I'm sick, how do I take care of my diabetes now?

Ask our CDE

I'm sick, how do I take care of my diabetes now?

Question:

Dear CDE,

I've been sick for the past couple of days and my blood sugars are wrecking havoc!  I'm trying the best that I can but I don't feel well due to the illness and feel even worse because my blood sugars are out of control.  Do you have any suggestions for what I need to do to manage my diabetes while being sick?

Thanks!

Answer:

Dear Reader,

It’s that time of year again…the cold and flu season. We have discussed this one time before but it deserves reiteration. The basic sick days guidelines for people with diabetes include
1) Always take your diabetes medication. Illness can make blood sugars
go up  
2) Monitor blood glucose more frequently (every 2-4 hours) especially if your blood sugars are higher than usual
3) Take your temperature every 4 hours
4) Eat or drink carbohydrates
5) If you have type1 diabetes check for ketones if the blood sugar is >240 mg/dl. You can buy “ketostix” at the drugstore which are dipsticks you test your urine with for ketones

You should contact your physician if your blood sugars are >300 mg/dl 2 times in a row or stay above 200mg/dl or you have persistent vomiting/nausea, a fever of 101.5 or higher, can’t keep fluids down for more than 4 hours, have rising ketone levels (type 1) or are sick for more than 24 hours. Your physician needs to know your symptoms, temperature, your blood sugars and ketones, the medicine you took, and the last time you took the medicine.

If you can’t eat regular foods, replace with liquid carbohydrate. Some recommend 10-15 grams every hour you are awake. The main focus should be to prevent dehydration so keep the fluids coming and some nutrition to replace what you are missing from regular food. Examples of 15grams of liquid would include regular (not diet) soft drinks like coke or ginger ale, jello, and broth type soups. If you are able to consume foods, you may want to stick with bland foods like saltine crackers, puddings, soups, and yogurt.

Given that it is the time of year for colds and/or the flu, it’s a good idea to have these fluids and foods around the house so you are prepared. Also if you do have Type 1 diabetes, make sure you have ketostix that are in date. Also all of us with diabetes should get a flu shot annually. Wash your hands a lot, use hand sanitizers, and stay away from those that are sick.  Good luck!