Table of ContentsView AllTable of ContentsWhy Blood Sugar SpikesSick Day RulesTesting When SickWhat to EatWhen to Seek CarePreventing Infection
Table of ContentsView All
View All
Table of Contents
Why Blood Sugar Spikes
Sick Day Rules
Testing When Sick
What to Eat
When to Seek Care
Preventing Infection
Diabetescan make it harder to recover from even minor illnesses like colds and flu. It not only makes your blood sugar harder to control but can lead to a serious condition known asdiabetic ketoacidosis(DKA)if your insulin levels are low.
If you have diabetes, developing a sick day plan is important to avoid DKA. This includes taking extra steps to monitor and manage your blood sugar until you are fully recovered.
This article explains what diabetic ketoacidosis is and what you can do to avoid this potentially life-threatening complication. It also describes ways to prevent illness and when it is time to see a healthcare provider.
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Why Blood Sugar Spikes When You’re Sick
Any type of illness can raise your blood sugar.This is because when you are sick, your body will release a hormone calledepinephrinethat helps you better deal with stressful situations.
One of the functions of epinephrine is to provide your body with extra energy in the form ofglucose(sugar). This not only increases your blood sugar but also increases the demand forinsulinto help the body absorb and utilize the sugar.
In people without diabetes, ketone levels almost never get high enough to cause harm because enough insulin is being produced. In people with diabetes, the lack of insulin can cause ketones to build to dangerous levels, leading to a condition known asdiabetic ketoacidosis.
People withtype 1 diabetesare at increased risk of DKA because they cannot produce enough insulin even during healthy days.DKA can also affect people withtype 2 diabeteswho have an intercurrent infection like pneumonia, influenza, gastroenteritis, or a urinary tract infection.
Signs of Diabetic Ketoacidosis
Early symptoms of DKA include:
Get immediate medical attention if you experience any of the following symptoms of DKA:
When you’re sick, diabetic ketoacidosis can develop within hours. Thus, it’s critical to have a diabetes sick day plan so that you are prepared if DKA symptoms develop.
The 10 Best Foods to Eat When You’re Sick
Sick Day Rules for Diabetes
Talk to your healthcare provider about what you need to do based on the type of diabetes you have and your risk factors for DKA.
A Word From VerywellIf you have diabetes, it’s vital to develop a sick day plan before you get sick. Preparing for an illness ahead of time helps you manage your diabetes and lowers your risk of serious complications. Talk to your doctor or diabetes care team if you are unsure where to start when making your sick day plan.—ALLISON HERRIES, RDN, MEDICAL EXPERT BOARD
A Word From Verywell
If you have diabetes, it’s vital to develop a sick day plan before you get sick. Preparing for an illness ahead of time helps you manage your diabetes and lowers your risk of serious complications. Talk to your doctor or diabetes care team if you are unsure where to start when making your sick day plan.—ALLISON HERRIES, RDN, MEDICAL EXPERT BOARD
If you have diabetes, it’s vital to develop a sick day plan before you get sick. Preparing for an illness ahead of time helps you manage your diabetes and lowers your risk of serious complications. Talk to your doctor or diabetes care team if you are unsure where to start when making your sick day plan.
—ALLISON HERRIES, RDN, MEDICAL EXPERT BOARD
Take Your Medicines as Usual
If you are on insulin, take it as usual, even if you are very sick.If your blood sugar levels are abnormal, don’t hesitate to call your healthcare provider to ensure you take the correct dose.
If you are on otherdiabetes medications, take them as you usually would, even if you have been vomiting. Stopping your drugs only increases the risk of DKA.
Eat As You Normally Would
A diabetes diet is designed to help you manage your blood glucose. You should do your best to continue eating as you normally would if you are ill. If you have problems keeping food down, focus on eating carbohydrate-rich snacks to avoidhypoglycemia(low blood sugar).
As a rule, you should aim to:
How to Eat If You Have Diabetes
Check Your Blood Sugar Regularly
It is generally advised that you check your blood sugar with anat-home glucometerat least four times per day while you are ill.Record your numbers and keep this information available to share with your healthcare team.
People with type 1 diabetes should check their blood sugar every two hours.
How to Use a Glucometer Correctly
Drink Plenty of Fluids
Staying hydrated is extra important if you are ill and have diabetes. Aim to drink 1 cup (8 ounces) of sugar-free and caffeine-free fluids every hour, taking small sips every 15 minutes to keep your fluid levels up.
