sick can make your blood glucose go too high. Tips on what to do include the following:

  • Check your blood glucose level every four hours. Write down the results.
  • Keep taking your diabetes medicines. You need them even if you can't keep food down.
  • Drink at least one cup (8 oz.) of water or other calorie-free, caffeine-free liquid every hour while you're awake.
  • If you can't eat your usual food, try drinking juice or eating crackers, popsicles or soup. If you can't eat at all, drink clear liquids such as ginger ale.
  • Eat or drink something with sugar in it if you have trouble keeping food down, because you still need calories. If you can't eat enough, you increase your risk of low blood glucose, also called hypoglycemia.
  • In people with type 1 diabetes, when blood glucose is high, the body produces ketones. Ketones can make you sick. Test your urine or blood for ketones if: Your blood glucose is above 240. You can't keep food or liquids down. Call your healthcare provider right away if: Your blood glucose has been above 240 for longer than a day. You have ketones. You feel sleepier than usual. You have trouble breathing. You can't think clearly. You throw up more than once. You've had diarrhea for more than six hours.

This answer is based on source information from the National Institute of Diabetes and Digestive and Kidney Diseases.

Stacy Wiegman, PharmD
Pharmacy Specialist

A cold or the flu can have serious repercussions if you have diabetes. When you have diabetes, your immune system is already somewhat compromised, so you are at risk of developing a more severe infection. A cold or fever can also cause your blood sugar levels to rise or become unstable.

So you need to be extra careful about managing your diabetes when you catch a cold or the flu. Continue taking your diabetes medication as usual, monitor your blood glucose level every four hours, and drink extra fluids. Keep a close eye on your weight and temperature, too. Weight loss can signal high blood sugar, and a rising temperature is a red flag for infection. If you have any concerns about managing your diabetes when you have a cold or the flu, contact your doctor.

Dr. Jack Merendino, MD
Endocrinologist

If you have diabetes and you're sick, here are the basic things you need to do:

  • Make sure you get lots of fluids so you don't get dehydrated. You should weigh yourself to make sure you're not losing a lot of water weight. You'll need to take in enough salt to keep the water in your system, so you may need to eat some chicken broth or other clear soup.
  • Get enough calories and carbohydrates to meet your energy needs. You may need to eat foods that are simple to digest, such as crackers or gelatin. Try to get 50 grams of carbohydrate into your system every three or four hours. If you can't eat because of nausea or stomach upset, you may have to drink sugar-containing liquids such as regular ginger ale—something we don't normally want you to do—just to get enough carbohydrates.
  • Test your blood sugar level more frequently, at least every three to four hours. If you have type 1 diabetes, be prepared to take extra insulin.
  • If you have type 1 diabetes, test the ketone level in your urine or blood. If it's high, make sure it comes down as you take in more fluid and insulin.
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Along with eating chicken soup and drinking lots of liquids, here are a few things you can do if you have diabetes and you are feeling under the weather:

  • If you have type 1 diabetes, continue to take your insulin—even if you can’t eat. You may even need extra insulin to take care of the excess glucose your body releases when you are sick. Ask your provider about what blood glucose levels call for a change in your insulin dose.
  • Monitor your blood glucose and ketone levels about every 3 to 4 hours. If the levels are too high or you are pregnant, you may need to monitor more often.
  • Make substitutions for your usual food if nausea and vomiting are making it difficult to eat. Try to eat or drink your usual amount of carbohydrates. Talk to your dietitian about ways to cover your basic eating plan. Prepare a sick-day plan before you even become sick. Try to keep some comforting foods like soup or frozen fruit bars on hand, especially during the cold and flu season.
  • Drink plenty of caffeine-free liquids. If you are losing fluids by vomiting, from fever, or from diarrhea, you may need nondiet soft drinks or sports drinks with sugar or carbohydrate. This can help prevent the hypoglycemia caused by not eating or taking extra insulin. If vomiting or diarrhea is severe, try sipping 3 to 6 ounces an hour to keep your blood glucose even.
  • Keep a thermometer on hand and a small supply of common sick-day medications that are safe to take. Be sure to read the labels.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.