Part of this journey is trial and error and finding out what all affects the sugar level—and then still not being able to completely predict outcomes.
—Trudy Schoepko, Type 2 Diabetes Patient
That's how Trudy Schoepko, 66, found out she was coming down with pneumonia.
"I remember feeling just miserable but insisting on going to a peace march downtown," says the Albuquerque resident. "When I came home my sugar level was an unheard of and unprecedented 195—in three years I'd never come anywhere near that.
"Two days later I discovered I had pneumonia. Part of this journey is trial and error and finding out what all affects the sugar level—and then still not being able to completely predict outcomes."
One thing you can predict is that you will catch a cold or a stomach bug at some point. Plan ahead so you know how to take medication if you are vomiting or can't eat or drink. Know how to recognize more severe symptoms that require medical attention.
Sick-Day Guidelines for People With Diabetes
What happens when you are sick
When you are sick, your body reacts by releasing hormones to fight infection. However, these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.
Plan ahead
Work with your health professional to make a sick-day plan for you or your child with diabetes. Discuss your target blood sugar goal during an illness, how you should adjust your insulin dose and timing (if you take insulin), and when you need to contact your health professional for help. Also, make sure you know how often to check blood sugar and urine ketone levels. Keep your plan in a convenient place, and include contact information in case you need to reach your health professional at night or on the weekends.
What happens when you are sick
When you are sick, your body reacts by releasing hormones to fight infection. However, these hormones raise blood sugar levels and at the same time make it more difficult for insulin to lower blood sugar. When you have diabetes, even a minor illness can lead to dangerously high blood sugar. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.
Plan ahead
Work with your health professional to make a sick-day plan for you or your child with diabetes. Discuss your target blood sugar goal during an illness, how you should adjust your insulin dose and timing (if you take insulin), and when you need to contact your health professional for help. Also, make sure you know how often to check blood sugar and urine ketone levels. Keep your plan in a convenient place, and include contact information in case you need to reach your health professional at night or on the weekends.
Last Updated: January 19, 2007 Steps to take during an illness
Here are some general sick-day guidelines:
Here are some general sick-day guidelines:
- Continue taking your pills for diabetes (if you have type 2 diabetes) or insulin, even if you are vomiting and having trouble eating or drinking. Your blood sugar may continue to rise because of your illness. If you cannot take your medications, call your health professional and discuss whether you need to adjust your insulin dose or other medication.
- Try to eat your normal types and amounts of food and to drink extra fluids, such as water, broth, carbonated drinks, and fruit juice. Encourage your child to drink extra liquids to prevent dehydration.
- If your blood sugar level is higher than 240 milligrams per deciliter (mg/dL), drink extra liquids that do not contain sugar, such as water or sugar-free cola.
- If you cannot eat the foods in your regular diet, drink extra liquids that contain sugar and salt, such as soup, sports drinks, or milk. You may also try eating foods that are gentle on the stomach, such as crackers, gelatin, or applesauce. Try to eat or drink 50 grams (g) of carbohydrate every 3 to 4 hours. For example, 6 saltine crackers, 1 cup (8 fl oz) of milk, and 1/2 cup (4 fl oz) of orange juice each contain approximately 15 g of carbohydrate.
- Check your blood sugar at least every 3 to 4 hours, or more often if it is rising quickly, even through the night. If your blood sugar level rises above 240 mg/dL and your health professional has told you to take an extra insulin dose for high blood sugar levels, take the appropriate amount. If you take insulin and your health professional has not told you to take a specific amount of additional insulin, call him or her for advice.
- If you are taking insulin, do a urine test for ketones every 6 to 12 hours, especially if your blood sugar is higher than 300 mg/dL. Call your doctor if you have more than 2+ or moderate ketones in your urine. Check your child's urine for ketones at least every 6 hours, even through the night.
- Weigh yourself and check your temperature, breathing rate, and pulse frequently if your blood sugar is higher than 300 mg/dL. If you are losing weight and your temperature, breathing rate, and pulse are increasing, contact a health professional. You may be getting worse.
- Don't take any nonprescription medications without talking with your health professional. Many nonprescription medications affect your blood sugar level.
When to call your health professional
Minor illnesses in people with diabetes—especially children with type 1 diabetes—can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need immediate medical attention. Call 911 or other emergency services if you or your child has:
Minor illnesses in people with diabetes—especially children with type 1 diabetes—can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need immediate medical attention. Call 911 or other emergency services if you or your child has:
- Symptoms of diabetic ketoacidosis (DKA), such as abdominal pain, vomiting, rapid breathing, fruity-smelling breath, or severe drowsiness.
- Symptoms of dehydration, such as a dry mouth and very yellow or dark urine. Dehydration is particularly dangerous in children and may be caused by vomiting and diarrhea.
- A low blood sugar level that continues.
- Your blood sugar level is higher than 240 mg/dL after taking the adjusted amount of insulin in your sick-day plan.
- You take oral diabetes medication and your blood sugar level is higher than 240 mg/dL before meals and stays high for more than 24 hours.
- You have more than 2+ or moderate ketones in your urine.
- You still have a fever and are not feeling better after a few days.
- You are vomiting or having diarrhea for more than 6 hours.