Many diabetics try very hard to live their lives as normal as possible. They get up every morning, test their blood sugar, take their medication, eat their breakfast, and go to work like every other working person in the world. When a diabetic person gets sick and cannot go to work, he or she must call in sick.
According to the WebMD Online Article written September 11, 2008, sick days often mean more than a runny nose and sneezing. An illness such as a cold or the flu, or any condition resulting in nausea, vomiting or diarrhea, may cause your blood sugar to increase. An infection also can raise blood sugar levels. Therefore, it is very important to test your blood sugar when you are sick. Here are some guidelines to follow when you are ill:
- Check your blood sugar every four hours.
- Test for ketones if your blood sugars are above 240mg/dl, or as directed by your health care provider. Ketones are a form of waste often produced in the bodies of people with type 1 diabetes when they are under stress (such as during an illness). Call your doctor if ketones are found in your urine. Depending on the degree of your illness, he or she may suggest that you go to the emergency room.
- Check your temperature regularly.
- Make sure you are drinking liquids if you are unable to keep down solid food. Drink one cup of liquid every hour while you are awake to prevent dehydration. If you are unable to hold down liquids, you may need to go to the emergency room or hospital.
- Do not stop taking your insulin, even if you are unable to eat solid foods. You may need to eat or drink something with sugar in some form so that your blood sugar doesn’t drop too low. People with type 2 diabetes who are on oral medicines may need to stop taking their medicines when sick. Check with your doctor if you are unsure of what to do.
- If you need an over-the-counter medicine to control symptoms such as cough and nasal congestion, ask your doctor or pharmacist for a list of sugar-free products that are available.
When Should I Call My Doctor?
If you have diabetes and are sick, call your doctor if:
- Your blood sugar stays higher than 180 mg/dL or lower than 70 mg/dL.
- You are unable to keep liquids or solids down.
- You have a fever (temperature over 101 degrees F or 38.3 degrees C).
- You have diarrhea or are vomiting.
What Foods Should I Eat When I’m Sick?
If you are sick and have diabetes, you should eat or drink 45 to 50 grams of carbohydrate every three to four hours to maintain your nutrition needs, to avoid ketone development and to prevent hypoglycemia.
If you can’t eat foods, you could try more easily tolerated foods, such as those listed below. Each of these items equal one carbohydrate choice.
- 1 cup clear soup
- 1/2 cup regular gelatin
- 1/2 cup regular soft drink, like 7-up or Sprite
- 1/2 Popsicle
- 1/2 cup unsweetened applesauce
- 1/3 cup apple juice
- 1/2 cup sports drink, like Gatorade
Calorie-free liquids you may drink during an illness include water and 1/2 cup of broth or bouillon.
Coping With Diabetes and Stress
When you have diabetes, stress can significantly affect your ability to control the disease. If you are under stress, you may skip meals or forget to take your medicines, which will affect your blood sugar level. Learning to deal with this stress is especially important if you have diabetes.
Although you can’t completely remove stress from your life, there are several ways you can reduce it. And by learning to better cope with stress, you can help keep your diabetes under control. Here are some tips.
Fight Stress With a Positive Attitude
When things seem to be going wrong, it’s always easier to see the bad instead of the good. Find something good in each important area of your life: work, family, friends, and health. Thinking about the good can help you get through the bad times and the stress.
Be Nice to Yourself
What are your talents, abilities, and goals? Are you expecting too much from yourself? Don’t expect more of yourself than you have or are able to give.
Accept What You Cannot Change
For those stressful situations or problems that cannot be changed, develop a simple plan of action. Ask yourself the following questions:
- “Will this be important two years from now?”
- “Do I have control over this situation?”
- “Can I change my situation?”
Talk to Someone About Your Stress
Don’t keep stress bottled up inside. If you don’t want to talk with a family member or close friend, there are counselors and clergy trained to provide support and insight. Ask your doctor for recommendations if you would like to see a psychologist or counselor.
Exercise to Fight Stress
The benefits of exercise in reducing stress are well known, particularly for someone with diabetes. Exercise gives you a feeling of well-being and may relieve symptoms of stress.
Take Time to Relax
Practice muscle relaxation, deep breathing, meditation, or visualization. Ask your health care provider for information and available programs.
Type 2 Diabetes and Exercise
Exercise is very important in managing type 2 diabetes. Combining diet, exercise, and medicine (when prescribed) will help control your weight and blood sugar level.
Exercise helps control type 2 diabetes by:
- Improving your body’s use of insulin.
- Burning excess body fat, helping to decrease and control weight (decreased body fat results in improved insulin sensitivity).
- Improving muscle strength.
- Increasing bone density and strength.
- Lowering blood pressure.
- Helping to protect against heart and blood vessel disease by lowering ‘bad’ LDL cholesterol and increasing ‘good’ HDL cholesterol.
- Improving blood circulation and reducing your risk of heart disease.
- Increasing energy level and enhancing work capacity.
- Reducing stress, promoting relaxation, and releasing tension and anxiety.
How Does Exercise Affect Blood Sugar Levels?
Normally, insulin is released from the pancreas when the amount of sugar (glucose) in the blood increases, such as after eating. Insulin stimulates the liver and muscles to take in excess glucose. This results in a lowering of the blood sugar level.
