When a diabetic comes down with the flu or a bad cold, diabetes care often takes a backseat. Who can be bothered to check blood sugar when just getting out of bed seems like a chore? And who wants to follow a meal plan when it's hard to keep food down?

As difficult as it may seem, you actually need to pay more attention to your diabetes when you aren't feeling well. Common illnesses such as a cold or flu can boost your blood sugar, so it's very important that you check your sugar levels several times during the day. You also need to get enough fluids and fuel to get through the day. A healthy diet will help speed your recovery and keep your blood sugar from getting too high or too low.

Before you feel that first sniffle coming on, talk to your doctor or a registered dietitian about your "sick day" diet. In general, you should stick as closely as possible to your regular meal plan. If your stomach is a little queasy, you can still reach your daily nutritional goals with mild foods such as gelatin, crackers, soup, or applesauce. If even these foods cause trouble and you need to keep your blood sugar levels steady, try broth, fruit juice, pudding, sherbet, or yogurt.

The American Diabetes Association recommends aiming for 50 grams of carbohydrates every three to four hours. Read the labels and do the math. (Or check with your doctor or nutritionist now -- before you get sick -- if you aren't sure how to do this.) You should also be sure to get plenty of fluids throughout the day. Four ounces of water or diet soda every hour should do the trick. As long as you're reading labels, be sure you take into account the sugar content of medications you're taking. Some cold and flu medicines contain sugar.

If your blood sugar gets too high, you may need to rethink your meal plan. According to a report from the University of Mississippi Medical Center, patients should limit meals to just 15 grams of carbohydrates if their sugar level is between 180 and 250. If your numbers climb even higher, you may need to stick to sugar-free beverages until your levels come down. Ask your doctor, dietitian, or diabetes educator to explain what you should do in this situation.

With plenty of food, fluids, and rest, you can expect to feel better soon. But every once in a while, people with diabetes need a little help getting through an illness. The American Diabetes Association urges patients to call their doctor or other member of their diabetes team if they have any of the following problems:

•Illness or fever that lasts for a couple of days without getting better

•Vomiting or diarrhea that lasts longer than 6 hours

•Moderate to large amounts of ketones in the urine (which you would check if you had an unusually high blood sugar reading)

•If you take insulin shots: blood sugar levels higher than 240 despite extra insulin as directed by your doctor

•If you take diabetes medications: blood sugar levels that stay above 240 for 24 hours

•Symptoms of dehydration or another serious condition, such as a fruity smell on your breath, chest pain, difficulty breathing, or dry and cracked lips or tongue.

Finally, be prepared. If you don't have a friend (or Mom) to bring over chicken soup or crackers, it may be worthwhile to stock up on sick-day supplies in advance. That way, when you're unexpectedly ill, you'll have plenty of what you need, when you need it most.

-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive and was a staff writer at Hippocrates, a magazine for physicians. His reporting on occupational health earned him an award from the Northern California Society of Professional Journalists.

References

First published September 24, 2003
Last updated January 3, 2008
Copyright © 2003 Consumer Health Interactive

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