Developing A Diabetes Sick Day Plan

By Melinda D. Maryniuk, MEd, RD, CDE When you are not feeling well, your blood glucose levels can rise, even if you have been sticking to a healthy diet. It’s important to have a plan in place for days when you feel sick or just off. Here are just a few examples of situations in which you may not feel your best

• Common cold
• Flu
• Nausea, vomiting, diarrhea
• Infection
• Surgery
• Dental work
• Stress
• Injury

Sick Day Plan: Whenever you feel sick, it’s important to pay extra close attention to your glucose levels as they can change very quickly and unexpectedly. Follow these guidelines and talk with your healthcare provider about a specific plan for you… Check blood glucose often. Check it 4 times a day for mild illness (like a cold) or every 3-4 hours for a more severe illness, such as the flu. Blood glucose can rise quickly when you are sick and you cannot always tell what’s happening just by how you are feeling. If glucose is over 250 mg/dl for two readings in a row, call your healthcare provider as you may need a change in your medications.  Ask your healthcare provider if you need to check ketones. This is always important for people with type 1 diabetes and sometimes recommended for those with type 2. You may need to check if your blood glucose goes above 250 mg/dl. Take your diabetes medication on time.  When you are not feeling well, you may not feel like eating. However, it is important to keep taking your diabetes medicine unless your healthcare provider instructs you not to. Some medications need to be adjusted or held temporarily if your appetite is low. Drink plenty of fluids. Drink plenty of water and fluids throughout the day while you are awake to prevent dehydration. If you are unable to eat solid food, switch back and forth between sugar-free drinks (like water, seltzer, tea, diet soda) and drinks containing carbohydrates (like juice, smoothies, and soups). Learn about easy-to-eat foods. When you don’t feel like eating your usual meals, it can still be important to get in some carbs to cover the medicines you’ve taken, especially insulin. Keep some foods handy specifically for a sick day emergency, such as plain crackers, oatmeal, broth based soups, applesauce, juice and popsicles. Talk with a dietitian to determine if you need a special sick day diet plan based on your diabetes medicines.  Rest and keep warm. Don’t exercise too much. Have someone help take care of you.  Know when to call for help. Never hesitate to call your doctor if you are worried, but pay particular attention to these signs & symptoms below…

• Signs of dehydration such as dry mouth, cracked lips, sunken eyes, skin that is flushed and dry, or weight loss.
• A fever of 100° or higher.
• Vomiting or unable to keep fluids down.
• Constant diarrhea.
• Abdominal pain.
• Chest pain.
• Rapid, shallow breathing.
• Blood glucose levels over 250 mg/dl for more than two readings with or without ketones.

Be prepared. Create a sick day supply kit. Talk with your healthcare provider or diabetes educator about what should be in your kit. This list offers some general ideas to get you started:

• Extra glucose meter and strips (you’ll be checking more often)
• Digital thermometer
• Medicines to relieve symptoms of cold, flu, pain, fever or diarrhea
• Sugar-free cough drops and cough syrups
• Ketone strips (if needed)
• Telephone numbers for healthcare provider
• Easy to digest foods such as:
  • Sugar-free and regular gelatin
  • Store-bought or homemade popsicles
  • Low-sodium vegetable or chicken broth
  • Herbal, non-caffeinated tea
  • Soft drinks (sugar-free and regular, if needed to replace carbs)
  • Fruit juice
  • Applesauce
  • Bananas

The medical information on Diabetes – What To Know’s website is provided as an information resource only. The content is not in any way intended to be nor should you rely on it as a substitute for professional medical evaluation, diagnosis, advice and treatment.