Diabetes & Sick Days: Which Meds Are Okay And When

Martin C. Abrahamson, MD, is the Chief Medical Officer, of the Joslin Diabetes Center.

Martin C. Abrahamson, MD, Chief Medical Officer, Joslin Diabetes Center, Associate Professor of Medicine, Harvard Medical School

It’s likely that sometime this winter you were sick – or will get sick. Whether it’s a cold or the flu, this season seems to be when illness strikes. When you’re living with diabetes and you get sick, your blood-sugar levels will likely go up. This can alter your normal diabetes-treatment routine.  Because of this, you need to think about what you would do, if and when you get sick, before your first cough or sore throat.

Martin J. Abrahamson, MD, medical director of Joslin Clinic, offers these tips on managing diabetes while you’re sick:

  • Make a sick-day plan with your diabetes specialist. This may include a special meal plan for when you are having trouble keeping food down. Most medications won’t have an effect on your diabetes, but some will.
  • Use caution with some antihistamines such as Allegra (fexofenadine hydrochloride) and Bumex (bumetanide) because they can affect heart and blood pressure.
  • Those with diabetes should avoid taking medications containing sugar, such as sucrose, dextrose, fructose, lactose and honey. Also, choose products with little or no alcohol.
  • Use sugar-free cough and cold medicines, including: Chlor-Trometon tablets; Dimetapp Elixir; Scot-Tussin DM Liquid; and Cerose-DM Liquid.
  • If you have questions of whether a certain medication is right for you, ask your doctor.

When you get sick:

  • Always take your diabetes medication. If you are having trouble keeping the medicine down, call your doctor.
  • Check your blood-glucose level at least four times a day. If you are too sick to test it yourself, have someone else do it.
  • Write down your levels in case you need to call your doctor.
  • Check for ketones when your blood glucose is 250 or higher. Write down levels in case you need to call your doctor.
  • Stick to your normal meal plan, if possible.
  • Drink lots of sugar-free liquids, to prevent dehydration

Call your doctor if you have any of the following:

  • A fever above 100.5 degrees.
  • Vomiting and/or diarrhea for more than two hours.
  • Blood-glucose levels above 250 milligrams after two checks, or if levels do not go down after taking extra insulin.
  • Moderate or large ketones

For more information:

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4 Responses to Diabetes & Sick Days: Which Meds Are Okay And When

  1. Doris Dickson says:

    I really wish you’d separate type 1 and type 2 (specfically insulin dependent) diabetes.

    It is totally insufficient to only check blood sugar four times a day with insulin dependent diabetes (unless you like passing out or being up and down) much less on sick day.

    Also … pseudophedrine also increases blood pressure, adrenalin and subsequently blood sugar.

    Finally, the new cough medicines just plain don’t work especially if you have something like bronchitis. So, based on a long conversation with my doc, I concluded ceasing the coughing (which in and of itself with screw up blood sugar) is more important and she now gives me a script for cough medicine. She said it is the only thing she gives her kids!!! So, that’s how strongly she feels OTC cough medicine has become useless.

  2. Joan says:

    I agree with Doris – (Hi Doris, hope you are doing fine, as usual)!

    When will those who write or discuss diabetes issues to remember that each type of diabetes is often treated slightly different! The cough medicine I use as a Type 1 diabetic is Robitussin, Sugar Free, that does not raise my BG at all. For other Type 1s this brand may NOT be best for them. I checked with my endocrinologist and found the brand that worked best for me – others should do the same.

    For Type 1 diabetics testing frequently, especially when ill, helps to keep the BG in control.

    Golly, I thought Joslin would know that specifying the type of diabetes in any article, would be far more helpful to all diabetics and far less confusing.

  3. Joseph Wolf says:

    I’m in a position to promote,plan a diabetes day and would like to hear some success stories of what kind of programs have worked historically-thanx

  4. Robert says:

    Thanks for the knowledge given about the Allegra. Keep providing the information of Allegra as much as possible.

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