Medication Guide App

Managing Diabetes During Sick Days


Sick day management is a plan you develop with healthcare providers to control your blood sugar level when you are sick. Your blood sugar level can rise because of stress from illness, surgery, or injury. Your plan will help prevent high blood sugar levels and other serious health conditions.



  • Keep using your diabetes medicine or insulin. Do not change your usual dose. Diabetes medicine and insulin are needed to lower your blood sugar levels. If you normally do not use insulin, you may need to use it while you are sick. If you already use insulin, you may need to increase the amount you take. Your healthcare provider will tell you if you need to make changes to how you use your diabetes medicine or insulin.

  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

What to do during sick days:

  • Blood sugar checks: Check your blood sugar level more often than usual. If you have type 2 diabetes, check at least 4 times each day. If you have type 1 diabetes, check every 4 hours.

  • Ketone checks: Check your urine or blood for ketones. Ask your healthcare provider which type of ketone testing is best for you. Ketone urine test kits are sold in pharmacies and some stores. You can also buy a meter to check the amount of ketones in your blood. Ask when and how often to check ketones. Do not exercise if you have ketones in your urine or blood.

  • Liquids: Drink about 8 ounces (1 cup) of liquid each hour. Drink liquids that do not contain sugar. Ask your healthcare provider which liquids are best for you.

  • Food: Follow your usual meal plan as closely as possible. If you cannot follow your meal plan, eat other foods that are easy for your body to digest. If you are eating less food than normal or cannot eat any foods, drink liquids that contain calories.

  • Inform others: Your sick day plan may change over time based on your needs. Tell others who help you while you are sick about your sick day plan. Put your plan in a place that is easy to find.

What to drink and eat while you are sick:

Keep these items ready for sick days. Each of the items has about 10 to 15 grams of carbohydrate:

  • Liquids:

    • ⅓ to ½ cup of fruit juice

    • ½ cup of regular soda

    • 1 cup of milk

    • 1 double-stick popsicle

    • 1 cup of a sports drink

  • Foods:

    • ½ cup of regular gelatin or cooked, hot cereal

    • ½ cup of sugar-free pudding or ¼ cup of regular pudding

    • ½ cup of mashed potatoes, macaroni, or noodles

    • ¼ cup of sherbet

    • ½ cup of regular ice cream

    • 1 slice of dry toast, 6 saltine crackers, or 3 graham crackers

Contact your healthcare provider if:

  • You are vomiting or have diarrhea.

  • You have a fever.

  • Your ketone level is higher than healthcare providers have told you it should be.

  • Your blood sugar level is higher than healthcare providers have told you it should be.

  • You have questions or concerns about your condition or care.

Return to the emergency department if:

  • You cannot keep food and liquids down at all for a few hours.

  • You have trouble breathing.

  • You are drowsy or confused.

  • Your mouth or eyes are dry.

  • You are breathing faster than normal for you.

  • Your heartbeat is faster than normal for you, or your heart is pounding.

  • You have leg cramps.

  • You are weak or dizzy.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.