When you get sick with things like colds or the flu, the illness and stress from it causes your body to release hormones that raise blood sugar (blood glucose) levels, making it harder to keep your blood sugar in your target range. 

And while having diabetes does not make you more likely to get a cold or flu, it does raise your chances of getting seriously sick. Having a plan for sick days ahead of time will help you manage your diabetes and will make additional complications less likely. 

One thing to keep in mind is to be sure you’re getting enough water—so drink plenty of it. If you’re having trouble keeping water down, have small sips every 15 minutes or so throughout the day. 

You’ll also want to be sure to get your annual flu shot to make getting the flu less likely.

Manage your blood sugar

Being sick can make it hard to eat. Having simple carbs handy like regular soda, Jell-O, or popsicles will help keep your blood sugar up if you are at risk for lows. Use the 15-15 rule to treat the lows you may have. Making sure your blood sugar remains in target is one of the best ways to help your body deal with sickness.

Watch for signs of DKA

If your body does not have the proper amount of insulin, you run the risk of your body producing too many ketones, which puts you at risk of developing a serious condition called diabetic ketoacidosis (DKA). We recommend testing for ketones every four to six hours when you’re feeling sick.

The following are warning signs of DKA. If you experience any of these, contact your doctor immediately. 

• High blood glucose
• High ketones
• Thirst or dry mouth
• Frequent urination
• Drowsiness
• Dry or flushed skin
• Nausea, vomiting, or abdominal pain
• Difficulty breathing
• Fruity odor on breath
• Confusion

NOTE: Severe DKA that goes untreated can cause coma or death.

Have a plan

Before you get sick, decide on an action plan with your health care team. This plan should include the following:

• When to call your doctor (in most cases if you are vomiting or have diarrhea more than three times over 24 hours or have had a fever over 101° for 24 hours).
• How often to check your blood sugar.
• What foods and fluids to take during your illness.
• How to adjust your insulin or oral medication, if you need to.
• If and when you need to check for ketones.
• Discuss what over the counter medications you should use for colds, flu, etc. Some can raise your blood sugar or affect your usual medications.

After you’ve discussed these topics with your diabetes care team, be sure to write your plan down to reference when you’re feeling sick. You will also want to keep a list of emergency information such as your doctor’s phone number, a list of medications you’re taking, and your insurance information. 

Create a Sick-Day Kit

If you do get sick, it'll make things easier if you already have a sick-day kit ready to go with the things you'll need. You might want to include:

• A glucose meter
• Extra batteries
• Supplies for your insulin pump or continuous glucose monitor
• Ketone test strips
• A week’s worth of glucose-lowering medication (don’t store these longer than 30 days before use)
• Glucose tabs or gels
• Flu or cold medications that won’t disrupt your diabetes management