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Important Things to Remember When You Get Sick
Check your Blood Glucose Frequently
When you are sick, most likely you will have higher glucose levels. You may need more medication. But
it is also possible to have low blood glucose (hypoglycemia) because you are eating less or from
vomiting. You need to know if there are any changes in your blood glucose—so check frequently.
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Type 1 diabetes: check glucose every 2-4 hours.
Type 2 diabetes: check glucose no less than 4 times a day.
Check your glucose level more frequently if you are vomiting.
Type 1 diabetes: Test for urine ketones every 4 hours.
Always Take Your Medications
When you are sick it is hard to remember to take medications or you may not feel like taking
medications. But you need your medications.
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ALWAYS take your diabetes pills unless you are vomiting, or are not able to hold down
food and liquids.
ALWAYS take your insulin unless you are vomiting, or are not able to hold down food or
liquids. See Other Side: ADJUSTING INSULIN IF YOU CANNOT EAT
Drink Plenty of Liquids
You need to prevent dehydration when you are sick.
 Drink liquids at least every hour or take small sips every 10-15 minutes.
 If you are not eating, try fluids that contain SUGAR.
 If your blood glucose levels are greater than 240 mg/dl, you will need to drink extra
water or sugar-free liquids and may need extra insulin.
When to Call Your Healthcare Provider
Your healthcare provider is there to help you when you are sick. Have your information nearby so that
you can give your provider your blood glucose levels, your temperature, and when you took your
medications.
1. Blood glucose level greater than 300 mg/dl for more than six hours
2. Not able to eat any food for more than a day
3. Persistent diarrhea for more than 8 hours
4. High (101.5 degrees F) or rising fever, fever for more than 24 hours
5. If sick for more than two days
6. Moderate to large ketones (type 1)
7. Dry mouth, thirst, dry skin, decreased urine, vomiting, abdominal pain, shortness of
breath or continual diarrhea.
Reviewed 11-10
Special Rules if you are on insulin
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Have a consistent amount of carbohydrates at meal times
Here are some examples of 15 gram carbohydrate choices:
½ (4oz) cup juice
1 cup (8oz) Gatorade
1 cup soup
½ cup sugar free pudding
½ cup hot unsweetened cereal
1 cup (8oz) skim or low-fat milk
½ cup (4oz) regular soda
6oz light yogurt
½ cup ice cream or frozen yogurt
½ cup regular gelatin
¼ cup sherbet
½ cup unsweetened applesauce
1/3 cup rice
6 saltine crackers
3/4 cup cold unsweetened cereal
1 slice toast
3 squares graham crackers
½ cup mashed potatoes
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This is how you adjust insulin if you can’t eat:
Type of Insulin
Doses to take if Not Eating
NPH
Take ½ of NPH
Lantus (glargine) or Levemir (detemir)
Take usual dose of Lantus (glargine) or Levemir (detemir)
Humalog (lispro), Novolog (aspart), Apidra
(glulisine)
Take insulin every 2 hours based on your sliding scale
Regular
Take Regular every 4 hours based on your sliding scale
70/30, 75/25 or 50/50
Take ½ of usual dose and contact healthcare provider
Test for ketones
Check your urine for ketones if the glucose is greater than 280 mg/dl. Keep ketone strips in your
medicine chest so you will have them when you need them. Ketone strips are available without a
prescription from your drug store
Actions to take based on Your Glucose
>300 mg/dl for more than 6 hours
Call your healthcare provider
 Know your body and know your blood glucose
 Check you Blood glucose frequently
 Always take your medications
 Drink plenty of liquids
Under 100 mg/dl & vomiting persists Call your healthcare provider. May require hospitalization.
Between 100 and 300