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Getting sick isn’t fun for anyone, especially for those with diabetes. For people with diabetes, sick days are more than just coughing and sneezing. With any illness, whether it be the cold, the flu, or any virus that can cause gastrointestinal issues, blood sugar can be boosted and lead to an infection.

With the possibility of infection looming, people with diabetes need to stay on top of their sugar levels even while they are sick. In addition to higher sugar levels, those with Type 1 may produce ketones when they are sick. Ketones can start to manifest once blood sugar levels reach above 240mg/dL.

Ketones are a build-up of chemicals that burn fat for energy. Ketones occur most frequently in diabetics when there is a lack of insulin. When there is not enough insulin, glucose will start to build up in the bloodstream and is unable to enter the cell. In turn, the cells burn fat over glucose. Ketones will then form in the blood and then appear in the urine.

Having ketones present in your body is a serious matter. If ketones aren’t managed, it can lead to diabetic ketoacidosis, also known as DKA. Symptoms of DKA can range to include moderate or large ketones, nausea, vomiting, fruity or acetone breath, rapid breathing, abdominal pain, flushed skin, and lack of energy. High level of ketones are toxic to the body, and if these symptoms are left untreated, they can lead to diabetic coma or death.

If you are sick or have Ketones, keep the acronym KISS in mind.

Sugar (blood)

If you have a mild illness with no fever, no vomiting, no ketones in urine, and can eat and drink, continue to take your insulin. On top of that, follow the KISS method;

Ketones: Check for ketones at least once a day.
Insulin: Make sure to administer all doses – carb ratio and correction.
Sugar (blood): Check your blood sugar before meals and before you go to sleep.
Sip: Make sure you stay hydrated and drink sugar-free drinks and lots of water.

For a more moderate to a serious illness that includes fever, nausea, vomiting, or diarrhea follow a more in-depth KISS model.

Ketones: Every time you urinate, you will want to check for ketones.
Insulin:  Every three hours you will want to use a syringe/pen to give correction insulin, leave out the carb ratio.
Sugar (blood): You will want to check your blood sugar more frequently, at least once every three hours.
Sip: If your blood sugar is greater than 250, stick with sugar-free drinks. However, if your blood sugar is less than 250, feel free to drink a more sugary drink to bring up your levels.

With these helpful tips, hopefully, you will be better prepared the next time you get sick or have ketones.