Published on April 15, 2021

Sick days and diabetes

By Guscilla Johnson, Mind and Body, Messenger-Inquirer

We all get sick but if you have diabetes it can be concerning.

By taking the time now to plan for those sick days before you actually get sick, it will give you more peace of mind knowing you have a plan. Illness can make it harder to manage your diabetes but with a plan in place it can ease the stress of caring for yourself or a loved one. A sick plan is especially important during COVID-19.

Gus Johnson

Guscilla Johnson, RN, CDCES

Planning ahead doesn’t have to be a hassle or something you have to do alone. Diabetes educators can help you setup a plan for those dreaded sick days and provide you the guidance and education needed to be prepared.

To begin thinking on what your next steps should be, we will go through some very important things to include and remember to help putting together a plan.

First, always be sure to have a working glucometer and plenty of strips or a continuous glucose meter. Even if your blood sugar is well controlled it can vary when you are sick. Test frequently when you are sick. Test about every six hours for a mild illness like a common cold and every three to four hours for a more severe illness like the flu.

Your healthcare provider will advise you but you may need to check for ketones if you take insulin. Regular testing is important because you will know your base levels and how illness is affecting your readings. Call your healthcare provider if blood sugar levels are 240mg/dl or higher for two checks. The American Diabetes Association recommends that blood sugar levels before meals should be 80 to 130mg/dl and less than 180 mg/dl one to two hours after a meal.

Secondly, you want to continue to take your long-acting insulin and diabetes medication even if you are not eating well. There may be certain oral medications and short acting insulin that may need to be adjusted or stopped during illness.

Talk to your healthcare provider about your oral medications to find out if any would need to be stopped if you became ill. When speaking with your healthcare provider, be sure to make a note of those medications to help you keep track and plan.

Hydration is key. Individuals who have diabetes that become dehydrated are more likely to suffer from hyperglycemia. You need to stay hydrated. Drink about six to eight ounces of liquids every hour.

Great options to help you keep hydrated include water, sugar-free soft drinks or unsweet tea. If you are battling nausea try ice chips, sugar-free gelatin or sugar-free popsicles. While you are sick, you may need to make changes in what you normally eat. If you find you can’t eat as normal try to eat or drink at least 45 grams of carbs every four to five hours.

For example, your lunch could consist of one cup of regular ginger ale and six saltine crackers. For dinner, your meal could be a small plain baked potato. If you would like to find out more meal ideas or are looking to meal plan in case of illness a diabetes educator or dietitian can help!

Consulting your healthcare provider is always recommended when you are sick. Some symptoms that are important to keep in mind for contacting your healthcare provider immediately include but are not limited to:

  • Blood sugar levels over 240mg/dl for 2 checks or more.
  • Unable to keep fluid down.
  • You have been having diarrhea for more than six hours.
  • A fever of 101.5 degrees Fahrenheit or an illness lasting more than 24 hours.
  • Fruity-smelling breath.
  • Severe stomach pain, chest pain or have a hard time breathing.
  • You are not sure what to do.

Planning for these sick days is important for any individual with diabetes. But planning does not have to be done alone. Diabetes educators can help you develop a plan for managing those sick days as well as guiding you to control your diabetes.

If you would like to begin working on your plan with a diabetes educator, please call 270-688-4804.


Guscilla Johnson, RN, CDCES, is a diabetes patient educator at Owensboro Health Healthpark.

About Owensboro Health

Owensboro Health is a nonprofit health system with a mission to heal the sick and to improve the health of the communities it serves in Kentucky and Indiana. The system includes Owensboro Health Regional Hospital, nationally recognized for design, architecture and engineering; Owensboro Health Muhlenberg Community Hospital; Owensboro Health Twin Lakes Medical Center; the Owensboro Health Medical Group comprised of over 200 providers at more than 20 locations; three outpatient Healthplex facilities, a certified medical fitness facility, the Healthpark; a surgical weight loss center and program, and the Mitchell Memorial Cancer Center.

On average each year, we have 16,000 inpatient admissions, deliver 2,000 babies and provide the region’s only Level III NICU. Owensboro Health physicians perform nearly 24,000 surgical procedures, including nearly 200 open-heart surgeries. Our physicians and staff have 70,000 Emergency Department visits, more than a million outpatient visits annually. Visit our home page for more information.