"Sick" means having a fever, vomiting, nausea, diarrhea, or congestion. When you have diabetes there are some special concerns:

• Being sick usually means your blood sugar level will be higher than usual.
  
  
• Sometimes, though, you can have low blood sugar (hypoglycemia) when you are sick.
  
  
• The guidelines below will help you know what to eat, when to test blood sugar, and when to call your doctor or diabetes care team.

• Keep taking your insulin unless your doctor or diabetes care team says not to.
  
  
• If you take pills to control your diabetes and have not been able to keep down fluids or solid foods for more than four hours, get instructions from your doctor or diabetes care team.
  
  
• Test your blood sugar every 2-4 hours and write down the results. It is also a good idea to take your temperature.
  
  
• Drink plenty of fluids. Sip about 8 ounces of water or other fluids each hour. Note: if your blood sugar is over 240, use sugar-free drinks like broth, tea, or water.
  
  
• Eat small frequent meals or snacks.
  
  
• Keep in contact with your diabetes care team.

Fluids containing 10-15 grams of carbohydrate:
     1 cup Gatorade
     1 cup fruit juice
     1 cup regular soft drink (not sugar free)
     1 cup milk (any kind)

Foods containing 10-15 grams of carbohydrate:
     1 cup regular Jello
     1 slice toast or bread
     3 graham crackers
     6 vanilla wafers
     1 cup cooked cereal
     6 saltines
     1 cup mashed potatoes
     1 cup sugar-free pudding
     1 cup regular ice cream
     1 cup regular sherbet
     1 popsicle
     1 cup custard

When you are sick you should:

• continue to take your insulin
  
  
• continue to take your pills for diabetes
  
  
• test your blood sugar every 2 to 4 hours
  
  
• test your urine for ketones whenever your blood sugar is over 240 mg/dl
  
  
• follow your meal plan if you can, or get some carbohydrate (sugar) from other foods or liquids

You should call your doctor when:

• you are not getting better after being sick for a day or two
  
  
• you have been throwing up or have diarrhea and have not kept any liquids down for more than four hours
  
  
• your blood sugar is more that 240 mg/dl and urine shows ketones
  
  
• you feel more and more drowsy; have chest pain, or trouble breathing; dry, cracked lips, mouth, or tongue; or there is a fruity odor on the breath
  
  
• you are not sure what you need to take care of yourself