Managing Diabetes When Sick

When you're sick, your body releases stress hormones that can spike your blood sugar, the amount of glucose in your bloodstream, which normally stays balanced by insulin. This isn't just about feeling worse—it's a real risk for dangerous complications like ketoacidosis or hyperglycemic hyperosmolar syndrome. Even a cold or the flu can throw your diabetes, a chronic condition where the body can't properly regulate blood glucose out of control. You don't need to be hospitalized to be in danger. Many people with diabetes wait too long to act because they think, "It's just a cold," but illness changes how your body uses insulin—and ignoring it can cost you.

When you're sick, your insulin, the hormone your pancreas makes to move glucose into cells needs might go up, even if you're not eating much. Your liver keeps pumping out glucose, and your muscles aren't taking it in like they should. That’s why checking your blood sugar every 2 to 4 hours isn't optional—it's survival. And if you have type 1 diabetes, checking for ketones is just as important. Ketones show up when your body starts burning fat for fuel because it can't use glucose. That’s a red flag. If your ketones are moderate or high, you need to act fast: drink water, take extra insulin (as directed by your provider), and call your doctor. You can't wait for symptoms to get worse.

Food doesn't disappear when you're sick, but what you eat might need to change. You still need carbs—even if you're nauseous. Try broth, crackers, applesauce, or gelatin. Skipping food doesn't lower blood sugar when you're sick; it makes it worse. And don't stop your insulin just because you're not eating. Many people make this mistake. If you're on insulin, your basal rate still matters. You might need more, not less. Also, avoid OTC meds that hide symptoms. Some cough syrups and cold pills have sugar or decongestants that raise blood sugar. Always check labels or ask your pharmacist. And yes, if you're on metformin and have a fever or vomiting, your doctor might tell you to pause it temporarily—kidney stress is real when you're dehydrated.

You're not alone in this. Thousands of people with diabetes face the same challenge every flu season, every infection, every fever. The key isn't perfection—it's awareness. Know your numbers. Know your triggers. Know when to call for help. The posts below give you real, practical steps: how to adjust insulin during illness, what to keep in your sick-day kit, how to tell if you're heading toward DKA, and what over-the-counter options are safe. These aren't theory pieces—they're what people actually use when they're too sick to think straight but still need to stay alive.