Managing Diabetes During Sick Days

Living with diabetes is a daily balancing act, but when illness strikes, that balance can feel even more precarious. Being sick can wreak havoc on your blood sugar levels, making an already challenging condition even more difficult to control, whether it's a common cold or something more serious. Here, we’ll explore some essential strategies to help you manage diabetes during sick days to recover smoothly and reduce the risk of hospitalizations or severe illness.

How Does Illness Affect Diabetes?

When you're sick, your body treats the illness as a stressor. This triggers a release of hormones that increase the amount of glucose in the blood, which can help fuel your body for the fight against harmful pathogens. In people without diabetes, this is a positive response that can give your body the energy it needs to maximize the power of the white blood cells. However, when living with diabetes, these changes in blood sugar can be a bit unpredictable and harder to control. Some illnesses may lead to spikes in blood sugar, while others can result in low blood sugar, especially if you're unable to eat or are vomiting. Therefore, it's important to understand how to care for yourself if you get sick and what to do in an emergency.

Preparing for Sick Days in Advance When Living with Diabetes

Often, illness is paired with fatigue and brain fog, which can make managing underlying conditions like diabetes even more difficult. Some strategic planning can help ensure that you're prepared to handle sick days.

Create a Sick Day Kit

One of the best ways to manage your diabetes when feeling sick is to have a sick day kit ready. This should include everything you need to stabilize your blood sugar levels and reduce the risk of experiencing diabetic ketoacidosis (DKA) or hyperglycemia. Some things to have on hand include:

• Thermometer
• Medicine to control vomiting or diarrhea
• Antacids
• Pain relievers
• Crackers
• Fruit juice
• Soda
• Sports drinks
• Canned soup or broth
• Unsweetened applesauce
• Cold or flu medications that won't affect your blood sugar
• Ketone test strips
• A glucagon kit for hypoglycemia
• Anti-nausea medication
• Glucose tabs or gels
• Glucose-lowering medications
• Glucose meter
• Continuous glucose monitor
• Insulin pump

Make a Plan with Your Doctor

It's also important to check with your doctor regarding what to do if you get sick. Making a sick day plan can help you manage your diabetes without putting yourself at risk. For example, some over-the-counter medications might do more harm than good when living with diabetes, so make sure you know which options will be okay for you to take. You should also talk about how often to check blood glucose levels, when to test for ketones, and what to do if you can't eat. If you begin feeling ill, continue with your diabetes management plan and call your doctor or diabetes specialist for more detailed instructions.

Preventing Illnesses

Although it's impossible to prevent every illness, there are some things you can do to decrease your chances of catching a bug. First and foremost, talk to your doctor about getting the flu vaccine. This should be done yearly before cold and flu season to help reduce your risk. Your doctor may also recommend updating your coronavirus vaccine. Always practice good hand hygiene and avoid people you know are sick. Eating a nutritious diet, exercising, and prioritizing a good sleep schedule will also help your body fight germs more effectively.

How to Manage Diabetes When You're Sick

Consider the following tips to help you avoid excessive blood sugar fluctuations while your body works hard to fight off pathogens.

Check Your Blood Sugar Levels More Often

Although it might be difficult if you're feeling fatigued or are sleeping a lot, you need to check your blood glucose levels more often when you're sick. Your doctor will give you a better idea of the best intervals based on your illness or how you're feeling, but you may need to test every few hours, even throughout the night.

Stay Hydrated

Dehydration when you're sick can worsen symptoms and affect your blood sugar, so it's important to try and drink plenty of water. If your blood sugar is below 180 mg/dl, you may also need to drink sugary drinks to help boost glucose levels. These can include things like Pedialyte, drinks with sugar (i.e., cola or ginger ale), lemonade or Kool-Aid, sports drinks, and more.

Manage Your Electrolytes

Getting sick can disrupt the balance of fluids and electrolytes in the body, which can increase your risk of complications, especially in people with diabetes. So, in addition to staying hydrated, take extra precautions to help address any electrolyte imbalances. These are typically drinks with things like sodium, potassium, and chloride. Sports drinks, oral rehydration solutions, and broths all have good levels of electrolytes.

Keep Your Blood Glucose Levels Stable

Some illnesses can make you feel sick to your stomach, making it hard to eat. However, not eating can affect blood sugar levels even more and make it challenging to manage diabetes. Ideally, eat or drink about 50 grams of carbohydrates every three to four hours. You can also use the 15-15 rule to raise your blood glucose levels if you experience hypoglycemia. If you don't feel like eating, have easily ingestible options, such as Jell-O, popsicles, orange juice, crackers, sports drinks, and more. Keeping your blood sugar within your target range is one of the best ways to handle sick days.

Take Your Diabetes Medicines

One of the most important things to do when you're feeling sick is to continue taking your diabetes medications. If you take insulin, talk to your diabetes team about any adjustments. Depending on how you're feeling and your blood sugar levels, you may need to take extra insulin or cut back on your insulin doses. However, diabetes tablets like SGLT2i may increase your risk for DKA when you're sick. So always confirm with your doctor, as there are some medications you should take less of or stop altogether.

Test for Diabetic Ketoacidosis (DKA)

Diabetic ketoacidosis is a serious and potentially life-threatening complication. It happens when the body starts breaking down fat at an unusually high rate, which produces acidic ketones as a byproduct. When too many ketones build up in the blood, they can make the blood acidic, leading to DKA. Some of the warning signs of DKA include:

• Drowsiness
• Elevated blood sugar
• High blood sugar levels
• High ketones
• Frequent urination
• Dry mouth
• Increased thirst
• Dry or flushed skin
• Nausea
• Vomiting
• Abdominal pain
• Shortness of breath
• Fruity breath
• Confusion