When You’re Sick

Having a cold, the flu, or an infection can raise your blood glucose levels. Being sick puts stress on your body. Your body releases hormones to deal with the stress and to fight the sickness. Higher hormone levels can also cause high blood glucose levels. You should have a plan for managing your diabetes when you’re sick. The first step is to talk with your health care team and write down

• how often to check your blood glucose levels
• whether you should check for ketones in your blood or urine
• whether you should change your usual dose of your diabetes medicines
• what to eat and drink
• when to call your doctor

People who are sick sometimes feel as though they can’t eat as much or can’t keep food down, which can cause low blood glucose levels. Consuming carbohydrate-rich drinks or snacks can help prevent low blood glucose.

If you are sick, your health care team may recommend the following:

• Check your blood glucose levels at least four times a day and write down the results in your record book. Keep your results handy so you can report the results to your health care team.
• Keep taking your diabetes medicines, even if you can’t eat.
• Drink at least 1 cup, or 8 ounces, of water or other calorie-free, caffeine-free liquid every hour while you’re awake.
• If you can’t eat your usual food, try eating or drinking any of the following to prevent low blood glucose levels:
  • juice
  • saltine crackers
  • dry toast
  • soup
  • broth or bouillon
  • ice pops or sherbet
  • gelatin that isn’t sugar-free
  • milk
  • yogurt
  • soda that isn’t sugar-free

Your doctor may ask that you call right away if

• your blood glucose levels are above 240 even though you’ve taken your diabetes medicines
• your urine or blood ketone levels are above normal
• you vomit more than once
• you have diarrhea for more than 6 hours
• you have trouble breathing
• you have a high fever
• you can’t think clearly or you feel more drowsy than usual

You should call your doctor if you have questions about taking care of yourself.

When You’re at School or Work

Take care of your diabetes when you’re at school or at work:

• Follow your healthy eating plan.
• Take your medicines and check your blood glucose levels as usual.
• Tell your teachers, friends, or close coworkers that you have diabetes and teach them about the signs of low blood glucose. You may need their help if your blood glucose levels drop too low.
• Keep snacks nearby and carry some with you at all times to treat low blood glucose.
• If you have trained diabetes staff at your school or work, tell them that you have diabetes.
• Wear or carry an identification tag or card that says you have diabetes.

When You’re Away from Home

These tips can help you when you’re away from home:

• Get all your vaccines and immunizations, or shots, before you travel. Find out what shot you need for where you’re going, and make sure you get the right shots on time.
• Follow your healthy eating plan as much as possible when you eat out. Always carry a snack with you in case you have to wait for a waiter to serve you.
• Limit alcoholic beverages. Ask your health care team how many alcoholic beverages you can safely drink. Eat something when you drink to prevent low blood glucose.
• If you’re taking a long trip by car, check your blood glucose levels before driving. Stop and check your blood glucose levels every 2 hours.
• Always carry your diabetes medicines and supplies in the car where you can reach them in case your blood glucose levels drop too low.
• In case you can’t leave for home on time, bring twice the amount of diabetes supplies and medicines you normally need.
• Take comfortable, well-fitting shoes on vacation. You’ll probably be walking more than usual. Keep your medical insurance card, emergency phone numbers, and a first aid kit handy.
• Wear or carry an identification tag or card that says you have diabetes.
• If you’re going to be away for a long time, ask your doctor for a written prescription for your diabetes medicines and the name of a doctor in the place you’re going to visit.
• Don’t count on buying extra supplies when you’re traveling, especially if you’re going to another country. Different countries use different kinds of diabetes medicines.

When You’re Flying on a Plane

These tips can help you when you’re flying on a plane:

• Ask your health care team in advance how to adjust your medicines, especially your insulin, if you’re traveling across time zones.
• Take a letter from your doctor stating you have diabetes. The letter should include a list of all the medical supplies and medicines you need on the plane. In the letter, the doctor should also include a list of any devices that shouldn’t go through an x-ray machine.
• Carry your diabetes medicines and your blood testing supplies with you on the plane. Never put these items in your checked baggage.
• Bring food for meals and snacks on the plane.
• If you use an insulin pump, ask airport security to check the device by hand. X-ray machines can damage insulin pumps, whether the pump is on your body or in your luggage.
• When on a plane, get up from your seat and walk around when possible.

Read more about planning for travel and travel safety if you have diabetes in Have Diabetes. Will Travel (319 KB) .

When an Emergency or a Natural Disaster Happens

Everyone with diabetes should be prepared for emergencies and natural disasters, such as power outages or hurricanes. Always have a disaster kit ready. Include everything you need to take care of your diabetes, such as

• a blood glucose meter, lancets, and testing strips
• your diabetes medicines
• insulin, syringes, and an insulated bag to keep insulin cool, if you take insulin
• a glucagon kit if you take insulin or if recommended by your doctor
• glucose tablets and other food or drinks to treat low blood glucose
• antibiotic cream or ointment
• a copy of your medical information, including a list of your conditions, medicines, and recent lab test results
• a list of your prescription names with dosage information and prescription numbers from your pharmacy
• phone numbers for the American Red Cross and other disaster relief groups

You also might want to include some food that doesn’t spoil, such as canned or dried food, along with bottled water. Read more about preparing for an emergency at the Centers for Disease Control and Prevention Emergency Preparedness and You website at www.emergency.cdc.gov/preparedness .

If You’re a Woman and Planning a Pregnancy

Keeping your blood glucose levels near normal before and during pregnancy helps protect both you and your baby. Even before you become pregnant, your blood glucose levels should be close to the normal range.

Your health care team can work with you to get your blood glucose levels under control before you try to get pregnant. If you’re already pregnant and you have diabetes, see your doctor right away. You can take steps to bring your blood glucose levels close to normal.

Your insulin needs may change when you’re pregnant. Your doctor may want you to take more insulin and check your blood glucose levels more often.

If you plan to have a baby,

• work with your health care team to get your blood glucose levels as close to the normal range as possible
• see a doctor who has experience taking care of pregnant women with diabetes
• don’t smoke, drink alcoholic beverages, or use harmful drugs
• follow your healthy eating plan

Be sure to have your eyes, heart and blood vessels, blood pressure, and kidneys checked. Your doctor should also check for nerve damage. Pregnancy can make some health problems worse.

More information about diabetes and pregnancy is provided in the NIDDK health topic, Diabetes and Pregnancy.