Diabetes: Caring for Your Diabetes at Special Times

Introduction to Caring for Diabetes

Diabetes is part of your life. You can learn how to take care of yourself and your diabetes when you're sick, when you're at work or school, when you travel, when you're thinking about having a baby or are pregnant, or when there's an emergency or natural disaster.

Controlling Diabetes When You're Sick

Having a cold, the flu, or an infection can raise your blood glucose levels. You can have serious health problems leading to a coma if your blood glucose levels are very high.

Be prepared for illness. Make a plan ahead of time for sick days. Ask your health care team

  • how often to check your blood glucose levels
  • whether you should check for ketones in your blood or urine
  • whether you should change your usual dose of your diabetes medicines
  • what to eat and drink
  • when to call your health care provider

Your health care team may recommend the following:

  • Check your blood glucose level at least four times a day and write down the results in your record book. Keep your results handy so you can report results to your health care team.
  • Keep taking your diabetes medicines, even if you're not able to eat.
  • Drink at least 1 cup, or 8 ounces, of water or other calorie-free, caffeine-free liquid every hour while you're awake.
  • If you can't eat your usual food, try eating or drinking any of the following:
    • juice
    • saltine crackers
    • dry toast
    • soup
    • broth or bouillon
    • popsicles or sherbet
    • regular-not sugar-free-gelatin
    • milk
    • yogurt
    • regular-not sugar-free-soda

Your health care provider may say you should call right away if

  • your blood glucose levels are above 240 even though you've taken your diabetes medicines
  • your urine or blood ketone levels are above normal
  • you vomit more than once
  • you have diarrhea for more than 6 hours
  • you have trouble breathing
  • you have a high fever
  • you can't think clearly or you feel sleepier than usual

You should call your health care provider if you have questions about taking care of yourself.

Controlling Diabetes When You're at School or Work

Take care of your diabetes when you're at school or at work:

  • Follow your meal plan.
  • Take your medicines and check your blood glucose as usual.
  • Tell your teachers, friends, or close co-workers about the signs of low blood glucose. You may need their help if your blood glucose drops too low.
  • Keep snacks nearby and carry some with you at all times to treat low blood glucose.
  • Tell your company nurse or school nurse that you have diabetes.

Controlling Diabetes When You're Away From Home

These tips can help you take care of yourself when you're away from home:

  • 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.
  • Limit your drinking of beer, wine, or other alcoholic beverages. Ask your diabetes educator how much alcohol you can safely drink. Eat something when you drink to prevent low blood glucose.
  • If you're taking a long trip by car, check your blood glucose before driving. Stop and check your blood glucose every 2 hours. Always carry snacks like fruit, crackers, juice, or soft drinks in the car in case your blood glucose drops too low.
  • Bring food for meals and snacks with you if you're traveling by plane.
  • Carry your diabetes medicines and your blood testing supplies with you. Never put them in your checked baggage.
  • Ask your health care team how to adjust your medicines, especially your insulin, if you're traveling across time zones.
  • Take comfortable, well-fitting shoes on vacation. You'll probably be walking more than usual, so you should take good care of your feet.
  • If you're going to be away for a long time, ask your doctor for a written prescription for your diabetes medicines and the name of a doctor in the place you're going to visit.
  • Don't count on buying extra supplies when you're traveling, especially if you're going to another country. Different countries use different kinds of diabetes medicines.

Controlling Diabetes When There's an Emergency or Natural Disaster

Everyone with diabetes should be prepared for emergencies and natural disasters, such as power outages or hurricanes. Always have your disaster kit ready. Include everything you need to take care of your diabetes, such as

  • a blood glucose meter, lancets, and testing strips
  • your diabetes medicines
  • a list of your prescription numbers
  • if you take insulin-some insulin, syringes, and an insulated bag to keep insulin cool
  • if you take insulin or if recommended by your doctor-a glucagon kit
  • glucose tablets and other foods or drinks to treat low blood glucose
  • antibiotic cream or ointment
  • a copy of your medical information, including a list of your conditions, medicines, and recent lab test results
  • phone numbers for the American Red Cross and other disaster relief organizations

You also might want to include some nonperishable food, such as canned or dried food, along with bottled water.

