Living with Diabetes

Sick Day Management

Managing diabetes when your child is sick can be challenging.  It is especially scary when it’s a stomach bug!

Recent posts on the DRIF’s PEP Squad Facebook page emphasize the concern many parents are experiencing.  They've asked whether other kids run high or low; what to do about insulin and food; and a number of other things. Truth is...some kids run high, some low -- some both depending upon the illness. One parent said it best…”What you will find out is that 100 kids with type 1 will have 100 different ways of treating. You have to know your child better than yourself.

However, there are definitely guidelines that the DRI’s Education Center recommends.

Illness can cause your blood sugar levels to rise, and lead to a serious complication of diabetes called diabetic ketoacidosis. In order to prevent this from happening, there are important things you will need to do:

Monitor blood sugar levels every four hours.

Take diabetes medication as usual. If unable to eat, contact your health care team for instructions on the dose to take.

Drink at least one glass of fluid every hour. If sugar levels are high drink sugar–free liquids. If the blood sugars are low, drink sugar-based liquids.

If vomiting and unable to keep fluids down, speak to your health care provider immediately, or go to the nearest Emergency Care Center.

Check for ketones every four hours. If ketones are “large,” call your health care provider or go to the nearest Emergency Care Center. It’s always good to let your doctor know so that he/she can call ahead to tell them you are coming.

Your body may use fat for energy when your blood glucose levels are high. The break down product of fat metabolism is ketones. Ketones become acid in the body, and if severe, can cause diabetic ketoacidosis or DKA. This is a very serious condition that requires immediate medical attention.

Symptoms of ketoacidosis include those for high blood sugar plus:

“Fruity” smelling breath



Stomach cramps



If your child experiences these symptoms, go to the nearest Emergency Care Center.

Sick Day Management Kit
“An ounce of prevention is worth a pound of cure”

Visits to the Emergency Care Center can usually be avoided if you are prepared for sick days and monitor your situation closely when your child is ill. Everyone with diabetes should have a Sick Day Management Kit. The kit should contain the following items:

Blood sugar test strips

Diabetes medications

Sugar‐free and sugar fluids

Ketone test

Medication for nausea or vomiting

Medication for diarrhea

Your health care team contact number

If you are well prepared, you are more likely to manage the situation without worry.


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