December 2014/January 2015
[Open as PDF]
Diabetes - The Medical Perspective
Sick Day Guidelines
Cold and flu season is upon us. Having a cold or the flu can make it hard to manage blood glucose. While battling an infection blood glucose can rise rapidly. It is important to prepare for sick days before getting sick, so you are ready when illness strikes. Ask your health care provider for help making a sick day plan. Think of it as a safety net. Your sick day plan is specific to your diabetes and may look a little different from someone else's plan.
Do not stop taking your medication or insulin unless specifically instructed to do so by your doctor. The stress from being sick may even increase your need for insulin or other diabetes medications. Ask your doctor or pharmacist before taking over the counter cold and flu remedies. If it is necessary to go to a walk-in clinic, or see a doctor you don't know, be sure to tell them you have diabetes. Take your medications with you to show them what you take.
Checking Blood Glucose Levels
More frequent glucose monitoring is usually needed on sick days. Checking glucose and ketone levels every 4 hours may be necessary with Type 1 diabetes. This frequent checking assures ketones are not building up causing diabetic ketoacidosis, a serious and life-threatening condition requiring immediate treatment. If you have Type 2 diabetes, you may not need to check this often. If you have Type 1 diabetes, you probably need to check often. However, no two people are alike. Check with your doctor or health care team. Vomiting and diarrhea can cause fluid loss and dehydration. Extreme dehydration can cause serious diabetes related complications for anyone with diabetes. If you are drinking enough fluids your urine should be straw colored. Shoot for 8 ounces of caffeine-free beverages every hour, while awake. If you are unable to tolerate solid food your usual carbohydrate intake will need to be replaced with carbohydrate containing beverages such as juice, sport drink, broth, frozen fruit bars or regular soda. With nausea and vomiting sip clear fluids like apple juice, broth and tea every 15 - 30 minutes.
Knowing When to Call Your Physician
If you are not sure what to do, call your doctor. Don't take the chance of getting more sick. The following symptoms warrant a call to your physician, despite your sick day plan:
- Vomiting or diarrhea for 6 hours or more
- Unable to eat or drink over 4 hours
- Fever or illness for a couple of days without signs of improvement
- Your glucose levels remain above 240 despite following sick day plan medication adjustments
- Moderate to large amount of ketones in your urine
- Signs and symptoms of dehydration, ketoacidosis or serious complication such as dry, cracked lips and tongue, fruity smelling breath, difficulty breathing, rapid breathing, rapid heart rate, chest pain
- Difficulty staying awake
- Don't know how to care for yourself
Be prepared to provide the following information to your health care provider:
- The last time you ate or drank anything
- What you ate or drank
- Frequency and results of blood glucose or ketone monitoring
- Any medications you have taken, including over the counter medications
- Any symptoms you are experiencing
Keep your health care provider's phone number in a readily accessible place at all times. Know who to contact or how to proceed after offices hours, on weekends or holidays. Let family and friends know you are sick and don't be afraid to ask for help. Teach family and friends how to recognize and treat hypoglycemia (low blood sugar). Keep an updated list of all medications with you and accessible to those closest to you.
- Glucose meter and strips
- Record book and pen
- Ketone strips (most commonly needed in Type 1 diabetes)
- Glucose tablets
Diabetes and Food
Even if you can't eat solid food, aim to consume your usual carbohydrate intake in liquid or semi-liquid foods containing sugar. Carbohydrates are necessary for proper bodily functions. Attempting to eat about 50 grams of carbohydrate every 3 to 4 hours can help keep blood glucose and food intake in balance. If you are unable to eat solid food and only drink sugar-free beverages your glucose may fall to dangerously low levels, if taking insulin or certain oral medications.
Most of these common foods supply about 15 grams of carbohydrate per serving (1 carb choice) and may be better tolerated on sick days than your usual diet.
- ½ cup cooked cereal
- ½ cup regular gelatin
- ½ cup regular soda
- ½ cup apple, orange or cranberry juice
- ⅓ cup grape juice
- ½ cup vanilla ice cream
- ½ cup cream soup
- 1 cup of broth based soup
- 6 saltine crackers
- 3 ounce frozen 100% fruit juice bars
- ½ cup sugar free pudding
- ½ cup sherbet or sorbet (30 grams of carbohydrate - 2 carb choices)
- ½ cup regular pudding (30 grams of carbohydrate - 2 carb choices)
Recipes to Try
Cauliflower Potato Soup
2 tablespoons margarine
1 cup chopped onion
4 ½ cups chopped cauliflower
4 cups peeled, diced potato
¾ cup shredded carrot
1 teaspoon caraway seeds
6 cups non-fat chicken broth
½ teaspoon salt
Pepper, to taste
Nutrition Facts per serving; (14 servings per recipe)
- Melt margarine in large saucepan; add onion. Cook until lightly browned.
- Add cauliflower, potato, carrot, and caraway seeds, stirring constantly for 4-5 minutes.
- Add remaining ingredients and bring to a boil. Reduce heat, cover and simmer about 15 minutes or until vegetables are tender.
- Remove lid, and lightly mash vegetables until chunky, pureed mixture.
- Replace lid and simmer another 20-30 minutes.
Calories from fat
Pineapple Whipped Salad
1 package (3-ounce) sugar-free gelatin
1 cup boiling water
1 can (20-ounce) crushed pineapple in its own juice
½ cup low-fat cottage cheese
1 cup non-fat whipped topping
Nutrition Facts per serving; (8 servings per recipe)
- Dissolve gelatin in boiling water.
- Drain pineapple, reserving ½ cup. Add this ½ cup of pineapple juice to gelatin.
- Chill until very thick.
- Fold in pineapple, cottage cheese, and whipped topping. Chill until firm.
Calories from fat
This and other recipes available at
Total: 1545 Calories, 201 grams Carbohydrates, 13 Carbohydrate Choices
|Cream of wheat
|575 Calories; 64 grams Carbohydrates; 4 Carbohydrate Choices
|Chicken Noodle Soup
|470 Calories; 72 grams Carbohydrates; 5 Carbohydrate Choices
|Cream of chicken Soup (made with 2% milk)
|Sports Drink (fluid replacement type)
| 500 Calories; 65 grams Carbohydrates; 4 Carbohydrate Choices
Diabetes | Food & Diabetes | Medications & Diabetes | Current Issue | Archive | En