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Sick-Day Guidelines for People With Diabetes

British Columbia Specific Information

If you have diabetes and you are sick, your risk of having unpredictable blood glucose levels goes up. During these times, it is a good idea to

  • Check your blood glucose levels more often than usual (for example, every 2 to 4 hours).
  • Drink plenty of sugar-free fluids or water.
  • Check for ketones by performing a urine ketone test or blood ketone test.
  • Develop a sick-day plan with your diabetes health-care team. This should include information on:
    • Which diabetes medications you should continue and which ones you should temporarily stop
    • Guidelines for insulin adjustment if you are on insulin
    • Advice on when to contact your health-care provider or go to the emergency room.

For more information see, Diabetes Canada: Stay Safe When You Have Diabetes and Are Sick or at Risk of Dehydration

For non-emergency information or advice, call 8-1-1 to speak with a registered nurse any time of the day, every day of the year.

Overview

What happens when you are sick

If you have diabetes, other illnesses can make your blood sugar go up. This can be dangerous. When you're sick with influenza (flu) or another illness, your body releases hormones to fight infection. These hormones raise blood sugar levels. They also make it hard for insulin or other medicines to lower your blood sugar.

Sick-day guidelines

Work with your doctor to write a sick-day plan for how to help prevent high blood sugar when you're sick. Keep your plan in a handy place, and let your family know where you keep the plan.

Here are some general sick-day guidelines.

  • Take your diabetes medicines as usual.
    • Keep taking your diabetes medicine, even if you vomit and have trouble eating or drinking.
    • If you are vomiting and can't take your medicine, call your doctor. You may need to adjust your medicines.
    • Write down the diabetes medicines you've been taking. Note if you have changed the dose based on your sick-day plan. You can give this information to your doctor if you need to call.
  • Keep eating and drinking.
    • Try to eat your normal types and amounts of food. Drink extra fluids to prevent dehydration.
    • If you can't eat your usual foods, drink extra liquids, such as soup, low-sugar electrolyte replacement solutions, or milk. You may also eat food that's gentle on your stomach, such as bananas, rice, crackers, gelatin, or applesauce.
    • If you are not able to eat the foods in your regular diet, try to eat and drink light foods or fluids that contain 15 grams of carbohydrate every hour. Examples of light foods and fluids that contain 10 to 15grams of carbohydrate include: 1 slice of bread or toast, 7 soda crackers, 1 medium size fruit, 1 popsicle, ½ cup unsweetened applesauce, ½ cup regular jello, ½ cup 100% fruit juice, ¾ cup regular pop, or 1 cup hot tea with a tbsp. of honey. 
  • Check your blood sugar.
    • Test your blood sugar at least every 2 to 4 hours. Check it more often, even through the night, if it goes up fast. Continue to test your blood sugars even if you are not able to eat.
    • Take insulin if your doctor told you to do so. If you don't have a sick-day plan for taking extra insulin, call your doctor for advice.
  • Do ketone testing if needed.

    If you take insulin, do a test for ketones, especially when you have high blood sugar. Some home blood sugar meters can also measure blood ketones.

  • Be careful with over-the-counter medicines.

    Don't take any non-prescription medicines unless you talk to your doctor first. Many non-prescription medicines can affect your blood sugar level.

  • Know when to contact your doctor.

    Minor illnesses in people with diabetes (especially children with type 1 diabetes) can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need medical attention right away.

    • Your doctor will tell you what signs to watch for and what blood sugar level they recommend.
    • Keep your doctor's contact information handy. And be sure you know how to reach your doctor at night or on weekends.

Credits

Adaptation Date: 6/14/2023

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC