Diabetes and Sick-Days

No one likes to get sick. but if you’ve got diabetes, you need to take extra care of yourself when you do. When you are sick, your body reacts by releasing hormones and other substances to fight the infection. These hormones can raise blood sugar levels and at the same time make it more difficult for insulin to bring your blood sugar levels back to normal. When you have diabetes, even a minor illness can lead to dangerously high blood sugar level. This may cause life-threatening complications, such as diabetic ketoacidosis or a hyperosmolar state.

There are many things that you can do to prevent this.

Plan ahead

Work with your doctor to make a sick-day plan for yourself or for your child with diabetes. Discuss your target blood sugar goal during an illness. If you are on insulin treatment, you should discuss how to adjust your insulin doses according to your blood glucose levels and when you should contact your doctor for additional help. Also, make sure you know how to check both blood sugar levels and ketones in your urine. It is advisable for you to check your blood sugar levels more often than normal during the time that you are sick. Keep your sick day plan in a convenient place, and include your doctor’s contact information in case you need to reach him/her at night or on the weekends.

When should I seek help?

You should reach out to your doctor or seek additional help if:

  • You have not gotten better after 24 to 48 hours or have a fever that is not relieved with medication.
  • You are vomiting or have diarrhea for more than 6 hours.
  • Your blood sugar levels stays above 240 mg/dL (13.9 mmol/L) even after taking additional insulin per your sick day plan.
  • You have symptoms of diabetic ketoacidosis or dehydration. Symptoms include trouble breathing, fruity breathy, chest pain, and extreme fatigue.
  • You have a large amount of ketones in your urine.
  • You are unsure of your condition or how to manage your sickness for any reason.

What You Need to Know if You are Being Treated with Insulin

The below applies to people with Type 1 and Type 2 Diabetes as some patients with Type 2 will be on insulin therapy at  a later stage in life.

  • If your blood sugar level rises above 240 mg/dL (13.9 mmol/L) and your doctor has told you to take an extra insulin dose for high blood sugar levels, be sure to take the appropriate amount. If you take insulin and your doctor has not told you to take a specific amount of additional insulin, call them for additional advice.
  • According to your sick day treatment plan you may need to increase your insulin dose to lower blood sugar levels so be sure to review this with your doctor.
  • Always test for ketones during illness. If you have ketones in your blood or urine it is a sign that your body is short of insulin and that you need to increase your insulin dose.
  • Check for ketones every 2 – 4 hours. Increasing levels of ketones means an increased risk of DKA.


  • Write up a sick day plan with your doctor to prepare yourself in the case that you do fall ill. This plan should include specific information on how to adjust your insulin if it is one of your current medications.
  • Continue taking your treatment for diabetes specifically insulin, even if you are sick. Your blood sugar will continue to rise because of your illness. There are some oral medications that may need to be stopped if you are severely dehydrated so be sure to seek your doctor’s advice.
  • Try to eat your normal diet to keep your calorie intake up. If you are unable to eat solid foods replace them with liquid and soft foods such as soups.
  • Drink plenty of extra fluids such especially water, soup broth, carbonated drinks, and fresh juice. Increasing the amount of fluids will help prevent dehydration. As a rule of thumb you should drink approximately one glass of fluid every hour.
  • Check your blood sugar level every three to four hours, or more often if it is rising quickly, even through the night.
  • Don’t take any nonprescription medications without talking with your doctor. Many nonprescription medications will affect your blood sugar level
  • For more information on Diabetes and Sick days, call Dasman Diabetes Resource Hub Team (DDRH) on 2226 0006 and ask our HealthCare Advisors.