Managing Diabetes When Sick

When you're sick, your body releases stress hormones that can send your blood sugar, the amount of glucose in your bloodstream, which must be kept within a safe range to avoid complications soaring—even if you're not eating. This isn't just about feeling worse; it's a medical risk. People with diabetes, a chronic condition where the body can't properly regulate blood sugar need a clear plan for when illness hits, because infection, fever, or even a cold can undo weeks of careful control. Insulin adjustment when sick, the process of changing insulin doses during illness to counteract hormone-driven glucose spikes isn't optional—it's essential. And it's not just about taking more insulin; it's about knowing when to hold off, when to check ketones, and when to call for help.

Most people with diabetes don't have a written sick day plan, and that's dangerous. When you're sick, your body doesn't care about your usual carb count or meal schedule. It's fighting, and that fight raises glucose. You might lose your appetite, but you still need fluids and some carbs to avoid low blood sugar from skipped meals or too much insulin. You need to check your blood sugar every 2 to 4 hours, not just morning and night. If you're on insulin, you may need to give extra doses—even if you're not eating. If you're on oral meds like metformin, you might need to pause them if you're vomiting or dehydrated. And if your blood sugar stays above 240 mg/dL for more than a few checks, test for ketones. High ketones with high sugar can lead to DKA, a life-threatening emergency. This isn't theoretical. A 2022 study in the Journal of Diabetes Care showed that over 60% of hospital admissions for DKA in type 1 diabetes were triggered by a simple infection like the flu or a urinary tract infection.

Managing diabetes when sick isn't about being perfect—it's about being prepared. It's knowing which phone number to call when your sugar won't budge, which over-the-counter meds are safe (avoid decongestants with pseudoephedrine), and how to keep hydrated with sugar-free fluids if you're vomiting. It's about having glucose tablets, ketone strips, and a list of your meds ready before you get sick. The posts below give you real, no-fluff advice on what to do when your body fights back. You'll find clear steps for adjusting insulin, what to eat when you can't eat much, how to avoid dehydration, and when to go to the ER. These aren't general tips—they're the exact strategies people use to stay out of the hospital when they're too sick to think straight.