How to Manage Diabetes When You Are Sick

Tips for Sick Days

A person with diabetes tests his blood.
A person with diabetes tests his blood. Emre Eldemir/Getty Images

Managing diabetes when you are feeling sick or ill can be difficult for multiple reasons. Any illness acts as a stressor to the body and can cause blood sugars to rise making controlling sugars more difficult. Illness can also interfere with the blood glucose lowering affects of insulin, which can also result in high blood sugar. In addition, if you're sick with a stomach bug or flu, it's hard to keep a good schedule for eating and taking medications, especially if you have trouble keeping food or drink down.


Sometimes when people are sick, blood sugars can rise to dangerous levels. Dangerously high blood sugar levels can cause ketoacidosis (more common in those persons with Type 1 diabetes) or hyperosmolar hyperglycemic nonketoic coma (more common in those with Type 2 diabetes). Knowing what to do when your blood sugar is dangerously low or high is very important and can be life-saving. 

The best way to handle a sick day is to be prepared. Being knowledgeable about what to do and how to handle the situation can make you feel more safe and relaxed and prevent an emergency. Make sure your caretaker or someone close to you also knows how to handle sick days too. In addition to knowing how to handle extremely high and low blood sugars, your loved one should also be equipped with your physician phone numbers, hours of operation, as well as what medications you are taking and when you are scheduled to take them.

Follow these guidelines to keep safe and prevent emergencies during times of illness: 

  • Call your health care provider if you have moderate to large amounts of ketones in your blood
  • Take your insulin or oral diabetes medications as scheduled unless your blood sugar is much lower than usual
  • Try to eat small amounts of food every 3 to 4 hours to keep your blood glucose levels as normal as possible
  • Drink plenty of fluids
  • If you can't hold anything down, or are sick for more than 24 hours, call your healthcare provider or go to the emergency room

Things to call your doctor about:

  • Illness that lasts longer than 1 or 2 days
  • Fever
  • Severe nausea, vomiting and/or diarrhea
  • Abdominal pain
  • Rapid or labored breathing
  • Excessive urination or thirst
  • Dehydration
  • Presence of ketones (moderate to high) 
  • Worsening symptoms

If it's after hours or late at night and your doctor is not available, take a trip to the emergency room.

It's also a good idea to keep handy an updated list of all medications you take and a schedule of when you take them. This way, healthcare providers can know your medication history at a glance. Include both diabetes medications and any others, including over-the-counter drugs and vitamins.


American Diabetes Association. Accessed on-line. March 28, 2016:

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