Medication Guide App

Managing Diabetes During Sick Days

What is sick day management?

Sick day management is a plan you develop with healthcare providers to control your blood sugar level when you are sick.

Why do I need a sick day plan?

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 such as the following:

  • Diabetic ketoacidosis (DKA): DKA is a condition that forces your body to use fat instead of sugar for fuel. DKA happens when blood sugar levels get very high. Fat leaves a chemical called ketones as it is broken down. Ketones are dangerous at high levels. DKA can lead to coma and is life-threatening if not treated.

  • Hyperosmolar hyperglycemic syndrome (HHS): Your body becomes severely dehydrated, which prevents you from getting rid of extra glucose through your urine. HHS can cause serious health problems and is life-threatening if not treated.

What steps should I follow during sick days?

  • Medicines: Do not stop using your diabetes medicine or change your usual dose. 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. Talk to your healthcare provider before you take any over-the-counter medicines.

  • 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.

Which foods should I eat?

If your stomach is upset or you are vomiting, the following are foods may be easier to eat. Each of the foods listed below 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

When should I contact my healthcare provider?

  • 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.

When should I seek immediate care or call 911?

  • 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.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 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.

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