When you are sick

Take good care of yourself when you have a cold, flu, infection, or other illness. Being sick can raise your blood sugar. Some rules for taking care of yourself are:

1. Tell your doctor that you are sick.
2. Test your blood sugar every 4 hours. Write down the results of the test.
3. Keep taking your diabetes medicine. Even if you can't keep food down, you still need your diabetes medicine.
4. Drink plenty of fluids if your blood sugar is too high.
5. Try eating crackers, jello, popsicles, or soup if you can't eat your usual food.
6. Drink clear liquids such as ginger ale if you can't eat at all. You can eat or drink something with sugar in it if you have trouble keeping food down.
7. Call your doctor RIGHT AWAY if:
   • your blood sugar is over 300 for two tests in a row
   • you find ketones in your urine
   • you can't keep fluid down
   • you feel sleepier than usual
   • you have trouble breathing
   • you can't think clearly
   • you throw up more than once
   • you have diarrhea
8. Tell the doctors and nurses that you have diabetes if you have to go to the hospital or to the emergency room.

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Take care of your diabetes when you are at school or at work. You should:

1. Try to eat your meals at the same time each day.

2. Take your medicine and test your blood sugar, as usual.

3. Tell your teachers, friends, or close coworkers about the signs of low blood sugar. You may need their help if your blood sugar drops too low.

4. Keep snacks with sugar in them in your desk and carry some with you at all times to treat low blood sugar reactions.

5. Tell your company nurse or school nurse that you have diabetes.

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When you will be exercising

Physical exertion and exercise, even walking, improves the uptake of blood sugar (glucose) into cellsand muscles. This decreases the amount of insulin needed to keep blood sugar in the normal range. Prior to mild or moderate exercise a person should have a small snack. If you engage in vigorous physical activities talk with tell your doctor. You may need to adjust (decrease) your medication dosages.

Profile: "Brittnie," a 9-year-old with insulin-dependent diabetes, loves her school gym class. She practices at her school gym every day for an hour. Before Brittnie exercises, she checks her blood sugar level to make sure it is okay to start her workout. If her blood sugar level is too low, she eats a snack before beginning her practice. Brittnie has told her gym teacher that she has diabetes. She knows that if she has a problem with low blood sugar her teacher will be there to help her.

If you USE insulin

• Exercise after lunch, not before. If you can't do this, take a snack to eat before gym or sports practice. Physical activity lowers the amount of insulin required to keep your blood sugar in the normal range.

• Test your blood sugar level at work or school before starting an extra hard job or activity or before a test.

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People with diabetes can eat out, go to parties, and travel. You can live a normal life. But, it's very important to remember to take care of your diabetes, even on vacation.

1. Follow your meal plan as much as possible when you eat out. Always carry a snack with you in case you have to wait to be served.

2. Limit your drinking of beer, wine, or alcohol. Ask your doctor or nurse how much alcohol is safe for you to drink. Eat food with your drink. Order drinks made with club soda instead of sugary sodas.
   
   Alcohol consumption will lower your blood sugar and therefore will decrease the amount of insulin your body needs to keep blood sugar normal. If you take your normal insulin dose prior to heavy drinking you may cause your blood sugar to go too low!

3. Try to do most of your driving early in the day if you're taking a long trip by car. If you haven't eaten in a while, test your blood sugar before driving. Always carry snacks like fruit, crackers, juice, or soda in the car in case your blood sugar drops too low.

4. Ask ahead of time for a diabetes meal if you're traveling by plane. Most airlines serve special meals for people with health needs. Carry food (like crackers or fruit) with you in case meals are late.

5. Carry your medicines (insulin, insulin needles, and diabetes pills) and your blood testing supplies with you. Never put them in the suitcase you check or leave with someone else.

6. Ask your doctor how to adjust your medicines, especially your insulin shots, if you're traveling across time zones.

7. Take comfortable, well-fitting shoes on vacation. You will probably be walking more than usual and should take extra good care of your feet.

8. Ask your doctor for a written prescription for your diabetes pills and the name of a doctor in the place you are going to be visiting if you're going to be away for a long time.

9. Don't count on buying extra supplies when you're traveling, especially when going to other countries. Most other countries use different kinds of insulin and needles.

If you USE insulin

• Buy special insulated bags to carry your insulin in to keep it from freezing or getting too hot.

Take extra needles, insulin, and blood test strips when you travel in case of loss or breakage. Ask your doctor for a letter saying that you have diabetes and need insulin shots if you're going to another country. If asked, show the letter to the customs people. Find out when the meal will be served when traveling by plane. Give yourself your insulin shot ahead of time.

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It is very important to plan ahead if you want to have a baby. High blood sugar can be harmful to both the mother and unborn baby. Poorly controlled blood sugar is known to increase the risk of miscarriage in the first 12 weeks of pregnancy and increase the rate of birth defects in surviving infants.

Even before you become pregnant, your blood sugar should be in a normal range. Keeping blood sugar near normal before and during pregnancy helps protect the baby and mother.

If you plan to have a baby, you should:

1. Work with your doctor to get your blood sugar as close to the normal range as possible.

2. See a doctor who has experience in taking care of pregnant women with diabetes. The doctor should also be with a large hospital or medical center that can care for you and your baby properly.

3. Have your eyes and kidneys checked. Pregnancy can make eye and kidney problems worse.

4. Do not smoke, drink alcohol, or use harmful drugs.

5. Follow the meal plan given to you by the dietitian or diabetes educator to be sure you and your unborn baby have a healthy diet.

If you are already pregnant, see your doctor right away. It's not too late to get your blood sugar in good control so that you stay healthy during the rest of your pregnancy. Then follow rules 2, 3, 4, and 5 listed above.

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Profile: "Maria," a 25-year-old woman with type 1 diabetes, wanted children. Her doctor told Maria and her husband that before she became pregnant her blood sugar levels should be in very good control and her kidneys, eyes, and blood pressure must be checked. Maria began to take care of her diabetes very carefully. She checked her blood sugar levels four times a day, ate healthy meals, began to walk a lot, and tested her blood and urine often to make sure that her body was healthy enough to carry a baby.

Once Maria became pregnant, she spent a great deal of time taking care of her diabetes. Maria's hard work paid off. After 9 months she gave birth to a healthy baby boy.

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Acknowledgments

Doctors Corner acknowledges the NIDDK as the primary source for this publication. This webpage has been modified by Doctors Corner to enhance readability and provide additional information of importance to our readers.

This material is not copyrighted and may be freely copied and distributed.

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