What extra precautions should my dad with diabetes take when he has the flu?

A fellow caregiver asked...

Are there any extra measures my father, who has type 2 diabetes, should take if he's sick with the flu, a cold, or another minor ailment?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

If your dad becomes ill, he should test his blood sugar levels more often than usual, as sickness -- even something seemingly minor like a cold or the flu -- can make his sugar levels soar. That's because the body produces more glucose as a natural response to illness. It's smart to check at least every four hours; if your dad feels too unwell to test his blood, you or another caregiver can do this task for him.

It's also important that he try to eat and drink. He needs food and liquid to prevent dehydration, fight the disease, and keep his temperature down and his blood sugar in check. Comfort foods such as applesauce, chicken soup, plain broth, dry crackers, and fruit sherbet are often well tolerated during an illness.

Your father also needs to continue taking his medications, even if he's eating very little during his illness, because his body still makes glucose and his pills or insulin are key to keeping blood glucose within his recommended range. Often people mistakenly think that if they're ill and not eating much, then they don't need their diabetes drugs, but that's not the case. If your dad takes any extra medicines to deal with his illness, he should check with his pharmacist or healthcare provider about any impact these drugs may have on his blood sugar levels while he's sick.

Of course, if your dad is unable to take his pills or keep food or fluids down, he should contact his healthcare provider as soon as possible. Severe dehydration during a routine illness can lead to serious conditions such as a coma if left untreated in people with diabetes. If his blood sugar level is consistently above 240 milligrams per deciliter for two days he should consult his doctor, who will consider treatment options to resolve the crisis. (Likewise, values consistently above 180 indicate a need to re-evaluate and adjust the treatment program to minimize the risk for long-term complications).

The best way to make sure a minor ailment doesn't become a major problem is for your dad to work with his doctor or diabetes educator to formulate an action plan for handling sick days ahead of time. That way, if he does fall ill, he'll know what to do and have the necessary supplies on hand. Such a plan might include how often he should test his blood sugar, what medicines he should take, what he should eat, and when to call his diabetes healthcare provider. The plan should include contact numbers for members of his diabetes team, including his doctor, diabetes educator, and dietician, so he can reach them in a hurry if he needs to.