The Cleveland Clinic offers excellent advice for managing diabetes during times of physical or emotional distress.  Experts offer the following five tips to help maintain blood sugar and  minimize the dangerous complications of uncontrolled diabetes.

1. Stay hydrated

Dehydration occurs quickly when you have fever, vomiting or diarrhea. The main risk from dehydration is hyperglycemia (high blood sugar).  Cold medications, skipping diabetes medications and eating food erratically may also lead to high blood sugar.

According to diabetes specialist Bartolome Burguera, MD, “when you’re ill, it’s very important to check your blood sugar regularly, continue to take medications on a schedule and drink fluids regularly.”  He also suggests that when your blood sugar goes over 250, check your urine for keytones (produced when your body has difficulty processing blood sugar) and call your clinician with the results.

2. Change up your diet

When you are ill or stressed, your diet may change.  If you are unable to eat normally or have a decreased appetite, meal replacement drinks are often helpful.  “Nutritional shakes formulated for people with diabetes have a moderate amount of carbohydrate, which is appropriate” (Burguera).  Homemade meal-replacement shakes are also helpful by using:

  • Frozen fruit
  • A protein source (e.g., protein powder, Greek yogurt, peanut butter, tofu)
  • Milk, soy milk or almond milk

Alternatively, “noodle soups are typically well tolerated and the noodles offer carbohydrates, which may help prevent low blood sugars” (Burguera).

3. Create a sick-day tool kit

Dr. Burguera recommends putting together a “sick-day diabetes tool kit” that includes items to be eaten or drank when feeling unwell.  “Some non-food items to include in your tool kit are extra blood-sugar monitoring supplies and a thermometer to check for a fever”  (Burguera).  Your kit may include:

  • Regular soda pop or juice (to prevent low blood sugars)
  • Broth-based soups
  • Gelatin (regular, not sugar-free)
  • Water
  • Electrolyte-supplemented beverages

4. Make sure you’re monitoring

Monitoring your diabetes is essential during times of stress.  “In general, if you’re taking insulin at meals and long-acting insulin once a day, you should monitor your blood sugar four times per day — before each meal and before bed”  (Burguera).

5. Talk to your clinician

Individualized care is important with diabetic management and your clinician will adjust your diabetes medications as necessary and dependent on:

  • The type of medications you’re taking
  • The extent to which your food intake has decreased

Dietician Dawn Noe states that “if you’re taking long-acting insulin, which is typically given at bedtime, we usually recommend you continue with the same dose, as long-acting insulin is mainly responsible for insulin needs not related to food intake.”

When insulin is taken before meals (also called rapid-acting insulin, fast-acting insulin, or mealtime insulin) your clinician may need to reduce your dose, depending upon your daily meals for breakfast, lunch and dinner. “If you skip a meal, skip the mealtime insulin” (Noe).

Oral medications may need to be adjusted by your clinician.  Diabetes medications, such as metformin, SGLT-2 inhibitors or DPP4- inhibitors, rarely cause low blood sugars and may not need adjusting.  “These medications usually bring down blood sugar from high to normal, but very rarely drop blood sugar too low” (Burguera).  However, sulfonylureas or acarbose may cause your blood sugars to drop if you are eating less. “These medications should be adjusted based on blood-sugar readings” (Burguera).

Whether during stress or illness, blood sugar management is imperative to control diabetes and maintain a healthy lifestyle and quality of life.

Read the Article Here:   5 Best Tips to Manage Diabetes When You’re Sick