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Managing Sick Days

Feeling fine? It's the perfect day to create a sick day plan.

When you're feeling ill, you'd like nothing more than to lie in bed with a good book or movie. Yet that's when you need to focus even more on diabetes self-care.

The key to sick days with diabetes is doing all of the thinking ahead of time. That way, when you don't feel like concentrating, you can simply follow the plan. 

What to include in your plan

Involve your diabetes care healthcare team in developing your sick day plan—ask them when you should call for help, how often you should check your blood glucose and ketones, what medicines to take and what to eat.

Gather a sick day kit so the additional items you might need will be ready.

Sick day kit checklist

  • Thermometer
  • Pain reliever
  • Sugar-free cough syrup or throat lozenges
  • Decongestant (keep in mind that even sugar-free decongestants may cause a rise in blood glucose )
  • Urine ketone strips
  • Extra blood glucose test strips and lancets
  • Extra insulin and supplies
  • Glucagon emergency kit
  • Easy-to-eat foods that contain carbs

At the first sign of illness

Understanding how illness might affect your blood glucose can help you take the right steps to care for yourself. For example:1

  • If you use insulin, don't stop taking it. Even if you are having trouble eating, you will likely need extra insulin to combat the hormones that often cause high blood glucose during illness. You might do this by raising meal or correction boluses, or using a temporary basal rate on an insulin pump. Follow your healthcare provider's recommendations.
  • Monitor blood glucose levels more frequently, at least every 1 to 2 hours.
  • Check your urine for ketones if blood sugar is high.
  • Stay hydrated. Drink calorie-free, caffeine-free, clear liquids.
  • Make sure you eat according to your regular meal plan. Keep easy-to-eat, fast-acting carbohydrates available. They can be useful in treating a low, as well as substituting for a meal. If you feel nauseated or are vomiting, try a sports drink, juice, regular soda or even frozen fruit bars to get the carbs you need.
  • Talk to your diabetes care provider about any medications you take, or any unexpected blood glucose results you experience while taking them. Some cold medicines, antibiotics and other prescription and over-the-counter drugs are known to affect blood glucose levels.2

When to contact your healthcare team

Get in touch with your doctor any time they recommend, as well as when you:1

  • Have been sick or had a fever for a couple of days without improvement.
  • Have had 2 or more vomiting or diarrhea episodes within 4 hours.
  • Detect moderate to large ketones in your urine.
  • Have blood glucose higher than 270mg/DL after increasing insulin and fluids.
  • Experience symptoms that might signal ketoacidosis or dehydration, such as worsening abdominal pain, trouble breathing or breath that smells fruity or like acetone.

The key to successfully navigating an illness is preparation. By creating your sick day plan and kit before you experience the first signs of illness, you'll be ready to attack a virus head-on.

Sick day snacks

These foods contain 10 to 15 grams of carbohydrate, and may be easier to eat when you don't feel well.

  • 1 double-stick ice pop
  • 1 cup sports drink
  • 1 cup soup
  • 4 ounces apple or orange juice
  • 1/2 cup regular soft drink
  • 6 Saltines
  • 3 graham crackers
  • 1/2 cup applesauce
  • 1/2 cup cooked cereal
  • 1/2 cup ice cream or frozen yogurt
  • 1/4 cup sherbet, sorbet or regular pudding

*Substitute local foods as appropriate

1International Diabetes Federation. Diabetes education modules 2011: hyperglycemia. Available at: http://www.idf.org/education/resources/modules-2011/download. Accessed June 30, 2015.

2Vue MH, Setter SM. Drug-induced glucose alterations part 1: drug-induced hypoglycemia. Diabetes Spectrum. 2011;24(3):172-177. Available at: http://spectrum.diabetesjournals.org/content/diaspect/24/3/171.full.pdf. Accessed August 21, 2015.

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