• Over-the-counter pain reliever such as acetaminophen or ibuprofen
• Sugar-free cough syrup or throat lozenges (In addition to looking for the word sucrose in the ingredients list, look for dextrose, fructose, glucose, and just about anything else that ends in –ose. These are usually types of sugar. However, if you don’t have sugar-free products in the house, the amount of sugar you receive in a regular product is small and shouldn’t have much effect on your blood glucose level.)
• Decongestant (Even if sugar-free, decongestants can raise blood glucose level. Nasal sprays, however, may have less of a blood-glucose-raising effect than decongestant products that are swallowed.)
• Ketone strips (Make sure they’re not expired.)
• Glucagon kit in case of severe hypoglycemia (Check the expiration date on this, too. A glucagon kit requires a prescription, which most doctors are willing to write for anyone with Type 1 diabetes.)
• Notebook or pad and a pen so you don’t have to go hunting for something to write on
• If needed, a sliding scale showing dosage adjustments for your diabetes medicines according to blood glucose and ketone levels
• Several bottles of water so you don’t have to get up to refill your glass
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.