Living with Diabetes: Managing Your Glucose on Sick Days

​Nobody enjoys being under the weather. But sick days can take a greater toll on individuals who suffer from diabetes. 

Common illnesses such as flu, cold, cough, and mild fever can put stress on an individual’s body. This stress releases hormones that affect one’s blood sugar (ie. glucose) levels, making it harder to keep one's blood sugar within a healthy range. Additionally, the stress could also dehydrate the body even if one hydrates regularly. In turn, this puts the body at greater risk of other illnesses. 

When sick, a diabetic individual may experience either:

3 Simple Rules to Manage Your Sick Days

1. Check your blood glucose levels

As stress affects one's glucose levels, test your blood glucose level more frequently if you are under the weather. Aim to test about 4-6 times a day and seek to get a blood glucose reading of 4-8 mmol/L before each meal.

Try to take regular meals even if your appetite is low. If your blood glucose level is slightly low but still in range (4-5 mmol/L), and you are able to keep food down, try to consume food that contains carbohydrates and is easier to digest. Here are some ideas:

However, if your blood glucose level falls to less than 4 mmol/L, that indicates hypoglycaemia (low blood glucose). Apply the 15-15 Rule and consume 15g of quick-acting carbohydrates like these:

2. Keep the body hydrated

Dehydration is one of the most common causes of illnesses. And when you are feeling unwell, you may fall short on your optimal water intake. 

Hydration is crucial to recovery. So be sure to hydrate your body with the following: 

• If your blood sugar level is high (more than 8 mmol/L), stay hydrated by sipping sugar-free fluids. 
• Then again, if you are experiencing low blood glucose due to poor appetite, consume fluids that contain sugar like fruit juice
  

3. Maintain your medications

Diet aside, diabetes medications are crucial in managing one's blood sugar. 

The doctor's advice would differ from patient to patient. But here's a broad overview of how one can expect to adjust one's medication on sick days:

A. Insulin

Do not stop your insulin injections if you take them for type 1 diabetes. However, your doctor may advise a higher dose of insulin if you notice a spike in your blood glucose levels. 

Likewise, if your blood sugar levels are still more than 10 mmol/L 24 hours after you first fell ill, your doctor may instruct you to increase your insulin intake (eg. 10%). This is true for individuals who take more than 1 dose of insulin a day as well. 

B. Sulphonylurea tablets

Tablets such as Gliclazide, Glipizide, Glibenclamide, Tolbutamide, and Glimerpiride work by increasing the body’s production of insulin regardless of the blood glucose level. 

Make sure you take regular meals if you take any of these tablets. Consider eating carbohydrates such as fruit, rice porridge or fruit juice as they are easier to digest.  

If you are unable to eat due to nausea, your doctor may advise you to halve your tablet or omit it completely while you recover.

C. SGLT2 inhibitors

SGLT2 inhibitors include tablets such as Empagliflozin, Dapagliflozin, and Canagliflozin. These tablets work by increasing the amount of glucose passed in the urine. 

In turn, this results in more water loss through urine when one is sick, which could increase the risk of dehydration. Plus, these tablets may also heighten the risk of acid (ketones) which form in the blood when one is ill. 

Stay well-hydrated as you recover and do not neglect your meals. 

If you are unable to eat and drink, your doctor or diabetes nurse educator may instruct you to stop your tablet intake temporarily.

Finally, be sure to consult your doctor about whether and how you may need to adjust your diabetes medication if you ever fall ill. Download a copy of this article as a reference:

Managing Your Glucose Levels on Sick Days.pdf