What is the sick-day management principle for patients with diabetes?

• A. Stop all medications and fast.
• B. Keep taking only half the usual dose and drink fluids.
• C. Exercise aggressively to control blood sugar.
• D. Increase monitoring, stay hydrated, continue insulin or oral agents if possible, check for ketones, seek care if ill.

Answer: (D)

When someone with diabetes is sick, the body’s stress hormones can push glucose up and raise the risk of dehydration and ketosis. The best sick-day approach is to monitor glucose more frequently, stay hydrated, continue insulin or oral diabetes medications if possible, check for ketones, and seek medical care promptly if illness worsens or ketones appear. Regular checks (often every 2–4 hours) help you adjust dosing as needed and prevent dangerous highs or ketoacidosis. Keeping fluids going—water or oral rehydration solutions as appropriate—helps with kidney function and glucose balance, and checking ketones guides whether to seek urgent care. Stopping all meds, or cutting doses in half, or exercising vigorously during illness can worsen hyperglycemia or trigger ketosis, so those are not appropriate strategies.