Being unwell can be challenging for anyone, but if you have diabetes, illnesses like colds, the flu, or infections can complicate your condition. During illness, your body responds differently, often causing fluctuations in blood sugar levels. Managing diabetes while you're sick requires special attention to keep your blood glucose levels under control and to prevent complications.
This guide will help you understand how illness affects diabetes and provide practical tips on managing your condition when you're not feeling your best.
How Illness Affects Blood Sugar Levels
When you're ill, your body releases stress hormones, such as cortisol, to fight off the infection. These hormones can make it harder for insulin to work effectively, causing blood sugar levels to rise. This effect can be particularly pronounced if you have an infection, fever, or are feeling severely unwell. High blood sugar levels, in turn, can weaken your immune system, making it harder to recover from illness.
Some symptoms of illness, such as vomiting or diarrhea, can also cause dehydration and affect blood sugar control, potentially leading to dangerous conditions like diabetic ketoacidosis (DKA) for those with type 1 diabetes, or hyperosmolar hyperglycemic state (HHS) for those with type 2 diabetes.
This interaction between illness and blood sugar levels means that you need to be extra vigilant when you're unwell.
Steps to Take When You’re Sick
Managing diabetes while you're sick requires a proactive approach to prevent complications and ensure your blood sugar levels stay within a safe range. Here are key steps to follow:
1. Monitor Your Blood Sugar More Frequently
When you're feeling unwell, check your blood glucose levels more often than usual. Aim to check your levels every 4-6 hours, or more frequently if recommended by your healthcare team. This helps you catch any rapid changes and respond quickly if your levels are too high or too low.
- Keep a record of your blood sugar readings and any symptoms you're experiencing. This can help your doctor if you need to seek medical advice.
2. Keep Taking Your Medications
Even if you're not eating as much or are feeling nauseous, it's important to continue taking your insulin or diabetes medications. Illness can cause blood sugar to spike, even if you're eating less, so stopping your medication can lead to dangerous complications.
- Adjusting insulin: You may need to adjust your insulin dosage during illness. Consult your healthcare provider about any changes in your insulin needs when you're sick.
3. Stay Hydrated
Dehydration can worsen blood sugar control and increase the risk of complications like diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). Drink plenty of fluids to stay hydrated, even if you don't feel thirsty.
- Choose water, broth, or sugar-free drinks to avoid raising your blood sugar further.
- If you’re vomiting or have diarrhea, rehydration solutions like oral rehydration salts (ORS) can help replenish electrolytes.
4. Adjust Your Food Intake
If you're able to eat, try to stick to your usual meal plan as much as possible. If you’re struggling to eat regular meals due to nausea or loss of appetite, aim to eat small portions of foods that are easy to digest, such as:
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Plain toast or crackers
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Soup or broth
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Yogurt or sugar-free pudding
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Smoothies or meal replacement drinks
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Carbohydrate intake: Even if you’re eating less, it's important to maintain some carbohydrate intake to prevent hypoglycemia (low blood sugar).
5. Check for Ketones (If You Have Type 1 Diabetes)
If you have type 1 diabetes and your blood sugar is above 13.9 mmol/L (250 mg/dL), it's crucial to check your urine or blood for ketones. Ketones are chemicals that the body produces when it burns fat for energy due to a lack of insulin. High levels of ketones can lead to diabetic ketoacidosis (DKA), a serious condition that requires immediate medical attention.
- When to seek help: If you have moderate to high levels of ketones, or if you're unable to bring your blood sugar down, contact your healthcare provider or go to the emergency room.
6. Rest and Take It Easy
Your body needs extra energy to fight off illness, so it's important to rest and avoid strenuous activities while you're unwell. Giving your body time to recover will help manage both your illness and your blood sugar levels.
Signs of Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS)
People with diabetes, particularly those with type 1 diabetes, need to be aware of the signs of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), as these conditions can develop quickly during illness.
Signs of DKA (Type 1 Diabetes)
- Nausea and vomiting
- Stomach pain
- Rapid breathing
- Fruity-smelling breath
- Extreme tiredness or confusion
- High levels of ketones in urine or blood
DKA is a medical emergency that requires immediate treatment. If you experience any of these symptoms, seek medical help right away.
Signs of HHS (Type 2 Diabetes)
- Blood sugar levels over 33.3 mmol/L (600 mg/dL)
- Excessive thirst and dry mouth
- Warm, dry skin with no sweating
- Extreme weakness or drowsiness
- Confusion or hallucinations
- Seizures or coma in severe cases
HHS is also a medical emergency, and immediate hospital care is essential to prevent serious complications.
When to Seek Medical Help
If your illness is causing uncontrolled blood sugar levels or if you're unable to manage your symptoms at home, it's important to seek medical attention. Here are key signs that you should contact your healthcare provider or go to the hospital:
- Your blood sugar stays consistently high (above 13.9 mmol/L or 250 mg/dL) despite taking insulin or medication.
- You’re unable to keep food or fluids down due to vomiting or diarrhea for more than 24 hours.
- You have moderate to high ketones in your urine or blood.
- You're feeling extremely weak, confused, or have difficulty breathing.
- You develop a fever that doesn't improve with over-the-counter medications.
Preventing Illness
While it’s impossible to avoid all illnesses, especially during cold and flu season, there are steps you can take to reduce your risk:
- Get vaccinated: Annual flu shots and the pneumococcal vaccine are especially important for people with diabetes, as illnesses like the flu and pneumonia can cause serious complications.
- Practice good hygiene: Wash your hands regularly and avoid close contact with sick individuals to minimize the spread of infections.
- Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and getting enough sleep can strengthen your immune system and reduce your risk of getting sick.
Final Thoughts: Staying in Control During Illness
Illness can make managing diabetes more challenging, but with the right approach, you can keep your blood sugar levels under control and reduce the risk of complications. By monitoring your blood sugar frequently, staying hydrated, and adjusting your medication as needed, you can effectively manage your diabetes even when you're feeling under the weather. If you're ever unsure or concerned about your symptoms, don't hesitate to seek advice from your healthcare provider.
With careful planning and awareness, you can navigate periods of illness while keeping your diabetes in check.