Colds, the flu or other illnesses can hit us at the worst of times. When you have diabetes, it’s important to know what to do when you aren’t feeling well in terms of medications and food choices.
If you are sick, but still able to eat:
Take your diabetes medications as usual.
Eat your usual meals and snacks (if you have them) at your usual times if you can.
Test your blood sugar level more often.
If your blood sugars are running higher than normal, try to drink more sugar free fluids, like water, tea, clear broths or diet pops. This can help to flush out some of the extra sugars in your blood.
If you cannot eat your usual meals and snacks, make sure you have one of the following every hour to reduce the risk of a having a low blood sugar, and to help with your hydration:
1/2 cup (125 mL) juice
1/2 cup (125 mL) regular pop
1/2 cup (125 mL) regular Jell-O
1 whole popsicle
You may need to test your blood sugars more often if you are unable to eat or drink. You may need to adjust your insulin or other oral medications.
If you are sick and cannot drink enough fluids to keep yourself hydrated (especially if you have vomiting and diarrhea), call your health care provider or go to your nearest emergency room. Also, you may want to HOLD certain medications as they can cause your kidney function to worsen or result in side effects:
Here is a list of some of the types of medications that may need to be held or adjusted during your illness:
ACE inhibitors or ARBs (ask your provider if you are not sure)
Diuretics (water pills)
Diabetes medications including: Metformin, glyburide, gliclazide (Diamicron MR)
Non-steroidal anti-inflammatory drugs (NSAIDs) (which are commonly found in pain medications like Advil or over the counter cold remedies)
You should speak to your physician, nurse practitioner or pharmacist to determine which of your medications should be stopped when you are ill. It’s usually best to discuss a plan for your medications at your regular diabetes visit before you are ill. That way you have an individualized plan if you become ill.
If you have type 1 diabetes, check for urine ketones every 4 hours. If your level is high, contact your health care provider or go to the nearest emergency room.
The Canadian Diabetes Association website is a great resource for information on sick day management at: www.diabetes.ca