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Tips To Control Glucose On Sick Days

Nina Ghamrawi, MS, RD, CDE
June 3, 2024
June 10, 2024

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. Here, we will discuss what to do when you are sick to anticipate glucose changes, and know better when your symptoms and glucose ranges are more serious.

More importantly, bacteria feed off of sugars, so if your glucose was already high before you got sick, it may take you longer to get over your illness than if glucose was normal. As we head into cold and flu season, keep your glucose as controlled as possible to reduce your duration of illness.

Here are some tips about how to manage blood sugar during sick days:

  1. Test your blood glucose more frequently: every 2-4 hours for people with type 1 diabetes, every 4 to 6 hours for people with type 2 diabetes or as your healthcare provider’s recommendation.
  2. Measure your urine ketones more often, especially if you are using insulin: every 4 hours (type 1 regardless of your blood glucose levels) and every 6 hours (type 2, especially when blood glucose persistently higher than 300 mg/dl).
  3. Contact your healthcare provider to find out whether your medications need to be adjusted during your illness. However, DO NOT change your medications without notifying your physician.
  4. Because over-the-counter medications can affect your blood glucose levels, consult your physician or pharmacist which ones are safe for you to use before taking them.
  5. A high blood sugar level can cause you to urinate more, keep hydrated by drinking more fluids, such as water or broth.
  6. If you are not able to eat or drink as your normal routine, pay more attentions to signs of low blood glucose (hypoglycemia). Check your blood glucose more frequently and try to have foods or fluids containing carbohydrates every 2-3 hours.
  7. Keep track of your insulin intake, medication use, blood glucose, and ketone results so the provider can make better decisions for treatment.

Most importantly, contact your healthcare provider or seek medical care, if you have:

  • Persistent nausea, vomiting or diarrhea
  • Prolonged fever or worsening signs of infection
  • Difficulty breathing
  • Chest pain
  • Signs of confusion or disorientation
  • Blood glucose level consistently above 240 mg/dl
  • Urine or blood ketones above normal

When you have questions about your conditions and medications, contact your healthcare provider as soon as possible and not to wait until your symptoms get worse or life-threatening. When in doubt or if you can’t reach your provider, go to an urgent care clinic or Emergency Department.​ Stay safe!

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