Managing Diabetes When You're Sick (and Not on Insulin)

Steps
When to Adjust Your Medications

If you cannot eat or drink or are at risk of dehydration (have a fever, diarrhea, vomiting, etc.), stop these medications until you feel better:

  • Metformin
  • Glyburide, glimepiride, or glipizide
  • Jardiance (empagliflozin)
  • Farxiga (dapagliflozin)
  • Invokana (canagliflozin)

If you are at risk of dehydration, you may also need to adjust your diuretic ("water pill") and blood pressure medications.  Reach out if you have questions about this.

If you have severe nausea and vomiting, stop these medications until you can eat/drink again:

  • Ozempic (semaglutide)
  • Trulicity (dulaglutide)
  • Victoza (liraglutide)
  • Rybelsus (semaglutide)
  • Bydureon, Bydureon BCise, or Byetta (exenatide)

If you're on a medication not listed above and want to know if it's okay to take it, just ask.

Check Your Blood Sugar More Often

When you're sick, check your blood sugars 1 to 2 times a day.

If your blood sugar is rising quickly, check more often.

Stay Hydrated & Read Labels

Keeping yourself from becoming dehydrated is especially important if you're vomiting or have diarrhea.

Every hour, drink a glass of sugar-free liquid, such as:

  • Water
  • Broth or bouillon
  • Gatorade ZERO
  • Crystal Light

Over-the-counter cough and cold medicines may have ingredients that increase your blood sugar.  When possible, choose sugar-free options.

When to Reach Out

Let us or another medical provider know if you:

  • Cannot keep down medication, fluids, or liquids.
  • Have a fever over 101°F that does not get better with a fever-lowering medication (Tylenol, ibuprofen, etc.).
  • Have blood sugar that is consistently over 250 or below 70.

Go to your local emergency room (ER) immediately if you have any of the following:

  • Vomiting that won't stop
  • Confusion
  • Severe abdominal (belly) pain
  • Blood sugar over 500

Being sick can make your blood sugar go up—here's what to do if it does.

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