When You're Ill
It's inevitable. Everyone comes down with a cold or the flu from time to time. Knowing that, it's important to plan ahead for these days—when you may not feel like eating much and you're unlikely to want to run out to the grocery store.
A Sick-Day Plan
The stress of illness causes your body to release hormones that can raise your blood sugar and interfere with the effectiveness of insulin. Some medications, such as decongestants, can raise it even further. As a result, it can be harder to keep your blood sugar in range. For people with type 1 diabetes, this can also lead to ketoacidosis, the presence of harmful ketones in the system.1 That's why your doctor will want you to take special precautions to keep your blood sugar under control whenever you're under the weather.
Talk with your doctor about how to handle sick days. In general, you'll want to:
•Know when to call your doctor and keep phone numbers nearby.
•Continue to take your insulin or diabetes pills as you normally would, unless your doctor instructs otherwise. In some cases, additional medication may be needed.2
•Test blood sugar regularly, and if you have type 1 diabetes, test ketones as well.
•Write down self-monitoring results, medications taken, your temperature, food you've eaten, and anything else that may affect your blood sugar, so you can update your healthcare team if needed.
•Drink plenty of liquids to avoid dehydration and help get rid of the extra sugar and ketones in your blood.1 Try to drink at least six to eight ounces every hour you're awake.2
•Keep sick-day foods on hand that let you get the carbohydrates you need, even if your stomach is upset.
•Get a flu shot each fall to reduce your chances of getting sick in the first place, and have the people you live with get one, too. Also, talk to your doctor about getting a pneumonia shot every five to ten years.1
Sick-Day Foods
Stick to your regular meal plan if you can. But if your stomach is upset, other foods can provide the carbohydrates your body needs. Many sick-day foods have a long shelf life, so you can purchase them well in advance and keep them on hand.
| • broth | • regular (not diet) soda | • applesauce |
| • mashed potatoes | • gelatin | • popsicles |
| • milk | • fruit juice | • hard candy |
| • dry toast | • ice cream | • graham or saltine crackers |
If necessary, try taking small sips every 15 minutes to help keep liquids down.
When to Call the Doctor
There are certain times your doctor will want to hear from you. Talk to your doctor about specifics, but in general, it's a good idea to call whenever:1
•You've been sick for a couple of days and aren't getting better.
•You've been vomiting or have had diarrhea for more than six hours.
•Your blood sugar is higher than 240, even though you've taken any extra insulin or medication recommended by your sick-day plan.
•You have any serious symptoms of ketoacidosis, dehydration, chest problems, or other issues.
•You aren't sure how to take care of yourself.
1 American Diabetes Association. "Flu and Pneumonia Shots." Available at: http://www.diabetes.org/gestational-diabetes/flu-pneumonia-shots.jsp (accessed June 27, 2006).
2 Joslin Diabetes Center. "Guidelines for Sick Days." Available at: http://www.joslin.org/managing_your_diabetes_653.asp (accessed August 21, 2006).