MSU Extension Food & Health

The impact illness has on individuals with diabetes can cause self-management challenges. Whether the illness comes from a bacterial or viral infection, daily blood sugar management is affected. Being prepared and taking precautions to manage diabetes if infection occurs is essential.

Michigan State University Extension educator Pam Daniels recently sat down with Lori King, RN and certified diabetes care and education specialist. Lori addressed ten common questions surrounding prevention and diabetes self-care.

1. How can people with diabetes be prepared for possible bacterial or viral infection?

Being ready includes many topics such as eating healthy, exercising, taking medications, and keeping blood sugar in range. Having uncontrolled diabetes puts you at increased risk for illness.

2. What are the best ways to prevent virus infections?

Wash your hands multiple times a day: after using the bathroom, before eating or preparing food, after going to any public place, before checking blood sugar. Soap and water are best, but hand sanitizers work very well also (do not use before checking blood sugar). Keep hydrated. Stay away from others during the peak season of illness if possible. Keep your hands away from your face!

3. What are the first steps a person with diabetes should take if they feel sick?

Taking your temperature and blood sugar will give you an idea if something is brewing in your body. This could be viral where it just needs to run its course or bacterial, which may need antibiotics to treat. Your doctor can help you decide your course of action. The American Diabetes Association has up-to-date COVID-19 and sick days information.

4. What are the most important care supplies to have on hand?

Meter, test strips, sugar-free and low-carb fluids, and a current supply of all diabetes medications, such as oral meds, insulin, syringes, pump supplies and sugar tablets.

5. What can blood sugar readings tell us about potential illness?

Often, someone with diabetes will see their blood sugar rise before they have symptoms of an illness.

6. Should persons with diabetes be testing blood sugar more often when ill?

Yes, testing more often when you are ill is important. Blood sugar is likely to be higher when you are ill.  Increasing sugar-free/caffeine-free fluids can help but this may also mean you would benefit from more medication. Call your doctor to discuss your blood sugar, your current symptoms and if you can increase your medications safely.  Unfortunately, people may check their levels less when they are sick.  Some of their symptoms such as vomiting, headache, nausea can also be related to their blood sugar not just their illness.  Checking every four hours and recording it in a log will help you be ready when the doctor asks for this information.

7. Should Vitamin D and other supplements be taken?

Supplements are more helpful, if taken regularly, not just in times of illness. Discuss with your physician what supplements you would benefit from and more importantly how much to take. If you take more than needed, then the extra is just secreted into the urine or stored in fat cells.

8. Are there common indicators or first symptoms that individuals with diabetes might experience?

People with diabetes will experience the onset of an illness the same way as those without diabetes, except for high blood sugar. If you are checking for ketones you may notice ketones in your urine, which can lead to dehydration. Report this to your doctor. When blood sugar is elevated you can have symptoms such as increased urination, excessive thirst, fatigue, blurred vision and/or headache.

9. At what point should a person with diabetes who is feeling ill contact the doctor?

You are unable to keep down food for more than 24 hours. You have vomiting and/or severe diarrhea for more than six hours. You feel sleepy or cannot think clearly. This may be a sign of high blood sugar. You cannot keep any liquids down for more than four hours. Your blood sugar is over 250 mg/dl for more than 24 hours and this is not normal for you, or any time you have questions or concerns.

10. What are the most important readiness skills or preventative steps?

First, have a plan! It is an essential tool to make sure you are prepared for emergencies or unexpected circumstances. For more on making a diabetes self-care plan, visit the Have a Plan website. Next, move towards a healthier lifestyle, which includes eating healthy foods such as more fruits and vegetables and low-fat foods.

Exercise! The recommendation is 150 minutes a week, but anything is better than nothing.

Keep your quarterly diabetes appointments which include doing blood work. This may notify you in advance that something needs to be addressed.

Take your medication! This will help keep your A1c in range (between 6.5-8% is recommended depending on your age and other health problems) also know how your meds work and how to properly take them.

Although we can be as prepared as possible viruses are highly contagious. Always notify your healthcare team of any diabetes healthcare concerns. For more information about COVID-19 and diabetes, please visit the Michigan Department of Health & Human Services' Covid-19 and Diabetes website.

Michigan State University Extension also provides health and nutrition related workshops on becoming better self-managers of chronic disease such as diabetes. For more information and resources, visit our Diabetes website.