Sick Day Management
o Do not skip medications, especially insulin. Take as prescribed.
o Never stop taking your medications without contacting your clinician.
o Test blood sugar at least 4 times a day or more often.
o Contact your clinician if your blood sugars are not in target range.
o Check for ketones if type 1 diabetes (and type 2 if your physician
o Contact your clinician if ketones are present.
o Check temperature 4 times a day.
o Drink plenty of fluids—at least 8 ounces of calorie free fluids every
hour while awake.
o Eat small frequent meals or snacks.
Call your clinician immediately if:
o you cannot keep fluids down
o diarrhea more than 5 times for longer than 6 hours
o have a fever
o blood sugars remain elevated over 300 mg/dl on 2 consecutive
o presence of moderate or large ketones
o or no improvement in your symptoms
(adapted from American Association of Diabetes Educators “A Core Curriculum for Diabetes
Education”, 5th edition 2003)