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Illness and Sick Days

It is important to have a plan for handling illness BEFORE you become sick. You need to pay closer attention to keeping you blood glucose under control when you have an infection or an illness like a cold, flu, fever, vomiting, or diarrhea.

When you are sick, your blood glucose may be higher, lower, or stay the same.

What things do I need to know?

Medication: You still need your insulin or oral diabetes medication even when you are sick. Do not stop taking your medicine even if you are unable to eat.

Testing: You need to test your blood more often when you are sick. Your doctor will want you to:

  • Test your blood glucose every four hours
  • Test your urine for ketones if your blood sugar is over 240. Ketone test strips are available at the drug store. You dip a test strip into your urine and compare the color of the test pad on the strip with the color chart on the bottle. If the test pad changes color, it shows that you have ketones and you need to call your doctor.
  • Temperature! Take your temperature if you think you may have a fever.
  • When you call the doctor be sure to tell him/her about your blood glucose, ketone test, and temperature

When to call the doctor or health care team:

  • Your blood sugar stays over 240
  • Your ketone level rises, or you have ketones in your urine for more than 12 hours
  • You have vomiting or diarrhea that continues for more than 6-12 hours
  • Your temperature is over 101 degrees Fahrenheit
  • You have trouble breathing
  • You have a weight loss of 5 pounds or more without trying
  • You feel sleepy all the time or cant think clearly

Eating tips for sick days:

Fluids: Drink plenty of fluids, especially if you have a cold, a fever, diarrhea, or have been vomiting. Some of these fluids can include water, diet pop, coffee, tea, sugar free gelatin, sugar free drinks from mixes and broth. Try small sips if you are unable to keep things down.

Food: If you are able, follow your regular meal plan. If you are not able to eat solid food, it is important to try to eat or drink the carbohydrate you would normally take in. Try to have one serving (15 grams) of carbohydrate containing soft food or beverage every hour, or 3-4 servings every 3-4 hours. Carbohydrate servings each serving has about 15 grams of carbohydrates:

  • cup orange, apple or pineapple juice
  • 1/3 cup grape or cranberry juices
  • cup regular soda pop (with sugar)
  • 1 twin Popsicle
  • 1/3 cup regular gelatin (with sugar)
  • cup sherbet
  • cup ice cream
  • 1 cup broth soup with noodles or rice
  • 1 cup thin cream soup
  • cup cooked cereal
  • 1 cup sports drink
  • cup sugar free pudding
  • 6-8 ounces light yogurt
  • 1 slice bread or toast
  • 6 saltine type crackers
  • 3 graham cracker squares
  • cup applesauce or canned fruit
  • 1 Tbsp sugar, honey, syrup, or jelly

Managing Diabetes

This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician and/ or other health care providers relative to diagnostic and treatment options of a specific patient's medical condition. In no event will the Diabetes Association of Greater Cleveland be liable for any decision made or action taken in reliance upon the information provided within this website.

Contact the Diabetes Association of Greater Cleveland at:

Phone: Fax: E-Mail:

All information on this website is subject to the DISCLAIMER and PRIVACY POLICY.


Diabetes Association of Greater Cleveland