Diabetic patients encounter a number of difficulties in blood glucose control for special situations such as illness, travel, eating away from home and physical activity. These patients should be provided with diabetes self-management skills for such special situations. During acute illnesses, insulin and oral glucose-lowering medications should be continued. Also, testing of plasma glucose and ketones, drinking adequate amounts of fluids, and ingesting carbohydrates are all important. Diabetic patients should adjust their meal plans in accordance with their travel plans and should carry a food kit at all times. They should learn guidelines for dining at restaurants, including food substitutes, portion control, and adapting one's meal pattern when eating away from home. Most people with diabetes do not need snacks during physical activity, but people with diabetes who take insulin or an insulin secretagogue may need snacks to prevent hypoglycemia during or after exercise. The need for a snack is dependent on the duration and intensity of the activity, the timing of recent meals and medication peaks.

Using data from blood glucose, food, exercise, and medication records, dietitians can provide diabetic clients with critical self-management skills.