Swine Flu Alert – Managing Diabetes When You’re Sick

April 29th, 2009


The Director-General, Dr Margaret Chan of the World Health Organization warns that a swine flu pandemic is imminent. She stated that all countries should immediately activate their pandemic preparedness plans. To read more about the swine flu just click here.

Flu of any sort can prove to be extra risky for the person with diabetes. So, just as the countries are preparing for the flu, you too need to make and activate a sick day plan. You know the old saying, “an ounce of prevention is worth more than a pound of cure.” The tips that follow can help you.

·        Monitoring: Regardless of the type of diabetes you have, you will need to check your blood glucose and urine ketones more frequently than you normally check. If you have type 1 diabetes consider monitoring your blood glucose and urine ketones every 4 hours. If you have type 2 diabetes, It will most likely be enough to monitor your blood glucose levels four times a day and only measure your urine ketone levels if your blood glucose levels go above 240 mg/dl.

·        Medications: Keep taking your diabetes medication. This is extremely important. Although you may not be eating much, your blood glucose will rise with illness. Even if you are vomiting, you will need to take the medications. With type 1 diabetes, you might have to take more insulin than usual to bring your blood glucose levels down. With type 2 diabetes, you may be able to just take your pills, but you may also need to use insulin for a brief time. In either case, your health care provider will help you determine medication needs for your individualized sick day plan.

·        Eating and drinking: Drink plenty of fluids while you are sick. Fluids help you get rid of the extra glucose in your blood while keeping you hydrated. You need to drink 8 ounces of water or calorie free fluid every hour you are awake. Even if you have to do this in small sips. While you are ill, you should attempt to eat the same amount of fruits and breads as usual. If you can, eat your regular diet. If you’re having trouble doing this, use carbohydrate choices: eat enough soft foods or drink enough liquids to take the place of the fruits and breads you usually eat. One carbohydrate choice has 15 grams of carbohydrate.   


Use the following list to make equal carbohydrate choices.

Fruit juice

½ cup

Fruit-flavored drink

½ cup

Soda pop (regular)

½ cup

Popsicle (regular)          

½ twin


¼ cup

Saltine crackers

6 squares


1 cup

Thin-soup-(examples:-vegetable,chicken noodle)

1 cup

Ice cream (vanilla)       

½ cup

Pudding (sugar-free)

½ cup

Pudding (regular)

¼ cup

Macaroni,-noodles,-rice,-mashed potato

½ cup (cooked)


·        Over the counter medications: When you are ill you might turn to an over the counter medication to relieve your symptoms. However, many over the counter medications contain sugar, alcohol or will naturally affect your blood glucose. Make sure you read all warnings on the label as well as the list of ingredients. If you suffer from diabetes complications like nephropathy (kidney disease) or heart disease, ask your doctor before taking any over the counter medication. Your pharmacist will be able to help you find medications that are sugar-free. Care should be taken when using large doses of aspirin or any antibiotic since these will possible lower your blood glucose. Decongestants and some cold and cough medications may raise your blood glucose. If you are unsure, talk to the pharmacist.

·        Call for Help: Ask your health care provider when you should call. During your sick time, you may need to call every day for advice.

You should call your health care provider or go to an emergency room if any of the following happens:

o   You feel too sick to ear normally and for more than 6 hours can’t keep food or liquids down.

o   You have severe diarrhea (loose bowel movement).

o   You lose 5 pounds or more without trying to.

o   Your temperature is over 101° F.

o   Your blood glucose level is lower than 60 mg/dl or stays over 300 mg/dl.

o   You have moderate to large amounts of ketones in your urine.

o   You’re having trouble breathing.

o   You feel sleep or can’t think clearly.





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