Health Library

How to Manage Diabetes During Illness

Battling a cold, getting over an injury or undergoing surgery is no fun for anyone. For people with diabetes, managing blood sugar is an extra concern. The stress of illness or injury can cause blood sugar to rise and make insulin less effective. This can lead to serious problems, including diabetic coma. That’s why it’s important to know what to do when illness strikes.

Manage medicine

When you’re sick, your blood sugar can be high even if you’re not eating much. So it’s especially important to take your diabetes medicine on time. You might need extra medicine. If you take diabetes pills, you may also need to take insulin until you’ve recovered. And if you already take insulin, you may need more than usual.

Monitoring glucose

When you’re ill, check your blood glucose often. Have someone help you if you can’t do it yourself. You may need to check ketones, too. Record the results in case you need to report them to your healthcare provider.

Food and fluids

Try to follow your diabetes meal plan. Drink plenty of calorie-free fluids, especially water. These fluids help rid your body of extra glucose and prevent dehydration. If you can’t eat or keep down enough solid food, you may need to have some soup or drink beverages that contain sugar, such as apple juice. Talk to your healthcare provider if you have questions about your food and beverage intake. 

Be prepared

The best way to cope with illness is to develop a sick-day plan before you get sick. Work with your diabetes care team to find out what type of diabetes medicine to take while sick and how much you will need. Ask how often you should check blood glucose and ketones. Check with your healthcare provider about over-the-counter, sugar-free cold medicines that are safe for you to take. Also list alternative food and beverage choices for when you can’t eat normally and have some on hand. Include the phone numbers of your diabetes care team so that you can reach them quickly if needed. Some diabetes care teams want their ill patients to call every day for instructions.  

When to get help

According to the American Diabetes Association, you should call for help if:

  • You feel sleepy and can't think clearly

  • You can't eat for more than 6 hours and can't keep any food down

  • You lose 5 or more pounds (when you're not trying to lose weight)

  • Your temperature increases to over 101° F (38° C)

  • You feel sick or have fever several days and aren't getting better 

  • Your blood glucose stays over 240 mg/dL even with extra insulin 

  • You have trouble breathing

  • You have diarrhea or vomiting for more that 6 hours

  • You have ketones in your urine or your breath smells fruity 

With a plan in place, you’ll have peace of mind the next time illness or injury lays you low.