Type 1 Diabetes and Your Child: Sick-Day
When your child is sick, his or
her blood sugar (glucose) levels may change. This may make blood glucose harder to manage.
You will need to:
Watch your child closely.
Check his or her blood glucose
Check his or her blood or urine
for ketones. Ketones are the waste when the body burns fat instead of glucose for
energy. The condition is called ketosis.
Adjust your child's insulin
dosage. Your child's healthcare provider will tell you what to do.
To be ready, work with your child's
provider to create a sick-day plan. This should include:
- What to monitor, check, and adjust during an illness
- The provider's phone numbers (including after-hour numbers and
when to call 911)
Keep a copy of the plan in an easily accessible place. Also keep a copy with you in
case your child becomes ill when you are away from home.
Educate your child's daycare providers
and teachers about diabetes and diabetes care. The American Diabetes Association’s “Safe at
School” program has tips on how to set up a diabetes care program at your child’s
Caring for your child
Infections, the flu, and even a
cold can cause your child’s blood sugar to rise. And eating less, nausea, and vomiting
may cause his or her blood sugar to fall. When your child is sick you may do the
Have a sick-day box ready. Before your child gets sick, make a sick-day
box. The box may include: a thermometer, blood and urine ketone testing strips,
and medicines your child's provider recommend. The provider may recommend other
types of insulin for high glucose levels or glucagon for low glucose levels. Also
add a can of soup, crackers, sugar-free juice, and regular juice. And keep some
frozen juice bars, some with sugar and some without sugar, in the freezer. Check
the expiration dates on the contents of the sick-day box once a month. Put a copy
of the sick-day plan in the box.
Encourage your child to eat and drink. This will help regulate your
child’s blood glucose and keep him or her from becoming dehydrated.
Have other food options ready. If your child can’t eat, have him or her
sip fruit juices, soft drinks with sugar, or ice cubes made from juice or sugar
water. Or try gelatin, frozen juice bars, or low-fat ice cream.
Make sure your child drinks plenty of water. Your child has to stay
Test blood glucose often. You may need to check your child's blood glucose
every few hours, or even more often.
Don't skip insulin. Always keep giving insulin. Even if your child is not
eating, you still need to replace the basal rate of the insulin the body is always
producing. Adjust the amount of insulin you give your child according to the
sick-day plan. But don't skip insulin. Even if your child is vomiting. Skipping
insulin could lead to ketoacidosis (see below). Call your child’s provider if
you're not sure how much insulin you should give your child. Don't let your child
exercise while his or her urine or blood ketones and sugar are still high.
What is ketosis?
The body needs glucose for energy.
If the body doesn’t get the glucose it needs, it starts burning fat. But fat is not the
best fuel for the body. Ketones can build up in the blood and urine. This is called
ketosis. Ketones are a warning sign of ketoacidosis. Check your child's blood or urine
for ketones when sick, as directed by your child's healthcare provider, usually every 4
hours. Call your child's provider right away if ketones are present in the blood or
What is ketoacidosis?
When ketone levels are high, it can
lead to ketoacidosis. Watch your child for the symptoms of ketoacidosis. They
Upset stomach and
Hard time focusing or
Dry or flushed skin
Ketones are positive in the
urine or blood
Ketoacidosis is a medical
emergency. If you think your child has ketoacidosis, call 911 or take your child to the
hospital emergency room right away.
Call your child’s healthcare provider
Call 911 or take your child to the hospital emergency room
right away if:
- You test your child for ketones and think he or she has
Call your child's healthcare
You’re not sure how much
insulin to give when your child is sick.
Your child’s blood sugar is
higher than normal or over 250 mg/dL and doesn’t go down after getting
Your child's blood sugar
level is lower than normal or less than 70 mg/dL.
Your child's blood or urine
For more information about
diabetes, visit these websites:
American Diabetes Association
Children with Diabetes
Juvenile Diabetes Research
Foundation International www.jdrf.org