Diabetes Sick Day Rules: What to Do When You're Ill and Blood Sugar Spikes

When you have diabetes, a chronic condition where the body struggles to manage blood sugar, getting sick isn’t just about feeling bad—it’s a medical event. Whether it’s a cold, flu, stomach bug, or even a minor infection, illness triggers stress hormones that push blood sugar way up. That’s why diabetes sick day rules, a set of proven actions to follow when you’re unwell aren’t optional—they’re life-saving. These rules help you avoid dangerous spikes, prevent diabetic ketoacidosis (DKA), and know when to get help before things turn critical.

Most people with diabetes don’t realize you still need insulin—even if you can’t eat. Skipping insulin because you’re not hungry is one of the biggest mistakes. Your liver keeps releasing glucose during illness, and without insulin, that glucose piles up. blood sugar management, the ongoing process of keeping glucose in a safe range during sickness means checking levels every 2 to 4 hours, drinking fluids to avoid dehydration, and adjusting insulin based on your doctor’s plan. If you’re on insulin, you might need more than usual. If you’re on oral meds, some might need to be paused. diabetic illness, the state where illness disrupts normal glucose control requires a different strategy than your daily routine. It’s not about eating perfectly—it’s about staying hydrated, monitoring closely, and acting fast.

There are clear red flags: blood sugar over 240 mg/dL for more than two checks, ketones in your urine, nausea that won’t go away, or trouble breathing. These aren’t normal. They signal DKA, a life-threatening condition that needs emergency care. You don’t need to wait until you’re dizzy or confused. If you’re unsure, call your doctor or go to urgent care. You also don’t need to force yourself to eat solid food—try broth, gelatin, or sugar-free electrolyte drinks if you can’t keep down meals. The goal isn’t to eat like normal; it’s to keep your body from breaking down fat for fuel, which produces toxic ketones.

What you’ll find in the posts below are real, practical guides from people who’ve been there. You’ll see how to adjust insulin during illness, what over-the-counter meds are safe, how to test for ketones at home, and why some diabetes meds should be paused when you’re sick. There’s no fluff—just clear steps, common mistakes to avoid, and what to do when things go wrong. These aren’t theory pages. They’re the kind of advice you’d get from a nurse who’s seen too many ER visits because someone waited too long. Read them before you get sick. Because when you’re feverish and shaky, you won’t want to search for answers—you’ll want to know exactly what to do next.