What To Do For Sick Days

Any kind of illness or infection stresses your body. This includes the sort of respiratory infection that gives you a cold and the viruses that cause the flu. When you are sick, whether it is a head cold, the flu, or a stomach virus, your body is stressed. Your body reacts to stress by releasing a cocktail of hormones that helps you fight disease. These so-called stress hormones may cause the liver to release glucose and inhibit the effect of insulin. The net result is that blood glucose levels rise. If not taken care of, these high blood glucose levels can lead to life-threatening situations. An important aspect of handling sick days is to plan ahead and keep a close watch on your blood glucose levels.

Here are some rules for taking care of yourself:

• Test your blood sugar every 4 hours. Write down the results of the tests.
• Keep taking your diabetes medicine as directed. Consult your health care provider if you have diarrhea or vomiting.
• Never skip an insulin dose. Your doctor may even suggest taking an extra dose of insulin when you are sick.
• Drink plenty of fluids.
• Try eating crackers, jello, popsicles, or soup if you can't eat your usual food.
• Drink clear liquids such as ginger ale if you can't eat at all. You can eat or drink something with sugar in it if you have trouble keeping food down.
• Test your urine for ketones if: your blood sugar is over 240, you can't keep food or drink down, or you are losing weight.
• Talk to your doctor or dietitian about what foods you should eat when you are sick, and when you should eat them.

If you are sick, you probably feel awful. It is hard to know when you are feeling bad because of your cold, or whether there is a problem with your diabetes or blood glucose control. You should call your doctor if you experience any of the following:

• You have been sick for 1 or 2 days without any improvement.
• You have had vomiting or diarrhea for more than 6 hours.
• You are taking insulin and your blood glucose levels continue to be above 250 mg/dl, even though you have taken two or three supplemental doses of regular insulin. Discuss with your doctor in advance about just how much extra insulin you need to take on sick days.
• You are taking insulin and your blood glucose level is under 60 mg/dl.
• You are controlling your type 2 diabetes with oral agents and your blood glucose levels are 250 mg/dl for more than 24 hours.
• You have any signs of severe hyperglycemia (very dry mouth, fruity odor on your breath, dehydration, confusion, or disorientation).
• You are sleepier than usual.
• You have any stomach pain, chest pain, or difficulty breathing.
• You have any doubts or questions about what you should be doing for your illness.

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