Children with diabetes do not experience more illnesses than their non-diabetic friends. Your child should not miss more school
days just because of his diabetes. An otherwise healthy person with well-controlled diabetes has normal resistance to infection
and normal healing of, injuries. However, even though your child is not more likely to fall ill or be more difficult to treat,
any illness may upset the blood sugar balance.
When children with diabetes get sick, their blood sugar often goes high and ketones may show in the urine. Illness is a stress
to the body, and stress creates a demand for more insulin. People without diabetes automatically make more insulin at such
times. Children with diabetes do not. So on a sick day the usual amount of insulin may not be enough. Monitoring may show
high blood sugar, with or without ketones. At such times you may need to increase the insulin dose, even though the appetite
may be poor, to prevent diabetic ketoacidosis (DKA).
Although all illnesses in people with diabetes must be taken seriously, not all illnesses make the blood sugar go up. In fact,
illnesses like diarrhea may be accompanied by low blood sugar levels. Careful monitoring of blood glucose levels and urinary
ketones will help determine the effect of each illness and the right response.
What do you do when your child with type 1 diabetes is sick?
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Check the blood sugar and urinary ketone levels when the illness first appears. You don’t need to do extra checks for a mild
case of the sniffles, but you should for a more severe cold or cough. Continue to check every 4 hours around the clock.
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Continue giving insulin. Even though your child may not be eating well, the physical stress of the illness will probably raise
the blood sugar level and cause ketones to form. Thus more insulin may be needed, rather than less. If the sugar levels go
lower, less (but never no) insulin may be required. Remember that insulin is always required to prevent the breakdown of body
fat into ketones.
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Give clear fluids containing sugar if your child doesn’t want to eat. Offer small amounts of fruit juice, frozen ice treats,
sugar-containing fruit-flavoured gelatin, or soft drinks often.
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Help or supervise teens with diabetes who are doing their own monitoring and insulin administration throughout the illness.
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Treat the underlying illness that is upsetting diabetes control. Give the medicines prescribed.
Acetaminophen in the usual
doses for
fever or pain is safe unless the doctor says otherwise.
Telephone the diabetes doctor or nurse immediately if illness is accompanied by:
Fluid guidelines for sick days
When your child with diabetes is sick, he may be unable to eat the usual amounts of food in the meal plan. It’s important
to replace the uneaten food with fluids that give enough sugar to balance the insulin administered.
If your child is on a meal plan and is carbohydrate-counting, serve drinks that have the right amount of carbohydrate for
each meal and snack. It’s not necessary for your child to take all the fluid at once. If necessary, the drinks can be spread
through the day. For example, if your child is scheduled to have 42 grams of carbohydrate at breakfast and 15 grams as a morning
snack, you can provide 10 to 15 grams each hour throughout the morning.
If your child is not carbohydrate-counting, you can offer one of the following choices every hour. Each contains 10 grams
of carbohydrate:
If your child vomits twice or more within 12 hours, call the diabetes team or take your child to the hospital immediately.
Continued vomiting may lead to DKA or severe hypoglycemia.
