Managing Sick Days

Being sick happens to all of us! People with diabetes have special things to think about, however. Here are some pointers for when you are feeling under the weather.

The first thing you need to do is gather all the necessary information. This will help you and your parents decide if you need to call the doctor.

Your body requires more energy when you are sick. Some important things to remember:

  • Ketones: Always check your ketones if you are feeling ill.
  • Vomiting: If you are vomiting and have low blood sugar, an insulin reaction could occur, you may still have ketones.
  • Insulin: Be sure to keep a bottle of short-acting insulin (Humalog, Novolog, or Regular) on hand.
  • Blood glucose monitoring: You should do some extra monitoring on sick days (every 2 to 4 hours).
  • Extra snacks: Remember to feed your body an adequate amount of calories so you don't start using fat for energy. Check our list of recommended sick-day foods, below. Your body needs about 15 grams of carbohydrates an hour to stay nourished.
  • Past experiences: Try to keep good records of your sick days, so you can refer back to them in the future.
  • Doctor: Call your pediatrician or family doctor for non-diabetes-related illness, like a sore throat, earaches, rashes, etc.

Information courtesy of Understanding Diabetes by Dr. H. Peter Chase.

Sick-day foods


These liquids are good choices in addition to water, particularly if your blood sugar is below 180 mg/dl (10 mmol/L):

  • Sugar-containing beverages: regular 7-Up, ginger ale, orange, cola, Pepsi, etc.*
  • Pedialyte or Infalyte (especially for younger children)
  • Sports drinks: Gatorade, Powerade, etc. (any flavor)
  • Tea with honey or sugar*
  • Fruit flavored drinks: regular Kool-Aid, lemonade, Hi-C, etc.
  • Jell-O: regular or diet* (for infants, use liquid Jell-O warmed in a bottle)
  • Popsicles: regular or diet*
  • Broth-type soup: bouillon, chicken noodle soup, Cup-a-Soup

*Sugar-free may be needed depending on blood sugar (for example, >280 mg/dl or >10.0 mmol/L)


When you feel ready to eat, these are good foods to begin with:

  • Saltine crackers
  • Bananas (or other fruit)
  • Applesauce
  • Bread, toast, or tortillas
  • Graham crackers
  • Soup
  • Rice

Important sick-day rules

  • Check blood glucose every 2 to 4 hours.
  • Check ALL urine for ketones.
  • Drink 4 to 8 oz. of fluid per hour.
  • Take extra insulin—a "correction"—every 2 to 4 hours, as directed.

Contact the Pediatric Endocrinology, Diabetes, and Metabolism team.

When to call your doctor

  • Your blood glucose is more than 250 and not coming down with extra insulin
  • You have vomited more than twice
  • You have had diarrhea more than twice or for longer than 6 hours
  • You can't keep fluids down
  • You have moderate to large ketones
  • You are having trouble breathing
  • You have ANY questions

What to tell the doctor

  • Your name and age
  • About how long you've had diabetes
  • Name of your diabetes doctor
  • Current problem
  • Blood sugar level
  • Urine or blood ketone result
  • Signs of low blood sugar or acidosis
  • How much food or liquid you're taking in
  • Usual insulin dosage, time and amount of last dosage
  • Last body weight (if known)