Whether it’s the common cold, a stomach virus, the flu, or something more serious, an illness can make managing blood sugars difficult.

The body’s response to illness is complex and includes the release of a variety of hormones—some of which work counter to insulin or work to increase blood glucose levels. This natural stress-response has significant implications and can lead to dangerously high blood sugars. Additionally, if the illness includes nausea and vomiting, it may be difficult to take your diabetes medications.

Generally during an illness, most experts recommend adjusting your target blood sugar level and insulin dosage (if you take insulin). It is best to have your specific plan written down and kept in a convenient place. Be sure to write emergency phone numbers on your sick day plan as well.

10 tips for dealing with diabetes when you're sick

  1. Always take insulin or oral medications. Often extra insulin will be required to adjust for insulin resistance. However, if vomiting and diarrhea are present, less insulin may be needed.

  2. Test your blood sugar frequently throughout the day (every two to four hours), as it can change quickly when you’re sick.

  3. If you can, continue to eat a normal amount of carbohydrates during the day. Liquid carbohydrates (such as sports drinks or broth) may be substituted for solid foods.

  4. If you cannot eat, try to consume at least 15 grams of carbohydrates via clear juice or soda every hour.

  5. If your blood sugar is over 240 mg/dL (13.3 mmol/L), drink extra fluids that do not contain carbs, such as water or sugar-free soda.

  6. If you take insulin, check for ketones every four to six hours, particularly if your blood sugar is higher than 240 mg/dL (13.3 mmol/L). Call your doctor if you have moderate ketones or greater in your urine.

  7. Know the symptoms of diabetic ketoacidosis (DKA): abdominal pain, vomiting, rapid breathing, fruity-smelling breath, or severe drowsiness.

  8. Know the symptoms of dehydration: dry mouth and very yellow or dark urine.

  9. If you have symptoms of diabetic ketoacidosis or dehydration, or if you have blood sugars over 240 mg/dL (13.3 mmol/L) for longer than 24 hours, or are experiencing low blood sugars that persist, call your doctor immediately.

  10. Make sure you’re not alone when you’re sick. If you live alone, arrange to have a neighbor or friend stay with you or check on you frequently.

Bonus tip: foods to have on hand in case of sickness

• Clear broth soups
• Gatorade
• Milk
• Clear fruit juice
• Soft drinks (be sure to avoid caffeine)
• Gelatin
• Saltine or club crackers
• Oatmeal
• Graham crackers
• Popsicles
• Applesauce

Use this knowledge to be prepared the next time you're not feeling well. And take the time to develop a specific plan with your healthcare team for how to manage blood sugars when a sick day strikes.

To learn more about being sick and managing diabetes:

How to Manage Diabetes Complications and Illnesses Simultaneously
7 Tips for When Diabetes Makes You Call in Sick to Work
Managing Diabetes When You're Under the Weather