Diabetes and illness

Blood sugar levels become harder to control when a diabetic person is ill. The body releases hormones to help fight the illness. The hormones have side effects that raise the blood sugar levels. For this reason, people with diabetes should never stop their diabetic medication when they are ill. A healthcare provider should be called immediately if the diabetic person is unable to take their diabetic medicine.

The provider can help the diabetic person develop a sick day plan. The plan should include when to call the provider, how often to check blood sugar levels and urine ketones, what medicines to take, and how to eat.

The sick day plan should include the following:

• check blood sugar levels every 4 hours
• keep taking insulin and diabetes pills, even if vomiting
• drink at least 8 ounces (.2 liters) of water or other calorie-free liquid every hour while awake
• if not able to eat usual food, drink juices and eat crackers, popsicles, or soup
• if unable to eat any food, drink ginger ale or any liquid with sugar
• test urine for ketones if blood sugar is over 250 milligrams or if unable to keep food or liquids down

Always keep the phone numbers for your provider, diabetes educator, and dietician by the phone. This is especially important when sick. It is not necessary to call your provider for each illness. But call if you have any of the following:

• fever for several days and not getting better
• unable to keep down food or fluids for 6 or more hours
• diarrhea for 6 hours or more
• urine is showing large amounts of ketones
• glucose levels are higher than 250 milligrams even after taking extra insulin
• blood sugar levels, in a pill-taking diabetic, are higher than 250 milligrams before meals and stay that high for 24 hours
• severe symptoms occur, such as chest pain, trouble with breathing, fruity smelling breath, unusual sleepiness, or dry cracked lips or tongue or
• questions about care during an illness

Remember, insulin or diabetic pills must be taken, even if vomiting. Keep a log of blood sugars, ketones, temperatures, drinks and food eaten, and medicines that have been taken. Be sure to have this information available when calling the provider.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File DIAB4392.rf2 VRS# 4392 Data Version 7.0 Copyright 1999, 2002-2003 McKesson Health Solutions LLC. All rights reserved.