Infections, particularly serious ones, can lead to diabetes complications. The most dangerous — although it’s rare in people with type 2 diabetes — is diabetic ketoacidosis, which can lead to a diabetic coma, according to endocrinologist Alan Garber, MD, PhD, a professor of medicine in diabetes, endocrinology, and metabolism at the Baylor College of Medicine in Houston and president of the American College of Endocrinology. “Infection is a metabolic stress, and it raises your blood sugar,” Dr. Garber says. It can be hard to know how you will respond to each infection, he adds. Being sick can also lead to dehydration, eating differently, oversleeping, and losing track of your schedule — all of which can make diabetes management harder.
How often you’ll need to test your blood sugarWhat to do if your blood sugar gets highWhen to test your ketonesWhat medications to takeWhat and how to eatWhen to call your doctor
Put your plan in writing, include your doctor’s contact information, and make sure the plan is available to a loved one or friend in case you need help. There are also many things you can do (or not do) to help keep your diabetes under control if you do get sick. The Dos and Don’ts of Diabetes Care When You’re Sick DO drink plenty of fluids. Fluids are recommended for anyone who’s sick because diarrhea and vomiting can cause dehydration. People with diabetes should be even more vigilant about drinking fluids because high blood sugar levels lead to more urination, adding to your risk for dehydration. Choose water or sugar-free sports drinks to replace electrolytes and fluids, Garber says. DON’T skip or double up on medication doses. Garber stresses that you shouldn’t try to adjust your diabetes medication or insulin without your doctor’s advice. If it hasn’t already been outlined in your sick day plan, call your medical team to find out what to do if your blood sugar is unusually high or low. DO check your blood sugar level regularly. When you’re sick, you’ll need to check your blood sugar more often. If blood sugar spikes over 300, the ADA recommends also checking ketones, which you can do with a urine test strip. DO pick diabetes-friendly cold medications. The ADA recommends asking a pharmacist to help you when you’re looking for over-the-counter medicines, if your doctor hasn’t already recommended the best ones for you. Try to find sugar-free cough syrup and be aware that decongestants can affect both blood sugar levels and blood pressure. DON’T ignore symptoms of potential diabetes emergencies. Your sick day plan should outline when to call your doctor, but some symptoms could signal a possible diabetes emergency. The ADA says these include:
Blood sugar levels that keep rising or are over 240Moderate to large amounts of ketones in your urineFrequent urinationDry mouth or thirstVomiting for more than six hoursAbdominal painConfusionLoss of consciousness
Even if you’re not experiencing these symptoms, call your doctor any time you aren’t sure about your medications or how to care for yourself. DO eat small meals often. Stock up on foods that are easy for a sick stomach, such as soup, crackers, applesauce, and gelatin. “Chicken noodle soup can do people a world of good,” says Garber. The ADA recommends 50 grams of carbohydrates every three to four hours, and you should generally try to get your usual daily calorie intake. If you can’t eat any solids, try frozen fruit pops, broth, pudding, or juice. DO keep a written record. Write down your blood sugar test results, the times you take medications, when you eat and what you eat, and any new symptoms you experience, such as vomiting, diarrhea, fever, or abdominal pain. The ADA also recommends tracking your weight if you’re sick for several days. DO wear a medical ID. Most sick days will pass without trouble, but if you ever lose consciousness or need to go to the emergency room, a medical ID will give vital information to medical professionals. DON’T isolate yourself. Although it may be tempting, Garber doesn’t recommend toughing it out alone. Going to the doctor could mean you get flu medications or antibiotics early in your illness, so don’t hesitate to make an appointment.
