Diabetes and Sick Days: Tips for When You're Under the Weather

Posted by hope on Thu, 01/09/2014 - 14:41 in

Caught the local stomach bug? Got a rotten case of the flu? A bad cold have you sneezing, sniffling and coughing?

When you or your loved one with diabetes feels under the weather extra burdens are added to your daily diabetes balancing act. Simply put by parent Podder Talk blogger Therese Balistrieri, “I dread Joey getting ill.” Another parent Podder Talk blogger, Scott Benner, adds, “Sick days are some of the most challenging.”

A lot of what you learn about handling sick days with diabetes comes from your healthcare providers. You gather general strategies and get the low-down on their how-to’s. But then a sick day strikes and you’re on call to take care of yourself or your loved one. Over time, and after many sick day episodes, you gain expertise, build confidence and become the pro of managing sick days with diabetes.

We’ve reached out to a few front-line managers of sick days (also bloggers), including two parents of kids with diabetes and two women who’ve had diabetes, collectively, for 30 years. They, or their loved ones, wear an insulin pump, which as diabetes blogger Alexis Pollak puts simply, “Is indispensable when I am sick!” Meet them on Podder Talk and read their wise tips below based on different sick day topics.

Alexis Pollak Hauptman


Scott Benner


Emily Viall


Therese Balistrieri


Topic 1: You Can’t Eat or Drink Other than Sips and Swallows

Alexis: “I take tiny sips of clear, sugar-sweetened soda like ginger ale if I just can’t get in any carbohydrate. I do the same if I need to treat a low when I’m sick.”

Scott: “Hydration is key. We try to continually sip water when blood glucoses are in range and we’ll move to a sugar-based sports drink if low blood glucoses become an issue. Small sips are sometimes the only way to take in carbs when feeling sick, especially when nausea is present. Small sips, stay hydrated, get sugar any way that you can when it’s needed."

“Be bold when a bold action is necessary. Otherwise err on the side of caution. Take advantage of moments of hunger and eat.”

Therese: Monitor for ketones with a blood ketone meter and keep them down. Ketone strips to measure urine ketones are also of value, but, Therese points out, “There’s lag time between a blood and urine measure.”

Emily: “Sneak in calories any way you can. Plus, focus on staying hydrated. I fill up a large water bottle and sit it right beside me so I don't forget to drink.”

Topic 2: It’s Cold and Flu Season

Therese and Emily both suggest getting a flu shot every year and early in the season. Since 2010, the Centers for Disease Control and Prevention (CDC) has recommended everyone with diabetes who is at least six months of age or older get the flu shot. Learn more here.

Alexis: “I make sure I have a stash of sugar-free throat lozenges as well as lemon and chamomile tea to soothe my sore throat.”

Therese: “When Joey is ill, we don't leave his side. We follow the sick day chart from our providers to a T.”

Scott: “Be okay with somewhat higher glucose levels, but not too high. For example, I wouldn’t bolus for a reading under 200 on a severe sick day, but I may increase the temporary (temp) basal to nudge it down ever so slightly.”

It’s also a good idea to have a plan in place for an on-call back-up caregiver. Scott says, “To make matters worse, if the illness is a severe one, you may have it too.  A few years ago, both Arden and I had the flu. Having to help her was the only thing that kept me from passing out, but we did it!”

Topic 3: Sick Day Supplies At-the-Ready

Our diabetes bloggers are in agreement on the must-haves to keep on hand during sick days. Find what works for you. Restock after an illness so they’re at-the-ready the next time.

  • Club soda or no-calorie bubbly water for hydration
  • Regularly sweetened soda – cola, ginger ale or lemon lime
  • Clear fruit juice – apple, cranberry or grape (these can be diluted if need be)
  •  Powder form of sports drink
  • Anti-nausea medication
  • Pain reliever suppositories
  • Cans or packages of chicken broth or soup
  • Bread for making toast or plain crackers
  • A supply of extra test strips
  • Ketone strips or meter which tests for blood ketones

Topic 4: Insulin Pump Tricks and Tactics

Alexis: “If I’ve eaten and bolused and then vomit, I turn my basal way down for the remainder for the time I have bolus insulin on board. If I’m running on the high side, which I do when I’m sick, I’ll use a higher temporary basal to keep my levels under control.”

“When you’ve got an upset stomach err on the side of caution with bolus doses. Use an extended bolus to spread your bolus out.”

Emily: “I may bump up the temporary basal and I'll check my blood sugar more frequently.”

Topic 5: When to Wave the Red Flag for Professional Help
Therese: “We’ve been told to call our endocrinologist’s office when we see moderate to large ketones. We head to the hospital if vomiting is out of control and my son is dehydrated.”

Alexis: “I’d call my provider if I have more than 24 hours of high blood glucose readings. I’d head to the ER (with assistance) if my glucoses were running low and I couldn’t keep any glucose from food or other sources down.”

*Note: Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.