Diabetes Self-Management Blog

My husband has had the flu, my granddaughter now has the flu, and I’ve decided it’s time to review my sick-day rules in case I get the flu. You might want to review yours, too, especially since this year’s flu vaccine doesn’t seem to be working all that well.

What’s that? You don’t have sick-day rules? You’ve never heard of them? You’re not alone: I didn’t know about sick-day rules until nine years after I was diagnosed with Type 2 diabetes.

Now that you do know sick-day rules exist, please get yourself to a diabetes educator as soon as you can. One of the best things you can do for yourself when you have diabetes is to be prepared for whatever may come your way.

Basically, what sick-day rules tell you is that on those days when you can barely lift your head off the pillow and don’t feel like doing a darn thing except lying there and moaning, you need to be extra vigilant. Unlike people who don’t have diabetes, our continuing good health depends on taking extra-good care of ourselves when we’re in ill health.

Most importantly, this is not the time to skip your insulin or diabetes medicines, even if you’re not eating. Just the stress of being ill can cause your blood glucose to rise and you may even need higher doses when you’re sick.

As an aside, did you know that your blood glucose can begin to rise even before you have symptoms of an illness? A friend of mine who is an endocrinologist once told me that people with diabetes are lucky because “you know when you are going to be sick. I just wake up sick.”

But I digress. Check your blood glucose every 2–4 hours or so. If your blood glucose is higher than 240 mg/dl (or whatever level your health-care provider tells you), check for ketones. If you have ketones, call your health-care provider. In fact, ask your health-care provider what to do about ketones before you even have a hint of getting them. It’s part of that “be prepared” thing.

Sip liquids—about 8 ounces every hour that you’re awake. If nothing else, my stomach usually can handle taking frequent small sips of ginger ale or sucking on a frozen pop.

Why is it important to pay attention to blood glucose, ketones, and hydration? Because diabetes ketoacidosis (DKA), a medical emergency that has the potential to kill you, is characterized by high blood glucose plus ketones plus dehydration.

Your body does need nourishment, so eat if you can. If you can’t eat, drink liquids that contain carbohydrate. Before you get sick is the time to figure out what might taste good when you’re not feeling up to par. Also figure out what the portion sizes are. I don’t like to commit math at any time, and certainly not when I’m sick.

As mentioned before, I like ginger ale and frozen pops. If I can’t eat, I sip on regular ginger ale and suck on frozen juice pops. If I’m consuming food, the ginger ale and frozen pops are sugar-free.

As far as food goes, nibbling on cheese crackers seems to help calm my tummy. Yogurt, Jell-O, applesauce, and clear broths seem to go down fairly well. If somebody in your house cooks, maybe he or she will make you what my grandmother used to make for me when I was sick: custard.

Hopefully, you’re in good health—and will remain that way. But if you’re not prepared for sick days, now’s the time to check in with your diabetes educator or health-care provider so you’ll be ready when the numbers on the thermometer begin to rise.


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