Updated: Apr 28
Managing diabetes can be complicated but with the right support and knowledge it is very manageable. Living with diabetes has a lot of similarities to living without diabetes. If you want to be healthy you have to watch what you eat, exercise regularly, and take precautions when you’re sick. Because no matter how well we take care of ourselves we all get sick once in a while. This blog will focus on what you need to know about managing diabetes while you are sick.
When we are sick our body produces a lot of responses that are meant to help fight off the illness. With respect to diabetes, our body increases glucose production to maintain our normal body functions. This happens regardless of whether we are eating or not, because when we are sick, we generally have a decreased appetite. Another key thing to keep in mind is that when we are sick, we can become dehydrated. This can be due to vomiting, diarrhea, or decreased fluid intake.
The goals to managing diabetes while sick include:
- Prevention of hyperglycemia (high blood sugar)
- Prevention of hypoglycemia (low blood sugar)
- Maintain hydration
- Treat the illness
Prevention of hyperglycemia and hypoglycemia
The best thing you can do to help prevent hyperglycemia and hypoglycemia is to test your blood sugar levels often (every 2-4 hours) during the days that you are sick. More frequent testing will give you information on your current sugar levels and help you manage them before they get too high or too low. For most people your optimal range is between 4-7 mmol/L fasting and between 5-10 mmol/L 2 hours after eating.
As mentioned before, our body will be increasing glucose production when we are sick to ensure our vital body functions are maintained. So even if we have no appetite when sick, our glucose levels may be higher than expected. If you are taking insulin it is important to make sure you continue to take your insulin, but adjustments maybe necessary based on our glucose readings (more if it is high and less if it is low). Talk to your health care team to help you adjust your insulin if you’re not sure.
Diabetic Ketoacidosis is a rare condition that can occur when our glucose levels are extremely high (usually > 14 mmol/L). This can present as nausea, vomiting, abdominal pain. It is caused by the breakdown of fats to produce energy which also produces ketones which can lead to increased acidity of the blood. This can be fatal if not treated (usually treated with insulin). If you have high glucose levels and vomit twice or more within 12 hours, you need to get this treated (may require a trip to the emergency room if severe).
To prevent low blood sugar levels, make sure you test often while sick and try to eat regular meals. If you cannot tolerate solid foods, then incorporate glucose-containing fluids during meal times.
It is very important to make sure we stay hydrated. Our bodies are made up of 60-70% water and is vital for many body functions. When the body is dehydrated this can lead to increased insulin resistance and decrease the elimination of glucose through urine. Try and drink plenty of glucose-free fluids when we are sick to stay hydrated.
Medications to avoid while sick?
There is a list of medications that should be avoided/stopped temporarily while sick because it can worsen your kidney function and put you at higher risk of side effects. Diabetes Canada has a Sick-Day Medication List. Their acronym is SADMANS. You can review the list for your knowledge but always talk to your health care team to determine the best plan for your medications while sick. 
The key takeaways on how to manage your diabetes while sick include:
- Keep taking your insulin if you’re on it but adjustments maybe necessary
- Test your glucose levels more frequently
- Stay hydrated
- Stop certain medications temporarily
- Talk to your health care team to develop a plan to manage your diabetes while sick
Read our other blogs for more information on how to live and optimize your health. Check out the services we offer. And as always, let’s optimize your health and feel great.