What to eat when I am sick?

Eating and drinking can be a big problem when you’re sick but it’s important to stick to your normal meal plan if you can. In addition to your normal meals, drink lots of non-caloric liquids to keep from getting dehydrated.

What if you can’t stick to your normal meal plan? Your sick-day plan should contain a meal plan. Try to take in your normal number of calories by eating easy-on-the-stomach foods like regular (non-diet) gelatin, crackers, soups and applesauce.

When your stomach is upset, try to eat small meals. Try carbohydrates, such as:

  • Bread
  • Cooked cereal
  • Mashed potatoes
  • Noodle or rice soup
  • Saltines
  • Gelatin (such as Jell-O)
  • Graham crackers

Many foods have the right amount of carbohydrates (about 15 grams) for your sick-day diet. Remember, on sick days it is OK to eat some foods you might not normally eat, if you cannot eat your regular foods. Some foods to try are:

  • ½ cup apple juice
  • ½ cup regular soft drink (non-diet, caffeine-free)
  • 1 Popsicle (1 stick)
  • 1 slice of dry toast
  • ½ cup cooked cereal
  • 6 saltine crackers
  • ½ cup frozen yogurt
  • 1 cup Gatorade or sports drink
  • ½ cup regular ice cream (if you are not throwing up)
  • ¼ cup sherbet
  • ¼ cup regular pudding (if you are not throwing up)
  • ½ cup regular gelatin/Jell-O
  • 1 cup yogurt (not frozen), sugar-free or plain
  • Milkshake made with ½ cup low-fat milk and ¼ cup ice cream mixed in a blender (if you are not throwing up)

If you throw up, do not drink or eat anything for 1 hour. Rest, but do not lie flat. After 1 hour, take sips of soda every 10 minutes.

Fluids you can drink if you are dehydrated are:

  • Water
  • Club soda
  • Diet soda (caffeine-free)
  • Tomato juice
  • Chicken broth

If your blood sugar is less than 100 mg/dL or falling quickly, it is OK to drink fluids that have sugar in them. Try to check their effect on your blood sugar, the same way you check how other foods affect your blood sugar.

Fluids you can drink if your blood sugar is low:

  • Apple juice
  • Orange juice
  • Grapefruit juice
  • Gatorade or other sports drink
  • Tea with honey
  • Lemon-lime drinks
  • Ginger ale

If you have already taken your insulin and are sick to your stomach, drink enough liquids with the same amount of carbohydrates that you would normally eat. If you cannot keep food or liquids down, go to the emergency room for treatment. You will receive fluids through a tube in your blood vessel (intravenous).

Keep Your Notebook Handy

No matter what kind of diabetes you have, measure your blood glucose and urine ketones more often than usual. If you have type 1 diabetes, you may need to measure blood glucose and urine ketones every four hours. Measuring ketones is very important because these waste products are more likely to build up when you are sick and lead to ketoacidosis.

If you have type 2 diabetes, checking blood glucose four times a day may be enough. You might only need to measure ketones if your blood glucose is higher than 300. If you do not have a meter, talk to your diabetes educator about getting one.

Diabetes Medications

When sick, you will still need to continue medications for your diabetes. Even if you are throwing up, don’t stop your medications. You need them because your body makes extra glucose (sugar) when you are sick.

If you have type 1 diabetes, you may have to take extra insulin to bring down the higher blood glucose levels. If you have type 2 diabetes, you may be able to take your pills, or you may need to use insulin for a short time. In either case, work with your doctor to develop your sick-day plan.

Medications to Watch Out For

You may want to take extra medications when you are sick. For example, if you have a cold, you may want to take a cough medicine.

Always check the label of over-the-counter medicines before you buy them to see if they have sugar. Small doses of medicines with sugar are usually okay. But to be on the safe side, ask the pharmacist or your team about sugar-free medicines.

Many medications you take for short-term illnesses can affect your blood glucose levels, even if they don’t contain sugar. For example, aspirin in large doses can lower blood glucose levels. Some antibiotics lower blood glucose levels in people with type 2 diabetes who take diabetes pills. Decongestants and some products for treating colds raise blood glucose levels.

If you must go to the emergency room or see a different doctor than usual, be sure to say you have diabetes, or have your identification bracelet in plain view. List all the medications that you are taking.

Your blood glucose level can also be affected by medications you take for chronic or long-term conditions.

How to manage your diabetes when you are sick

Making a Sick-Day Plan

Prepare a plan for sick days in advance. Work with your doctor, or a diabetes educator. The plan will include when to call your doctor, how often to measure blood glucose and urine ketones, what medications to take, and how to eat.

Also, attach to your plan a list of phone numbers for your doctor, diabetes educator, and dietitian. Make sure you also know how to reach them at night and on weekends and holidays. Then when illness strikes, you will be ready.

When to call your doctor

You do not need to call your doctor every time you have a sniffle. But you will probably want to call if certain things happen.

For example:

  • you’ve been sick or have had a fever for a couple of days and aren’t getting better
  • you’ve been vomiting or having diarrhea for more than 6 hours
  • you have moderate to large amounts of ketones in your urine
  • your glucose levels are higher than 240 even though you’ve taken the extra insulin your sick-day plan calls for
  • you take pills for your diabetes and your blood glucose level climbs to more than 240 before meals and stays there for more than 24 hours
  • you have symptoms that might signal ketoacidosis or dehydration or some other serious condition (for example, your chest hurts, you are having trouble breathing, your breath smells fruity, or your lips or tongue are dry and cracked)
  • you aren’t certain what to do to take care of yourself

Be ready to tell what medications you’ve taken and how much, how long you’ve been sick, whether you can eat and keep food down, whether you’ve lost weight, and what your temperature, blood glucose level, and urine ketone level are. To be prepared, keep written records of all these things as soon as you become sick.