Diabetes: Sick-Day Management

Did you know... that a simple illness such as a cold or the flu can make your diabetes harder to manage? Read on for tips to manage these illnesses and avoid complications.

Be prepared

If you have diabetes, it’s important to be prepared for other illnesses. Simple illnesses that others can fight off easily can be more difficult for you to deal with:
  • Your immune system may not be able to handle viruses such as the flu
  • Your blood glucose may be higher or lower and yet you may not feel like eating
  • You are also at a higher risk of developing complications such as pneumonia from a bad cold or the flu
Preventing colds or the flu would be ideal, but as that is difficult, you should be prepared for the day the cold or flu strikes.

Prevent the spread of flu

You can play an active role in staying healthy and preventing the spread of flu if you:
  • Frequently wash your hands with soap and water
  • Cover your nose and mouth with tissue when coughing or sneezing, throw away the tissue, and then wash your hands
  • Avoid touching your eyes, nose, or mouth
  • Eat well and stay hydrated
  • Get regular physical activity
  • Avoid people who are sick
The Pharmacist at Walmart can help you prepare a sick-day plan. Just ask!


A flu shot (influenza vaccine) is recommended for everyone who has diabetes. The flu shot won’t guarantee that you will not get the flu but it can help. Flu shots are safe and effective and you cannot get the flu from the vaccine. You might notice some soreness, stiffness, redness or swelling in your arm after the injection, but this should only last a day or two. People who have diabetes should not have the nasal spray vaccine.
Note: Some people with diabetes also have the pneumococcal vaccine. Ask your doctor or healthcare professional if you should have that, as well.

A sick-day checklist

  • Talk to your doctor if you think you are getting the flu
  • Take your diabetes medication, including insulin
  • Check your blood glucose at least 4 times a day
  • Check your urine or blood for ketones if your blood glucose is higher than 14 mmol/L
  • Try to eat and drink fluids. You should try to consume the same amount of carbohydrates as usual
  • Keep hydrated. If your blood glucose is high, drink more unsweetened fluids such as water
  • If you have a fever, try to drink a cup of fluid every hour
  • If you are vomiting or have diarrhea, sip on fluids to replace what you are losing

When to see your doctor

You should seek medical attention:

  • If you vomit more than two times in four hours
  • If you are unable to keep food or fluids down
  • If you have severe diarrhea
  • If your temperature is over 38.3°C
  • If your blood glucose is higher than 16 mmol/L
  • If you have moderate-to-high ketones in your urine
  • If you are very sleepy and confused

Making a sick-day kit

Prepare for an illness by making a sick-day kit and stocking it with things you will need.
Here are some items that may be helpful to include in your Sick-Day Kit:
  • Extra strips for your meter – check the expiry date on the unopened container of strips
  • Urine ketone strips or a ketone testing meter with strips – be sure to check expiry dates
  • Thermometer
  • Bottles of water
  • Foods that contain carbohydrates and are easy on the stomach, such as soda crackers, sport drinks, plain cookies
  • Phone number for your doctor or healthcare professional

About OTC medications

Ask your pharmacist about over-the-counter (OTC) medicines to include in your kit:
  • Medicines to reduce fever
  • Cough/cold/flu medicine – many contain sugar or alcohol
  • Antidiarrheal medicine
Check with your pharmacist to see which medications are the best fit with your diabetes medications.
Some things to be aware of:
  • The medications will not cure the cold or flu
  • Anything in liquid form might contain sugar or alcohol, which could affect your glucose levels. Be sure to read the label
  • Some medications are not recommended for people with diabetes. Check with your pharmacist


Cold/flu symptom relief

Depending on your symptoms, you might use:
Cough syrup
  • Sugar-free and without alcohol
  • Some are sugar-free
  • Usually NOT recommended for people with diabetes. They should only be used under the advice of a physician
  • Decongestants might decrease the effects of your diabetes medicine and increase your blood pressure
  • Antihistamines do not affect diabetes, but they should be used with caution by the elderly as they might cause low blood pressure
  • NSAIDS are medications such as ibuprofen and naproxen. Ask the pharmacist if these are safe for you

Important information

The Pharmacist at Walmart knows which medications for colds, flu, and fever fit best with your diabetes medications, and can help you prepare a sick-day plan. Just ask!

This information should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your physician may recommend based on individual facts and circumstances. If you have questions about your symptoms, ask the Pharmacist at Walmart for more information, and/or contact your doctor.

This article is intended as general information. Always be sure to read and follow the label(s)/instruction(s) that accompany your product(s). Walmart will not be responsible for any injury or damage caused by this activity.



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