Got the Sniffles? What to Do When You Have Diabetes

These tips can help keep your infection in check.

Maria Lissandrello
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When you have diabetes, your get-well plan will need to include more than a box of tissues and a cup of soup. That’s because the hormones your immune system releases to fight off infection also happen to elevate blood sugar levels. And failing to get them under control can set the stage for a dangerous chemical cascade: Without available sugar to burn for fuel, your body will burn fat, a process that releases acids called ketones into the bloodstream and urine. At too-high levels, ketones can upset the acid-base balance of the body and lead to a life-threatening condition called diabetic ketoacidosis, which is more common in patients with type 1 diabetes.

So what should you do at the first signs of a cold, like a scratchy throat or a stuffy nose? Start with these tips to help keep the infection—and your diabetes—in check. And ask your healthcare team if you should take any other special precautions, especially if you have other conditions in addition to diabetes.

Check your blood sugar every two to three hours.

Letting your blood sugar levels soar while you have the sniffles can allow a more serious infection, like pneumonia, to take hold.

Adjust your insulin, if need be.
If you notice your blood sugar is elevated even though you’re taking your insulin, tell your doctor or diabetes educator. She may suggest increasing your dosage.

Keep taking your medicine.
If you’re taking oral meds for type 2 diabetes, don’t stop. If they don’t seem to be working, alert your healthcare team.

Check your ketones every four to six hours.
Use ketone test strips. If your levels are high, call your healthcare provider right away. Note: The earliest signs of ketoacidosis include increased thirst and/or dry mouth and frequent urination. But these signs of ketoacidosis are also the symptoms of hyperglycemia without ketoacidosis. Other symptoms, weakness, vomiting, confusion are not specific, but taken together are warnings.


You might not feel like eating if you’re under the weather, but it’s important to have meals and snacks totaling about 50 grams of carbs every three or four hours. Broth with soda crackers, applesauce and gelatin snacks are easy on the stomach.

Drink up.
Fluids help you dodge dehydration, which can elevate blood sugar and ketone levels when you have a cold. Down at least a cup of water, herbal tea or other caffeine-free beverage each hour. If your blood sugar is high, stick to sugar-free drinks; if it’s low, try ginger ale or apple juice. 

April 2013