Sick-Day Guidelines for People With Diabetes

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When to call your doctor

Minor illnesses in people with diabetes—especially children with type 1 diabetes—can lead to very high blood sugar levels and possible emergencies. When children are sick, watch them closely for signs that they need immediate medical attention. Call 911 or other emergency services if you or your child has:

  • Symptoms of diabetic ketoacidosis (DKA), such as abdominal pain, vomiting, rapid breathing, fruity-smelling breath, or severe drowsiness.
  • Symptoms of dehydration, such as a dry mouth and very yellow or dark urine. Dehydration is particularly dangerous in children and may be caused by vomiting and diarrhea.
  • A low blood sugar level that continues.

It may not be necessary to call your doctor every time you or your child with diabetes has a mild illness, such as a cold. But it is a good idea to call for advice when you are sick and:

  • Your blood sugar level is higher than 240 mg/dL after taking the adjusted amount of insulin in your sick-day plan.
  • You take oral diabetes medicine and your blood sugar level is higher than 240 mg/dL before meals and stays high for more than 24 hours.
  • You have more than 2+ or moderate ketones in your urine.
  • You still have a fever and are not feeling better after a few days.
  • You are vomiting or having diarrhea for more than 6 hours.

When you are sick, write down the medicine(s) you have been taking and whether you have changed the dosage of your diabetes medicines based on your sick-day plan. Also note changes in your body temperature, weight, blood sugar, and urine ketone levels. Have this information with you when you talk to your doctor.

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