Diabetes Sick-Day Plan

Infections like the cold and flu can cause your blood sugar to rise. Eating less or experiencing nausea and vomiting may cause your blood sugar to fall. Ask your health care provider to help you make a sick day plan.

Plan ahead for an illness

Tell one or two friends or family members about blood sugar monitoring and the types of symptoms that require emergency care. Put together a “sick box” with medicines and easy-to-fix foods. It’s best to gather these items before you need them. We recommend putting a copy of the sick-day plan in the box.

Dont's

  • Don’t stop taking your diabetes medicine.
  • Don't take other medicines without your provider’s guidance. This includes cold and flu medicines.

Do's 

  • Eating. Stick to your meal plan if you can. If you can’t eat, try fruit juice, regular gelatin or frozen juice bars as directed by your health care provider.
  • Drinking. Drink at least one glass of liquid every half hour. If you’re eating, these liquids should be sugar-free.
  • Checking blood sugar. Check your blood sugar as often as your health care provider tells you to do so. Your provider may suggest checking it more often than usual.
  • 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 and can happen to anyone with diabetes — most commonly for those with type 1 diabetes. While it’s very rare for those with type 2 diabetes, it can be a concern if you’re taking an SGLT-2 inhibitor.
  • Taking diabetes medicines.
    • Adjust your insulin based on your sick day plan. Don't skip insulin — you need it even if you can't eat your normal meals.
    • If you take oral pills for diabetes, take your normal dose unless your health care provider instructs you otherwise.
  • Choosing sugar-free medicines. Look for sugar-free cough drops and other medicines. Ask your health care provider if it’s okay for you to take these.
  • Getting help. If you're alone, ask someone to check on you several times a day.

When to call your health care provider

Call your health care provider if you have any of the following:

  •  You vomit or have diarrhea for more than six hours.
  • Your blood sugar level is higher than usual — or more than 250 mg/dL — even after you’ve taken extra insulin (if recommended in your sick day plan).
  • You take oral medicine for diabetes and your blood sugar is higher than usual — or over 250 mg/dL — before a meal and stays that high for more than 24 hours.
  • Your blood sugar is lower than usual 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 two days.
  • You can't stay awake or think clearly.