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Basic Knowledge

Sick Days

By in Basic Knowledge

Being sick can cause both high and low glucose levels and put you at risk for ketones.  Below are some tips for sick-day management:

Check for ketones if your glucose is higher than 240 mg/dL (if using a pump) or 300 mg/dL (if taking injections), and every 4 hours when you are nauseous, vomiting, or when you have a fever.

Keep taking insulin, even if you are nauseous or vomiting.   If you stop giving insulin, you will develop ketones.  Check glucose levels every 2-4 hours to better understand the effect of the illness (every hour for a large bolus dose.)

Drink fluids to prevent dehydration and ketoacidosis.  When sick, you may not feel like eating or drinking.  Take small sips to stay hydrated.  If glucose levels are:

  • Low –  have sips of Gatorade, Powerade, juice, non-diet soda, or a popsicle.
  • In Range – drink fluids and eat at least 15 grams of carbohydrates such as Jello, toast or ½ of a banana.
  • High – stick to sugar-free or diet options and consume small amounts of food until glucose levels decrease.

Contact your health care team if moderate or large ketones are detected, you are nauseous or throwing up, or if you are unable to keep fluids down. Your doctor may prescribe medication to help you stop vomiting. They may also recommend you go to the hospital.


Reviewed by Michael Haller, MD, 3/25/19

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.


What are Ketones?

Monitoring Ketones

Treating Hypoglycemia

Giving Emergency Glucagon

Wearing a Medical Alert


Managing Sick Days|Diabetes – Centers for Disease Control and Prevention

Planning for Sick Days – American Diabetes Association