When exercising, the body needs extra energy or fuel (in the form of glucose) for the exercising muscles. For short bursts of exercise, such as a quick sprint to catch the bus, the muscles and the liver can release stores of glucose for fuel. With continued moderate exercising, however, your muscles take up glucose at almost 20 times the normal rate. This lowers blood sugar levels.
But intense exercise can have the opposite effect and actually increase your blood glucose levels. This is especially true for many people with diabetes. The body recognizes intense exercise as a stress and releases stress hormones that tell your body to increase available blood sugar to fuel your muscles. If this happens to you, you may need a little bit of insulin after intense workouts.
For a variety of reasons, after exercise, people with diabetes may have an increase or a decrease in their blood sugar levels.
Is Blood Sugar Ever Too High to Exercise?
Yes. In some cases, you should hold off on exercising if your blood sugar is very high.
What Types of Exercise Is Best for Diabetes?
While most any exercise is healthy for people with diabetes, let’s look at some specific types of exercise and their benefits:
Strength Training and Type 2 Diabetes
The latest findings show that exercise such as strength training has a profound impact on helping people manage their diabetes. In a recent study of Hispanic men and women, 16 weeks of strength training produced dramatic improvements in sugar control that are comparable to taking diabetes medication. Additionally, the study volunteers were stronger, gained muscle, lost body fat, had less depression, and felt much more self-confident.
For more detail, see WebMD’s article Strength Training and Diabetes.
Aerobic Fitness and Type 2 Diabetes
Any activity that raises your heart rate and keeps it up for an extended period of time will improve your aerobic fitness. Aerobic exercise helps decrease the risk of type 2 diabetes and helps those with diabetes to better manage their blood sugar levels. Besides the health benefits, exercise is fun and boosts your mood. It’s hard to feel stressed when you’re walking fast on a treadmill or swimming laps in a pool.
Type 2 Diabetes and Exercise Tips
- To reduce the risk of hypoglycemia if you have diabetes, follow a regular routine of exercising, eating your meals, and taking your medicines at the same time each day.
- Prolonged or strenuous exercise can cause your body to produce adrenaline and other hormones that can counteract the effects of insulin and cause your blood sugar to rise. If you are participating in strenuous exercise (exercising at your maximum capacity) or prolonged exercise (lasting for several hours or more), your insulin and/or oral diabetic medicine may need to be changed. Talk to your health care provider about how to adjust your medicine.
- Be careful exercising when your medicine is reaching its peak effect.
- Depending on the time of exercise, reducing your dose of either long-acting insulin or short-acting insulin will be necessary. Your doctor can recommend how to make this adjustment.
- Exercise with someone who knows you have diabetes and knows what to do if you have a low blood-sugar reaction.
- Wear a medical identification tag (for example, MedicAlert) or carry an identification card that states you have diabetes.
More Diabetes-Specific Exercise Tips
The American Diabetes Association offers these basic exercise guidelines for those with diabetes:
- Discuss with your doctor what types of exercise might be appropriate for you. Complications of diabetes such as severe eye disease and nerve damage may make some forms of exercise dangerous for you. Your doctor may also schedule a test to see how your heart responds to exercise.
- Do not exercise if your blood sugar is greater than 250 mg/dL (milligrams per deciliter) and your ketones positive. This is an indication that you already may have a lack of insulin and exercise will only cause a greater rise in your blood sugar. Hydrate yourself and adjust your insulin as necessary, contact your health care provider.
- Use caution when exercising if your blood sugar is greater than 300 mg/dL without evidence of ketones, exercise may help decrease your sugars, but it’s possible they will increase instead. Hydrate well prior to and after exercise and keep track of your sugars and ketones.
- Learn the effects of various types of exercise on your blood sugar.
- Have carbohydrate-based foods available for exercise and for the period following exercise. Add carbohydrates to your meals if you plan on doing exercise, adjust your insulin dose appropriately in anticipation of exercise.
General Exercise Guidelines and Precautions
- If you have diabetes, check with your health care provider before you begin a an exercise program. Tell your doctor what kind of exercise you want to do so adjustments can be made to your medicine schedule or meal plan, if necessary.
- Start slowly and gradually increase your endurance.
- Choose an activity that you enjoy. You’ll be more likely to stick with a program if you enjoy the activity. Make exercise a lifetime commitment.
- Consider a water exercise program. Some other exercise options include walking, riding a stationary bicycle, swimming, or muscle stretching.
- Exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day. A good exercise program should include a 5- to 10-minute warm-up and at least 15 to 30 minutes of continuous aerobic exercise (such as walking or biking) or muscle stretching exercises, followed by a 5-minute cool down.
- Wear good shoes and practice proper foot care.
- Drink water before, during, and after exercise to prevent dehydration.
- Do not ignore pain — discontinue any exercise that causes unexpected pain. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage to your joints.
Should I Stop Exercising When I Reach My Ideal Weight?
Exercise is a lifetime commitment. Regardless of your weight, you should exercise at least three to four times per week for 20 to 40 minutes each session. Ideally, you should exercise every day to help manage your type 2 diabetes long-term.
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
