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Sick Day Guide

Sick Days Happen - Here's How to Plan for Them

Being sick can cause chaos for your blood sugar. In extreme cases, this can put you in a coma or lead to other serious consequences. Don't worry, we'll help guide you so you can avoid any nastiness - it just takes the right preparation. 

The safest course is to prepare for sick days before they happen, so you won't be caught off guard during an unexpected illness. This way, you'll have all the supplies and comforts with you just when you need them. Be sure to download and print our Sick Day Guidelines handout to have them available and contact us with any questions.

Sickness + Diabetes

When you're sick, your body is under extra stress. To fight the sickness, your body releases cells and hormones in your bloodstream to help you recover faster. These hormones can raise your blood sugar and interfere with your ability to process insulin. Certain symptoms, like vomiting or diarrhea can lead to dehydration, which will also interfere with your care routine.

Your body's natural responses to sickness will make it harder to stay in your target blood sugar range. This can lead to ketoacidosis, which is potentially life-threatening. To prevent this, follow the tips below and pay attention for key warning signs so you can contact the clinic for help.

When to Call

We are happy to help if you have a question or concern, but most sick days won't be a big deal. Please contact the clinic immediately for the following issues:

  • Missing school or work (for documentation purposes)

  • Need instructions on insulin dosing

  • Vomiting more than 3 times

  • Moderate/large ketones

  • No fluid intake for 3 hours

  • Blood sugar is over 240 even with sick day extra insulin

  • Any signs of ketoacidosis (fruity breath, chest or stomach pain, very dry skin and lips, labored breathing)


When calling, please have the following information available:

  • Name and age of the patient

  • About how long the patient has had diabetes

  • Recent blood sugar levels

  • Urine ketone results

  • Recent food and liquid intake

  • Last insulin dose

  • Most recent body weight

What to Do While You're Sick

Below are some practical guidelines for how to handle sickness with type 1 diabetes. You should continue to follow these guidelines until you feel better and there are no traces of ketones in your urine.

Do not stop taking your insulin. Insulin is needed even if you're not eating, since the illness could be raising your blood sugar level. You may need to adjust your dose to supply extra insulin. Contact the clinic for specific advice.


Check your blood sugar and ketones often. Your blood sugar can become dangerously high, so it's best to check your blood sugar every 2-4 hours. Check your ketones whenever you urinate until you've recovered.

Drink extra fluids. Your body needs extra fluids, so take small sips often. If you cannot eat, take your carbs in liquid form. Otherwise, this fluid should be sugar-free. Check the Sick Day Guidelines handout for information on how to deliver carbs through liquids.

Avoid solid foods in the case of vomiting. Instead, give liquids in small doses every 15-30 minutes as tolerated. Avoid dairy foods until light food like soup and crackers are tolerated. If vomiting lasts for more than 4 hours, go to the ER.

Give over-the-counter medications as appropriate. If your child needs medication, you may administer it according to the directions on the bottle or given to you by the doctor. These medicines may have a small amount of sugar, but they can be controlled easily with a slight increase in insulin. You do not need to look for "sugar-free" medications.

How to Stay Prepared

When you aren't feeling well, it's harder to go out and get the things you need. We recommend that all patients prepare and maintain a "sick box" of supplies that are good to have on hand in case of illness.

  • Glucose meter and test strips

  • Rapid and long-acting insulin

  • Ketone test strips

  • Glucagon

  • Glucose gel, glucose tabs, or candy (like gummy bears)

  • Regular and diet soda (for delivering carbs or settling stomach)

  • Juice

  • Soup or broth (boullion cubes work well)

  • Gelatin cups or applesauce

  • Popsicles

  • Any other comforts you enjoy while sick

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