If you are on insulin, DO NOT STOP TAKING your insulin. Viral colds, flu syndromes, upper respiratory infections, fevers and diarrheal illnesses can all increase your need for insulin. Stopping your insulin may allow your blood sugars to go very high, which could make you much sicker and even precipitate the need for hospitalization.


If you are on oral agents for diabetes and you are eating less than your usual diet, reduce the dose of the diabetic medicines by 1/3 to 1/2. If you are on Glucophage (metformin), stop it altogether. Once you are feeling better, you can resume your usual medications at their usual doses.


Test your blood sugars often, at least 4 times daily.


If you normally take insulin, test your urine for ketones once or twice a day. Urine ketone sticks can be bought over the counter in a pharmacy. Directions are on the bottle.  Moderate to large urine ketones are a signal to call the doctor.


Drink lots of liquids. Eat salty foods. You should drink at least ˝ cup every hour. Soups and broths help to replace vital sodium and potassium salts lost during vomiting and diarrhea and will help you feel stronger. If you start getting dehydrated, your blood sugar may rise further and precipitate the need for hospitalization.


Small, frequent meals may be easier to tolerate during an illness. Try foods like cooked cereal, plain yogurt, Jell-O, fresh fruit, scrambled egg, toast or sherbet.


If you are not able to eat, you can keep your sugar from going too low by taking frequent sips of sugar rich drinks such as regular cola, fruit juices or sugar sweetened drinks. If you have been taking oral agents for diabetes and your sugars are less than 120 mg%, you must take some sugar rich drink at least every 4 hours. Artificial sweeteners will not work to keep your blood sugars up.


Rest. You should not exercise during an illness.


Read the labels on cold medications and don't take them if they say they are not to be used for people with diabetes. Medications you CAN take include Chlortrimaton, Sudafed, Drixoral, Dimetapp, Pepto-Bismol, Kaopectate, Immodium, Phospho-soda, Milk of Magnesia, Colace, Metamucil, Dramamine.


Call the doctor if you are not able to take in adequate liquids or can't keep liquids down; if you have vomiting or diarrhea for more than 8 hours; if you have blood sugars over 400 mg% on two CONSECUTIVE tests; if your urine test for ketones shows large ketones; if you feel very ill or are having pain; if you have extreme fatigue; if you have shortness of breath; or if you have dizziness and feel like you might faint.

Revised 9/08 



ŠTed A. Tobey, M.D., Inc. ~ All Rights Reserved