Diabetes Care When You Don't Feel Well

Q: I recently became ill with a very bad infection. I lost my appetite, so I quit taking my glipizide (a medication that stimulates insulin release during meals). I thought I was doing the right thing because I could not eat. A few days later, my blood sugar was 370, which shocked me. Can you tell me how I should handle diabetes when I'm not feeling well?

A: When you're sick, you need to monitor your blood glucose more closely, because the stress of an illness can raise blood glucose levels more than eating does. It's a good idea to call your health-care providers to let them know your symptoms and see whether you should visit their office or an emergency room. They'll probably encourage you to check your blood glucose every two to four hours while your levels are elevated or until your symptoms subside. They may want you to call them with the results.

If you have no appetite or have nausea or vomiting, substitute liquids or soft foods. Divide about 150-200 grams of carbohydrates evenly throughout the day, eating 45-60 grams of carbohydrates every three or four hours.

Make sure you drink plenty of fluids to prevent dehydration. If you take insulin or blood-glucose-lowering medications, you still need them, even when you're unable to eat. Work with your health-care providers to make necessary adjustments.

Foods that contain 15 grams of carbs (1 carbohydrate choice):

• 2-5 crackers
• 1/2 cup fruit juice
• 3/4 cup ready-to-eat cereal
• 6 ounces sugar-free yogurt
• 1/2 cup cooked pasta or rice
• 1 slice dry toast

Jeannette Jordan, M.S., R.D., CDE, is the American Dietetic Association's national spokesperson for African-American nutrition issues and oversees nutrition education at the Medical University of South Carolina.