For people with diabetes, being sick can affect blood
sugar levels. The good news is that taking a few precautions can help you keep
your blood sugar levels under control.
How Does Illness Affect Blood Sugar Levels?
When you get sick — whether it's a minor illness like a cold or a bigger
problem — the body sees the illness as stress. To deal with the stress, it releases
hormones that increase sugar
in the blood.
In one way, this is good because it helps supply the extra fuel the body needs.
But in a person with diabetes, it can lead to blood sugar levels that are too high.
Some illnesses cause the opposite problem. If you don't feel like eating or have nausea
or vomiting, and you're taking the same amount of insulin
you normally do, your blood sugar levels can get too low.
Blood sugar levels can be very unpredictable when you're sick. Because you can't
be sure how the illness will affect them, it's important to check blood sugar levels
often on sick days and change your insulin doses as needed.
Planning for Sick Days
Your diabetes management plan will help you know what to do when you're sick. The
plan might tell you:
how to check your blood glucose levels and ketones when you're sick
Also, people with diabetes should get the pneumococcal vaccine, which protects
against some serious infections. You also should get a flu
vaccine every year. These vaccines may help cut down the number of sick days you
have and keep your diabetes under better control.
What to Do When You're Sick
Your doctor will give you specific advice when you're sick. But here are some general
Stay on track. Unless your doctor tells you to make a change,
keep taking the same diabetes medicines. You need to keep taking insulin when you're
sick, even if you're not eating as much as you usually do. That's because your liver
makes glucose and releases
it into your blood — even when you're stuck on the couch — so you always
need insulin. Some people with diabetes need more insulin than usual on sick days.
Even some people with type 2 diabetes
who don't usually take insulin may need some on sick days.
Check blood sugar and ketone levels often. Your doctor will tell
you how often to check your blood sugar and ketone levels — usually you'll need
to check more often while you're sick.
Pay special attention to nausea and vomiting. People with diabetes
sometimes catch a bug that causes nausea or vomiting. But nausea and vomiting are
also symptoms of ketoacidosis.
If you feel sick to your stomach or are throwing up, it's important to keep a close
eye on your blood glucose and ketone levels and get medical help according to the
guidelines in your diabetes management plan. The best approach is to stick to your
insulin schedule, check ketones regularly, and follow your doctor's advice about when
to get help.
Be sure to drink plenty of fluids, even if you have nausea or vomiting. Your doctor
can recommend the types and amounts of fluids to drink that can help you manage both
your illness and your blood sugar levels.
Use over-the-counter (OTC) medicines wisely. People sometimes
take OTC medicines (the kind you can buy without a prescription) for illnesses like
the cold or flu. But these have ingredients that can raise or lower blood sugar or
cause symptoms that look like high or low blood sugar. Follow your doctor's advice
about taking an OTC medicine. Your doctor might even include common medicines that
are OK for you in your diabetes management plan, and can also explain what to check
for on medicine labels.
Take notes. Your doctor might have a lot of questions about your
illness and your symptoms. So it can help if you write down your symptoms, medicines
and doses, what food and drinks you had, and whether you kept the food down. Also,
tell the doctor if you've lost weight or had a fever, and have your blood sugar and
ketone level test results handy.
Get some rest. People need rest when they're sick. It helps your
body focus its energy on fighting illness. If you think you need to, let a parent
take over managing your diabetes for a day or two. Your mom or dad can keep track
of your blood sugar levels and figure out the best insulin dosage — and you
can get some sleep!
When Should I Call the Doctor?
Your diabetes management plan will explain when you may need medical help and what
to do. Here are some general reasons to call
if you have no appetite or you can't eat or drink
if your blood sugar level is low because you haven't been eating much —
but remember to take steps at home to bring your blood sugar back up
if you keep vomiting or having diarrhea
if your blood sugar levels are high for several checks or don't decrease when
you take extra insulin
if you have moderate or large amounts of ketones in the urine (or high levels
of blood ketones if you have a meter that tests for this)
if you think you might have ketoacidosis
if you can't eat or drink because you're having a medical test like an X-ray,
surgery, or a dental procedure
Any time you have questions or concerns, ask your doctor for advice.