Managing Sick Days

These tips can help people with diabetes prepare for getting sick and take care of themselves if they do become ill.

Like everyone, people with diabetes can get sick even when trying their best to prevent it. So being prepared and knowing what to do if you get sick is very important. There are several things you can do now, but also talk to your doctor about the best way to handle being sick if it happens. Visit these pages for more information:

Sick man blowing his nose

These tips can help you take care of yourself if you get sick.

Prepare Now Before Getting Sick

Make sure you have insulin, other diabetes medicines, and easy-to-fix foods in your home, enough for several weeks or longer:

  • Medicines and supplies
    • Milk of magnesia
    • Medicine to control diarrhea
    • Antacid
    • Pain reliever
    • Thermometer
    • Suppositories to treat vomiting
  • Foods 
    • Sports drinks
    • Juice boxes
    • Canned soup
    • Regular gelatin
    • Regular soft drinks
    • Instant cooked cereals
    • Crackers
    • Instant pudding
    • Unsweetened applesauce

If you can’t eat meals, you will need to eat or drink about 50 grams of carbohydrates every 4 hours, such as 1½ cup of unsweetened applesauce or 1½ cup of fruit juice.

If You Get Sick

If you do get sick, your blood sugar can be hard to manage. You may not be able to eat or drink as much as usual, which can affect blood sugar levels.

Your doctor may ask you to test your blood sugar more often when you’re sick. That’s because when your body releases hormones to fight the illness, those hormones can also raise your blood sugar levels and increase how much insulin you need. This is especially important for people with type 1 diabetes since they depend on insulin to live.

When your body doesn’t have enough insulin, it starts breaking down fat as fuel, which produces ketones. When too many ketones are produced too fast, they can cause diabetic ketoacidosis, or DKA. DKA is very serious and can cause a coma or even death.

If you think you may have DKA, use an over-the-counter kit to test your urine for ketones. If ketones are present, call your doctor right away. You’ll probably need to go to the hospital for treatment.

Follow these additional steps when you’re sick even if your blood sugar is within your target range:

  • Continue taking your insulin and diabetes pills as usual.
  • Test your blood sugar every 4 hours and keep track of the results.
  • Drink extra calorie-free liquids*, and try to eat as you normally would.
  • Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
  • Check your temperature every morning and evening. A fever may be a sign of infection.

*Drink plenty of fluids – 4 to 6 ounces every half-hour – to prevent dehydration. You may also need to drink beverages with sugar if you cannot get 50 grams of carbohydrates every 4 hours from other food choices. Drink small portions of these sweet beverages to keep your blood sugar from getting too high.

Go to an emergency room if any of the following occurs:
  • You’re having trouble breathing.
  • You have moderate to high ketone levels in your urine.
  • You can’t keep any liquids down for more than 4 hours.
  • You lose 5 pounds or more during the illness.
  • Your blood sugar is lower than 60 mg/dl.
  • You feel too sick to eat normally and are unable to keep down food
    for more than 24 hours.
  • You have vomiting and/or severe diarrhea for more than 6 hours.
  • Your temperature is over 101 degrees F for 24 hours.
  • You feel sleepy or can’t think clearly. Have someone else call your doctor or take you to the emergency room.
Page last reviewed: February 28, 2022