Check and update your kit at least twice a year.

Controlling Diabetes When You're Planning a Pregnancy

Keeping your blood glucose near normal before and during pregnancy helps protect both you and your baby. Even before you become pregnant, your blood glucose should be close to the normal range.

Your health care team can work with you to get your blood glucose under control before you try to get pregnant. If you're already pregnant, see your doctor right away. It's not too late to bring your blood glucose close to normal so that you'll stay healthy during the rest of your pregnancy.

Your insulin needs may change when you're pregnant. Your doctor may want you to take more insulin and check your blood glucose more often. If you take diabetes pills, you'll take insulin instead when you're pregnant.

If you plan to have a baby,

  • work with your health care team to get your blood glucose as close to the normal range as possible before you get pregnant
  • see a doctor who has experience in taking care of pregnant women with diabetes
  • don't smoke, drink alcohol, or use harmful drugs
  • follow the meal plan you get from your dietitian or diabetes educator to make sure you and your unborn baby have a healthy diet

Be sure to have your eyes, heart and blood vessels, blood pressure, and kidneys checked. Your doctor should also check for nerve damage. Pregnancy can make some health problems worse.

People Who Can Help You Control Diabetes

  • Your doctor. You may see your regular doctor for diabetes care or someone who has special training in caring for people with diabetes. A doctor with special training in diabetes is called an endocrinologist or diabetologist.

You'll talk with your doctor about what kind of medicines you need and how much you should take. You'll also agree on a target blood glucose range and blood pressure and cholesterol targets. Your doctor will do tests to be sure your blood glucose, blood pressure, and cholesterol are staying on track and you're staying healthy. Ask your doctor if you should take aspirin every day to help prevent heart disease.

  • Your diabetes educator. A diabetes educator may be a nurse, a dietitian, or another kind of health care worker. Diabetes educators teach you about meal planning, diabetes medicines, physical activity, how to check your blood glucose, and how to fit diabetes care into your everyday life. Be sure to ask questions if you don't understand something.
  • Your family and friends. Taking care of your diabetes is a daily job. You may need help or support from your family or friends. You may want to bring a family member or close friend with you when you visit your doctor or diabetes educator. Taking good care of your diabetes can be a family affair!
  • A counselor or mental health worker. You might feel sad about having diabetes or get tired of taking care of yourself. Or you might be having problems because of work, school, or family. If diabetes makes you feel sad or angry, or if you have other problems that worry you, you can talk with a counselor or mental health worker. Your doctor or diabetes educator can help you find a counselor.

Other Helpful Tips to Control Your Diabetes

  • Follow your meal plan.
  • Don't skip meals, especially if you've already taken your insulin, because your blood glucose may go too low.
  • See your doctor before starting a physical activity program.
  • Check your blood glucose before, during, and after exercising. Don't exercise when your blood glucose is high and you have ketones in your blood or urine.
  • Don't exercise right before you go to sleep because it could cause low blood glucose during the night.

Keep a daily record of

  • your blood glucose numbers
  • the times of the day you took your insulin
  • the amount and type of insulin you took
  • whether you had ketones in your urine

Other tips

  • Tell your doctor if you have low blood glucose often, especially at the same time of the day or night several times in a row.
  • Tell your doctor if you've passed out from low blood glucose.
  • Ask your doctor about glucagon. Glucagon is a medicine that raises blood glucose. If you pass out from low blood glucose, someone should call 911 and give you a glucagon shot.
  • Take your insulin, even if you are sick and have been throwing up. Ask your doctor about how to adjust your insulin dose based on your blood glucose test results.

When you travel

  • take a special insulated bag to carry your insulin to keep it from freezing or getting too hot
  • bring extra supplies for taking insulin and testing your blood glucose in case of loss or breakage
  • ask your doctor for a letter saying that you have diabetes and need to carry supplies for taking insulin and testing blood glucose

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Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

SOURCE: National Diabetes Clearinghouse; NIDDK. Taking Care of Your Diabetes at Special Times.
Last update: 5/31/2011