How to Handle Sick Days

With cold and flu season here, it's important to know what to do when you're sick. For people with diabetes, sick days can sometimes cause serious problems with glucose levels and can lead to a dangerous situation.

When you are sick, blood glucose levels will likely increase. This is because the hormones that your body is using to help fight off an infection are also fighting against your insulin.

Here are six steps to managing your diabetes when you are sick:

1. Test blood glucose levels more often. Health care professionals recommend that you check every two to four hours when ill. This way, you can very quickly detect if your levels are going up, and how fast.
2. Check for ketones. If your blood glucose level is greater than 250 mg/dL, you should always check for urine ketones. Ketones are substances produced when your body starts to break down fat and use it for energy. Ketones can be produced if you don't have enough insulin working in your body, or if you're dehydrated, or if you haven't eaten enough carbohydrates. You can find out if ketones are in your urine by using ketone strips, which you can buy over the counter at your drug store. (If you've had a package of ketone strips around for a while, be sure to check its expiration date.) If your blood glucose levels remain greater than 250 mg/dL, repeat ketone testing every 4 to 6 hours. And if your ketone readings are moderate to large, call your doctor immediately.
3. Stay hydrated. If you have a fever or diarrhea, or if you start vomiting, you are more likely to become dehydrated. Make it your goal when you are sick to drink at least one 8-oz. glass of non-caffeinated fluid each hour. The kinds of beverage you drink in order to furnish these fluids to your body will depend on what your blood glucose levels are. You may even drink a regular soda if your glucose levels are low--but be sure to drink a diet soda if your glucose levels are already elevated.
4. Continue to take your diabetes medications. Even though you might be eating less or don't feel like eating, you still need to take all your diabetes medications, unless advised otherwise by your health care provider. Again, blood glucose levels are often elevated during sickness, and your medications will help to control this.
5. Don't forget about carbohydrates. No matter what your blood glucose level is, you still need some carbohydrates. Your goal should be to eat about 15 grams of carbohydrate each hour. It is a good idea to keep some "sick day" foods and beverages on hand. When you are sick, it is all right to drink some regular beverages such a soda or juice, and to eat non-sugar-free foods like regular gelatin.
6. Ask your health care provider for a sick-day plan. The best time to plan for sick days is before you get sick. Talk with your health care provider about over-the-counter medications for colds and flu, any changes you might need to make in your insulin or medication regimen, and when an illness might get serious enough for you to contact them. Together, you can create a plan.

To keep yourself well, be informed and proactive. And when you do get sick, know how to take care of yourself. This can save you a trip to the emergency department or the hospital.