When you're sick, your body produces stress-related hormones that help your body fight the illness, but they can also raise your blood sugar level. Changes in your appetite and normal activity may also complicate diabetes management.
What to do:
- Plan ahead. Work with your health care team to create a sick-day plan. Include instructions on what medications to take, how often to measure your blood sugar and urine ketone levels, how to adjust your medication dosages, and when to call your doctor.
- Continue to take your diabetes medication. However, if you're unable to eat because of nausea or vomiting, contact your doctor. In these situations, you may need to adjust your insulin dose or temporarily stop taking your medication because of a risk of hypoglycemia.
- Stick to your diabetes meal plan. If you can, eating as usual will help you control your blood sugar levels. Keep a supply of foods that are easy on your stomach, such as gelatin, crackers, soups and applesauce. Drink lots of water or other fluids that don't add calories, such as tea, to make sure you stay hydrated. If you're taking insulin, you may need to sip sugar-sweetened beverages, such as juice or a sports drink, to keep your blood sugar level from dropping too low.
The liver normally releases stored sugar to counteract falling blood sugar levels. But if your liver is busy metabolizing alcohol, your blood sugar level may not get the boost it needs from the liver. Alcohol can result in low blood sugar shortly after you drink it and for as many as 24 hours more.
What to do:
- Get your doctor's OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, an occasional alcoholic drink is fine. Moderate alcohol consumption is defined as no more than one drink a day for women of any age and men over 65 years old and two drinks a day for men under 65. One drink equals a 12-ounce beer, 5 ounces of wine or 1.5 ounces of distilled spirits.
- Don't drink alcoholic beverages on an empty stomach. If you take insulin or other diabetes medications, be sure to eat before you drink or drink with a meal to prevent a low blood sugar level.
- Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, sugar-free mixers — such as diet soda, diet tonic, club soda or seltzer — won't raise your blood sugar.
- Tally your calories. Remember to include the calories from any alcohol you drink in your daily calorie count. Ask your doctor or dietitian how to incorporate calories and carbohydrates from alcoholic drinks into your diet plan.
- Check your blood sugar level before bed. Because alcohol can lower blood sugar levels long after you've had your last drink, check your blood sugar level before you go to sleep. If your blood sugar isn't between 100 and 140 mg/dL (5.6 and 7.8 mmol/L), have a snack before bed to counter a drop in your blood sugar level.
Menstruation and menopause
Changes in hormone levels the week before and during menstruation can result in significant fluctuations in blood sugar levels. And in the few years before and during menopause, hormone changes may result in unpredictable variations in blood sugar levels that complicate diabetes management.
What to do:
- Look for patterns. Keep careful track of your blood sugar readings from month to month. You may be able to predict fluctuations related to your menstrual cycle.
- Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity level or diabetes medications to make up for blood sugar variation.
- Check blood sugar more frequently. If you're likely approaching menopause or experiencing menopause, talk to your doctor about whether you need to monitor your blood sugar level more often. Symptoms of menopause can sometimes be confused with symptoms of low blood sugar, so whenever possible, check your blood sugar before treating a suspected low to confirm the low blood sugar level.
Most forms of birth control can be used by women with diabetes without a problem. However, oral contraceptives may raise blood sugar levels in some women.
If you're stressed, the hormones your body produces in response to prolonged stress may cause a rise in your blood sugar level. Additionally, it may be harder to closely follow your usual diabetes management routine if you're under a lot of extra pressure.
What to do:
- Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
- Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques, prioritize your tasks and set limits. Whenever possible, avoid common stressors. Exercise can often help relieve stress and lower your blood sugar level.
- Get help. Learn new strategies for coping with stress. You may find that working with a psychologist or clinical social worker can help you identify stressors, solve stressful problems or learn new coping skills.
The more you know about factors that influence your blood sugar level, the more you can anticipate fluctuations — and plan accordingly. If you're having trouble keeping your blood sugar level in your target range, ask your diabetes health care team for help.
June 10, 2014
See more In-depth
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- Diabetes and me: Eat right. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/consumer/eatright.htm. Accessed March 6, 2014.
- Diabetes and me: Be active. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/consumer/beactive.htm. Accessed March 6, 2014.
- What I need to know about diabetes medicines. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.aspx. Accessed March 7, 2014.
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- Stress. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/mental-health/stress.html. Accessed March 7, 2014.
- Chang JS, et al. Pattern of stress-induced hyperglycemia according to type of diabetes: A predator stress model. Diabetes & Metabolism. 2013;37:475.