Water is always best, but you can also drink:
Use Diabetes-Friendly OTC Medications
One of the first things many people do when they get sick is reach for over-the-counter (OTC) cold and flu medications. However, not every medication is diabetes-friendly. Some contain sugar or alcohol that can raise your blood sugar.
Call your healthcare provider if you’re unsure what OTC drugs can and cannot take.
Testing When You’re Sick
When you are sick, you need to monitor not only your blood sugar but also your temperature, weight, and ketone levels to ensure that you respond quickly if DKA symptoms develop.
This includes:
When to Seek Emergency CareHaving ketones in your urine while you are sick is a medical emergency. If your urine tests positive for ketones, go to the nearest emergency room immediately.
When to Seek Emergency Care
Having ketones in your urine while you are sick is a medical emergency. If your urine tests positive for ketones, go to the nearest emergency room immediately.
Maintaining your regular diabetes-friendly diet is advised even when you’re sick. However, it’s not always easy to eat or drink the exact same way while you are ill. Even so, you need to try.
To prevent hypoglycemia, aim to consume around 50 grams of carbohydrates every four hours.An example is 1½ cups of unsweetened applesauce or 1½ cups of fruit juice.
Foods that are good for people with diabetes include:
When to See a Healthcare Provider
When you have diabetes and get sick, there are certain situations that require immediate medical attention. If you have any of the following symptoms, contact your healthcare provider right away:
Do not delay seeking medical care. If you cannot see your healthcare provider, go to the emergency room.
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Preventing Infection When You Have Diabetes
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Summary
People with diabetes, especially type 1 diabetes, are vulnerable to a potentially serious condition called diabetic ketoacidosis (DKA) whenever they are ill. DKA occurs when insulin levels are low, causing ketones to accumulate as the body turns to fat for fuel.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Managing sick days.Sharma D, Farrar J.Adrenergic regulation of immune cell function and inflammation.Semin Immunopathol. 2020;42(6):709-717. doi:10.1007/s00281-020-00829-6Verberne AJM, Korim WS, Sabetghadem A, Llewellyn-Smith IJ.Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes.Br J Pharmacol. 2016 Feb;173(9):1425-1437. doi:10.1111/bph.13458Elendu C, David J, Udoyen AO, et al.Comprehensive review of diabetic ketoacidosis: an update.Ann Med Surg (Lond). 2023 ;85(6):2802-2807. doi:10.1097/MS9.0000000000000894UW Health.Sick day guidelines when you have type 1 diabetes.American Diabetes Association.Diabetes & DKA (ketoacidosis).National Institute of Diabetes and Digestive and Kidney Diseases.Take care of your diabetes during sick days & special times.National Library of Medicine: MedlinePlus.Diabetes - when you are sick.American Diabetes Association.Planning for sick days.Unnikrishnan R, Misra A.Infections and diabetes: risks and mitigation with reference to India.Diabetes Metab Syndr. 2020;14(6):1889-1894. doi:10.1016/j.dsx.2020.09.022Pelinski da Silveira M, da Silva Fagundes K, Ribeiro Bizuti M, Starck É, Calciolari Rossi R, Tavares de Resende e Silva D.Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature.Clin Exp Med. 2021;21(1):15-28. doi:10.1007/s10238-020-00650-3Centers for Disease Control and Prevention.How much physical activity do adults need?.University of Rochester Medical Center.Important vaccines for people with diabetes.Centers for Disease Control and Prevention.Infection prevention during blood glucose monitoring and insulin administration.Centers for Disease Control and Prevention.When and how to wash your hands.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Managing sick days.Sharma D, Farrar J.Adrenergic regulation of immune cell function and inflammation.Semin Immunopathol. 2020;42(6):709-717. doi:10.1007/s00281-020-00829-6Verberne AJM, Korim WS, Sabetghadem A, Llewellyn-Smith IJ.Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes.Br J Pharmacol. 2016 Feb;173(9):1425-1437. doi:10.1111/bph.13458Elendu C, David J, Udoyen AO, et al.Comprehensive review of diabetic ketoacidosis: an update.Ann Med Surg (Lond). 