Diabetes Sick-Day Plan: Care Instructions

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Your Care Instructions

If you have diabetes, many other illnesses can make your blood sugar go up. This can be dangerous. When you are sick with the flu or another illness, your body releases hormones to fight infection. These hormones raise blood sugar levels and make it hard for insulin or other medicines to lower your blood sugar.

Work with your doctor to make a plan for what to do on days when you are sick.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Work with your doctor to write up a sick-day plan for what to do on days when you are sick. Your blood sugar can go up or down, depending on your illness and whether you can keep food down. Call your doctor or nurse call line when you are sick, to see if you need to adjust your pills or insulin.
  • Write down the diabetes medicines you have been taking and whether you have changed the dose based on your sick-day plan. Have this information ready when you call your doctor or nurse call line.
  • Eat your normal types and amounts of food. Drink extra fluids, such as water, broth, and fruit juice, to prevent dehydration.
    • If your blood sugar level is higher than your doctor recommends [for example, above 14.0 millimoles per litre (mmol/L)], drink extra liquids that do not contain sugar, such as water or sugar-free cola.
    • If you cannot eat your usual foods, drink extra liquids, such as soup, sports drinks, or milk. You may also eat food that is gentle on the stomach, such as crackers, gelatin dessert, or applesauce. Try to eat or drink 50 grams of carbohydrate every 3 to 4 hours. For example, 6 saltine crackers, 1 cup of milk, and ½ cup of orange juice each contain about 15 grams of carbohydrate.
  • Check your blood sugar at least every 3 to 4 hours. Check it more often, even through the night, if it goes up fast. Take insulin if your doctor told you to do so. If you and your doctor did not have a sick-day plan for taking extra insulin, call him or her for advice.
  • If you take insulin, check your urine or blood for ketones, especially if your blood sugar is high.
  • Do not take any over-the-counter medicines, such as pain relievers, decongestants, or herbal products or other natural medicines, without talking with your doctor first.
  • Do not drive. If you need to see your doctor or go anywhere else, ask a family member or friend to drive you.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness), or you suddenly become very sleepy or confused. (You may have very low blood sugar.)
  • You have symptoms of high blood sugar, such as:
    • Blurred vision.
    • Trouble staying awake or being woken up.
    • Fast, deep breathing.
    • Breath that smells fruity.
    • Belly pain, not feeling hungry, and vomiting.
    • Feeling confused.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are sick and cannot control your blood sugar.
  • You have been vomiting or have had diarrhea for more than 6 hours.
  • Your blood sugar stays higher than the level your doctor has set for you.
  • You have symptoms of low blood sugar, such as:
    • Sweating.
    • Feeling nervous, shaky, and weak.
    • Extreme hunger and slight nausea.
    • Dizziness and headache.
    • Blurred vision.
    • Confusion.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have a hard time knowing when your blood sugar is low.
  • You have trouble keeping your blood sugar in the target range.
  • You often have problems controlling your blood sugar.
  • You have symptoms of long-term diabetes problems, such as:
    • New vision changes.
    • New pain, numbness, or tingling in your hands or feet.
    • Skin problems.

Where can you learn more?

Go to http://www.healthwise.net/ed

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Current as of: May 23, 2016