Diabetes at home: low blood sugar, sick days and the feet

Most diabetes care happens at home: the meter on the kitchen counter, the insulin in the fridge, the evening look at the feet. After a hospital stay or a change in medicines, those routines can wobble, and a low blood sugar can come on fast. This note covers three parts of the daily work, low blood sugar, sick days and the feet, and what Medicare covers to help. It uses guidance from the CDC and the National Library of Medicine.^1,2

The short answer

• Blood sugar below 70 mg/dL is low. Treat it with the 15-15 rule: 15 grams of fast-acting carbs, wait 15 minutes, check again.²
• Know the signs: shaking, sweating, hunger, headache, crankiness, trouble thinking clearly, blurry vision and a pounding heartbeat.¹
• If the person isn’t alert or can’t be woken up, it’s an emergency. Call 911.¹
• On a sick day, check blood sugar every 2 to 4 hours, keep taking medicines unless the provider says otherwise, and drink plenty of sugar-free fluids.³
• Check the feet every evening when the shoes come off.⁴

Low blood sugar

Blood sugar below 70 mg/dL is considered low, and below 55 mg/dL is severely low.² Common signs include:¹

• Shaking, sweating or a fast, pounding heartbeat
• Hunger, weakness or feeling tired
• A headache
• Feeling nervous, anxious or cranky
• Trouble thinking clearly
• Double or blurry vision

Confusion or brain fog can be a sign too,² which is why the family should know the routine as well as the person does. Someone with low blood sugar shouldn’t drive.¹

The 15-15 rule

The CDC describes it this way:²

• Have 15 grams of fast-acting carbs: 4 ounces of juice or regular soda, 1 tablespoon of sugar, honey or syrup, hard candies or gumdrops, 3 or 4 glucose tablets, or 1 dose of glucose gel.
• Wait 15 minutes, then check again.
• If it’s still under 70 mg/dL, repeat.
• Once it’s back in the target range, eat a balanced snack or meal with protein and carbs.

In one picture

The 15-15 rule

1. 115 grams of fast-acting carbs
2. 2Wait 15 minutes, then check again.
3. 3If it’s still under 70 mg/dL, repeat.

Once it’s back in the target range, eat a balanced snack or meal with protein and carbs.

Source · cdc.gov

Keep fast-acting carbs wherever a low might happen: the nightstand, the car, a purse. Injectable glucagon is the best way to treat severely low blood sugar,² so ask the doctor whether the person should have it at home, and have the nurse teach the family to use it. If symptoms don’t improve after a sugary snack, or the person isn’t alert or can’t be woken up, call 911.¹

Sick days

Being sick can push blood sugar up or down. On a sick day, MedlinePlus advises:³

• Check blood sugar more often, every 2 to 4 hours, and write down each reading, the time and the medicines taken.
• Most of the time, take medicines as usual. Don’t skip or double doses unless the provider says to, and call if the person can’t eat their usual carbohydrates, since doses may need to change.
• Drink plenty of sugar-free fluids, about 3 liters a day, such as water, broth or diet soda.
• With type 1 diabetes and high blood sugar, check urine ketones each time the person urinates.

Call the provider for blood sugar above 240 mg/dL for more than a day, moderate to large ketones, vomiting or diarrhea for more than 4 hours, or a fever of 100°F or higher. If the provider doesn’t call back promptly, go to the emergency room.³ For chest pain, or sudden confusion or trouble with vision, speech or balance, call 911.

The feet

Diabetes can damage the nerves in the feet, so a person may not feel a pebble in a sock or a blister, and poor blood flow can make a sore slow to heal.⁴ Check the feet every evening, when the shoes come off, for cuts, sores, red spots, swelling, blisters, ingrown toenails and warm spots.⁴ Get care right away for a cut, blister or bruise that doesn’t start to heal after a few days, or skin that turns red, warm or painful.⁴ Wound care at home covers what to do once a sore starts.

What Medicare covers

• Testing supplies. Part B covers blood sugar meters, test strips, lancets and continuous glucose monitors. After the Part B deductible, the person pays 20% of the Medicare-approved amount.⁵
• Shoes. For people with diabetes and severe diabetes-related foot disease, Part B covers therapeutic shoes or inserts each year, also at 20% after the deductible.⁵
• Foot exams. For diabetic nerve damage, Part B covers a foot exam every 6 months by a podiatrist or another foot care specialist.⁵
• Training. Diabetes self-management training covers up to 10 hours at first and 2 hours a year after that.⁵

When someone qualifies for home health, a nurse can teach and watch diabetes care at home. Medicare’s examples of covered skilled nursing include patient and caregiver education, injections and monitoring unstable health.⁶ The complete guide to home health explains who qualifies.

Questions families ask

What counts as low blood sugar?

Below 70 mg/dL is low, and below 55 mg/dL is severely low.²

What should Mom have when her sugar is low?

15 grams of fast-acting carbs, like 4 ounces of juice or regular soda, or 3 or 4 glucose tablets. Wait 15 minutes, check again, and repeat if it’s still under 70.²

Dad has the flu and isn’t eating. Should he skip his diabetes medicine?

Not on his own. Most of the time, medicines are taken as usual on sick days. Call his provider, since doses may need to change when he can’t eat his usual carbohydrates.³

When is low blood sugar an emergency?

When symptoms don’t improve after a sugary snack, or the person isn’t alert or can’t be woken up. Call 911.¹

Does Medicare pay for diabetic shoes?

For people with diabetes and severe diabetes-related foot disease, Part B covers therapeutic shoes or inserts each year, at 20% of the Medicare-approved amount after the deductible.⁵

Sources

Sources · 6 references

1. MedlinePlus, “Low blood sugar - self-care,” National Library of Medicine, reviewed January 25, 2026. medlineplus.gov (opens in a new tab)
2. Centers for Disease Control and Prevention, “Treatment of Low Blood Sugar (Hypoglycemia),” May 15, 2024. cdc.gov (opens in a new tab)
3. MedlinePlus, “Diabetes - when you are sick,” National Library of Medicine, reviewed May 18, 2026. medlineplus.gov (opens in a new tab)
4. National Institute of Diabetes and Digestive and Kidney Diseases, “Diabetes & Foot Problems,” last reviewed January 2017. niddk.nih.gov (opens in a new tab)
5. Centers for Medicare & Medicaid Services, “Medicare Coverage of Diabetes Supplies, Services & Prevention Programs,” Product No. 11022, July 2026. medicare.gov (opens in a new tab)
6. Medicare.gov, “Home health services.” Centers for Medicare & Medicaid Services. medicare.gov (opens in a new tab)