Controlling Blood Sugars When You’re Sick

With diabetes, there’s no such thing as a simple case of the sniffles. That’s because cold and flu can send your blood sugar on a roller coaster ride. Follow these steps to keep your levels healthy—no matter what’s ailing you.

Stephanie Guzowski

Sick days may mean more than a stuffy nose and high temperature when you have diabetes. The reason? The hormones your body releases to fight off infection also raise blood sugar levels. “So when you’re sick and your body is stressed, it becomes that much more difficult to keep your blood glucose in target range,” explains Amy Hess-Fischl, RD, CDE, of the University of Chicago Medical Center.

The good news: Frequent testing of blood sugar and ketones can keep complications at bay. Read more.

Have a sick-day plan. Know when to call your diabetes care team, how often to monitor your blood sugar and ketones, which medications to take and what foods to eat. “Being proactive is the best way to prevent an illness from becoming a bigger issue,” says Hess-Fischl. “This way, you won’t be scrambling when you aren’t feeling well—you’ll already have reminders and supplies on hand.” Need help creating a plan? Speak with your doctor or diabetes educator at your next visit.

Monitor frequently. Measure your blood sugar levels every two to four hours, recommends Hess-Fischl. Staying on top of testing may help protect against a more serious infection. Record results to keep track of how you’re doing.

Adjust your insulin, if necessary. “Many people experience higher blood sugar levels when they’re sick, so don’t dwell on the numbers,” says Hess-Fischl. Simply modify your insulin dose to compensate. “It’s important not to skip insulin doses, especially the long-acting doses,” Hess-Fischl explains. Keep on hand a bottle of rapid-acting insulin—even if you don’t regularly take this type of insulin—in case you need an extra sick-day dose or need to lower blood sugar quickly.

Check your ketones. Uncontrolled blood sugar levels can increase your risk of diabetic ketoacidosis, or DKA, a life-threatening condition more common in people with type 1 diabetes. Without sugar to burn for energy, your body begins burning fat, a process that releases acids called ketones into the bloodstream and urine.

Use ketone test strips every four to six hours. If your levels are high, call your diabetes care team. Early symptoms of ketoacidosis include increased thirst and/or dry mouth and frequent urination. Later symptoms include weakness, confusion, fruity odor on breath and nausea, vomiting or abdominal pain.

Stay on top of medication. Ask your doctor or pharmacist if your over-the-counter cough medicine, for example, contains sugar, which could raise your blood sugar levels. Also, be aware that many medications taken for short-term illness can affect blood sugar, even if they don’t contain sugar, according to the American Diabetes Association. For instance, large doses of aspirin can lower blood sugar; some decongestants can raise blood sugar levels. It’s also important to keep taking any prescribed oral meds, even if you’re not feeling well.

Eat small meals. If you’re feeling under the weather, you probably don’t feel like eating much. But it’s important to have meals and snacks that total about 50 grams of carbs every three to four hours to keep levels healthy. Try easier-on-the-stomach foods, like soup, crackers, pretzels, applesauce, gelatin and frozen popsicles.

Drink plenty of fluids. To keep hydrated, drink at least 12 8-ounce cups of fluid a day, such as water, club soda, herbal tea and broth. If your blood sugar is low, opt for drinks with sugar like apple juice, orange juice, tea with honey or ginger ale.

October 2013