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Planning Ahead for Sick Days

by Michelle Kowalski

If possible, share your sick-day plan with family members or those you live with. That way, you won’t be the only one managing your illness. One easy way to make your information readily available to others is to write it down and keep it with your sick-day food and supplies. Be sure to include on it the daytime and evening phone numbers for your doctor(s), other health-care providers, and the local hospital, just in case a friend or family member needs to call for help on your behalf. (Click here for more about what to include in your sick-day kit.)

It may be counterintuitive to take blood-glucose-lowering medicines if you’re not eating much and particularly if you’re vomiting. But your body needs help combating the elevation in blood glucose level caused by stress hormones. If you take oral diabetes medicines and can’t keep any foods or liquids down, you may need to take insulin for a short time. This is something to discuss with your health-care team ahead of time since you will need both supplies and training to inject insulin.

People who take insulin may find that their insulin needs increase during an illness, and they may need to take more insulin to bring down high blood glucose. Your log of blood glucose readings will be critical to your insulin management for you and your doctor.

If you take multiple daily injections, it is wise to continue taking both long-acting and rapid- or fast-acting insulins while sick. Supplemental doses of fast-acting insulin may be necessary if blood glucose levels stay high, if large amounts of ketones are present, or if ketones persist over time. Check with your health-care team about when to take supplemental insulin, how much to take, and how frequently to inject it.

If you use an insulin pump, you should be able to utilize your temporary basal rate feature or customize additional basal patterns specifically designed for sick days.
There are some medicines to watch out for because they can affect your blood glucose level even if they don’t contain sugar. Aspirin, for example, can lower your blood glucose if taken in large doses. Also, some antibiotics have been known to lower blood glucose levels in people who take oral diabetes medicines. When you talk to your physician about sick-day care, be sure to ask about any drugs you take regularly and whether to continue taking them during an illness.

Eating and drinking
If you’re dealing with a stomach bug or the flu, eating is likely the farthest thing from your mind. Even if you have a cold you may not have as much of an appetite as normal. But your body still needs nourishment when you’re sick. If possible, eat 45–50 grams of carbohydrate (or 3 carbohydrate choices) every 3–4 hours. If your stomach can’t tolerate regular food, try to consume liquids or soft foods that contain carbohydrate such as regular soft drinks, juice, soups, and ice cream.

Some food portions that contain 15 grams of carbohydrate include the following:

  • ½ cup regular ice cream
  • 3-ounce frozen fruit juice bar
  • ½ cup frozen yogurt
  • ½ cup sherbet
  • 1 slice of toast
  • 1 cup of soup
  • 6 saltine crackers
  • 5 vanilla wafers
  • ¼ cup regular pudding

If you are losing fluids because of vomiting or diarrhea, try to drink plenty of water in addition to other fluids, if possible. A good rule of thumb is to drink 1 cup of fluid every hour. If your blood glucose is running high, drink sugar-free liquids such as water, tea, sugar-free ginger ale, or broth. Increased liquids will help to flush high blood glucose or ketones from your system. If you need to raise your blood glucose, try drinks with 10–15 grams of carbohydrate per serving, such as the following:

  • ½ cup fruit juice
  • ½ cup regular ginger ale or regular soda
  • 1 cup milk
  • 1 cup sports drink
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Also in this article:
Diabetes Sick-Day Kit



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