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Diabetes: Sick-Day Plan

Infections, the flu, and even a cold can cause your blood sugar to rise. And eating less or having an upset stomach (nausea) and vomiting may cause your blood sugar to fall. Ask your healthcare provider to help you make a sick-day plan.

Plan ahead for an illness. Tell 1 or 2 friends or family members about blood sugar monitoring and the symptoms that need emergency care. Put together a sick box with medicines and easy-to-fix foods. Try to gather all these supplies before you need them. Put a copy of the sick-day plan in the box.


Don'ts include:

  • Don’t stop taking your diabetes medicine without advice from your healthcare provider.

  • Don't take other medicines without advice. Check with your healthcare provider first. This includes medicines such as those for colds or the flu.


Man sitting in bed with a cup of soup.

Do's include:

  • Eating. Stick to your meal plan, if you can. Even if you can't eat your normal diet, you may still be able to eat some saltine crackers or dry toast. If you can’t eat, try fruit juice, regular gelatin, or frozen juice bars as directed by your healthcare provider.

  • Drinking. Drink at least 1 glass of liquid every half hour. If you’re eating, these liquids should be sugar-free and caffeine-free.

  • Checking blood sugar. Check your blood sugar as often as your provider told you to do so. You may need to check it more often than normal.

  • Checking ketones. Check your blood or urine for ketones. Ketones are the waste from burning fat instead of glucose for energy. They are a warning sign of ketoacidosis. Ketoacidosis is a medical emergency that can happen to anyone with diabetes, but more commonly seen in type 1 diabetes. It may also be a problem if you are taking a certain type of medicine for type 2 diabetes. This medicine type is called an SGLT-2 inhibitor.

  • Taking diabetes medicines.

    • Adjust your insulin based on your sick-day plan. Don't skip insulin. You need insulin even if you can't eat your normal meals.

    • If you take pills for diabetes (oral medicines), take your normal dose unless your provider tells you something different.

  • Choosing sugar-free medicines. Look for sugar-free cough drops and other medicines. Ask your provider if it’s OK for you to take these.

  • Getting help. If you're alone, ask someone to check on you several times a day. Have your phone available at all times.

Call your healthcare provider

Call your provider right away if you have any of the following:

  • You vomit or have diarrhea for more than 6 hours.

  • Your blood sugar level is higher than normal or more than 250 mg/dL even after you have taken extra insulin (if advised in your sick-day plan).

  • You take oral medicine for diabetes, and your blood sugar is higher than normal or over 250 mg/dL, before a meal and stays that high for more than 24 hours.

  • Your blood sugar is lower than normal or less than 70 mg/dL.

  • You have moderate to large amounts of ketones in your blood or urine.

  • You feel weak standing up. Or you have signs of dehydration, such as dry lips or tongue.

  • You aren’t better after 2 days.

  • You can't stay awake or think clearly.

Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Rita Sather RN
Online Medical Reviewer: Robert Hurd MD
Date Last Reviewed: 12/1/2021
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