2023 ;85(6):2802-2807. doi:10.1097/MS9.0000000000000894UW Health.Sick day guidelines when you have type 1 diabetes.American Diabetes Association.Diabetes & DKA (ketoacidosis).National Institute of Diabetes and Digestive and Kidney Diseases.Take care of your diabetes during sick days & special times.National Library of Medicine: MedlinePlus.Diabetes - when you are sick.American Diabetes Association.Planning for sick days.Unnikrishnan R, Misra A.Infections and diabetes: risks and mitigation with reference to India.Diabetes Metab Syndr. 2020;14(6):1889-1894. doi:10.1016/j.dsx.2020.09.022Pelinski da Silveira M, da Silva Fagundes K, Ribeiro Bizuti M, Starck É, Calciolari Rossi R, Tavares de Resende e Silva D.Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature.Clin Exp Med. 2021;21(1):15-28. doi:10.1007/s10238-020-00650-3Centers for Disease Control and Prevention.How much physical activity do adults need?.University of Rochester Medical Center.Important vaccines for people with diabetes.Centers for Disease Control and Prevention.Infection prevention during blood glucose monitoring and insulin administration.Centers for Disease Control and Prevention.When and how to wash your hands.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Managing sick days.Sharma D, Farrar J.Adrenergic regulation of immune cell function and inflammation.Semin Immunopathol. 2020;42(6):709-717. doi:10.1007/s00281-020-00829-6Verberne AJM, Korim WS, Sabetghadem A, Llewellyn-Smith IJ.Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes.Br J Pharmacol. 2016 Feb;173(9):1425-1437. doi:10.1111/bph.13458Elendu C, David J, Udoyen AO, et al.Comprehensive review of diabetic ketoacidosis: an update.Ann Med Surg (Lond). 2023 ;85(6):2802-2807. doi:10.1097/MS9.0000000000000894UW Health.Sick day guidelines when you have type 1 diabetes.American Diabetes Association.Diabetes & DKA (ketoacidosis).National Institute of Diabetes and Digestive and Kidney Diseases.Take care of your diabetes during sick days & special times.National Library of Medicine: MedlinePlus.Diabetes - when you are sick.American Diabetes Association.Planning for sick days.Unnikrishnan R, Misra A.Infections and diabetes: risks and mitigation with reference to India.Diabetes Metab Syndr. 2020;14(6):1889-1894. doi:10.1016/j.dsx.2020.09.022Pelinski da Silveira M, da Silva Fagundes K, Ribeiro Bizuti M, Starck É, Calciolari Rossi R, Tavares de Resende e Silva D.Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature.Clin Exp Med. 2021;21(1):15-28. doi:10.1007/s10238-020-00650-3Centers for Disease Control and Prevention.How much physical activity do adults need?.University of Rochester Medical Center.Important vaccines for people with diabetes.Centers for Disease Control and Prevention.Infection prevention during blood glucose monitoring and insulin administration.Centers for Disease Control and Prevention.When and how to wash your hands.
Centers for Disease Control and Prevention.Managing sick days.
Sharma D, Farrar J.Adrenergic regulation of immune cell function and inflammation.Semin Immunopathol. 2020;42(6):709-717. doi:10.1007/s00281-020-00829-6
Verberne AJM, Korim WS, Sabetghadem A, Llewellyn-Smith IJ.Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes.Br J Pharmacol. 2016 Feb;173(9):1425-1437. doi:10.1111/bph.13458
Elendu C, David J, Udoyen AO, et al.Comprehensive review of diabetic ketoacidosis: an update.Ann Med Surg (Lond). 2023 ;85(6):2802-2807. doi:10.1097/MS9.0000000000000894
UW Health.Sick day guidelines when you have type 1 diabetes.
American Diabetes Association.Diabetes & DKA (ketoacidosis).
National Institute of Diabetes and Digestive and Kidney Diseases.Take care of your diabetes during sick days & special times.
National Library of Medicine: MedlinePlus.Diabetes - when you are sick.
American Diabetes Association.Planning for sick days.
Unnikrishnan R, Misra A.Infections and diabetes: risks and mitigation with reference to India.Diabetes Metab Syndr. 2020;14(6):1889-1894. doi:10.1016/j.dsx.2020.09.022
Pelinski da Silveira M, da Silva Fagundes K, Ribeiro Bizuti M, Starck É, Calciolari Rossi R, Tavares de Resende e Silva D.Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature.Clin Exp Med. 2021;21(1):15-28. doi:10.1007/s10238-020-00650-3
Centers for Disease Control and Prevention.How much physical activity do adults need?.
University of Rochester Medical Center.Important vaccines for people with diabetes.
Centers for Disease Control and Prevention.Infection prevention during blood glucose monitoring and insulin administration.
Centers for Disease Control and Prevention.When and how to wash your hands.
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