Kids with diabetes
get sick once in a while, just like other kids. However, because the effects of illness
on the body can raise or lower their blood
sugar levels, a few extra steps are needed to keep blood sugar levels under control.
With planning and some advice from your doctor, you'll be ready to handle sick
days with confidence.
When your child gets sick — whether it's a minor illness like a sore throat
or cold or a bigger problem like dehydration or surgery — the body sees the
illness as stress. To relieve the stress, the body fights the illness. This requires
more energy than the body normally uses.
In a way, this is good because it helps supply the extra fuel the body needs. But
in a person with diabetes, this can lead to high blood sugar levels. While stress
tends to make blood sugar rise in people with diabetes, some illnesses cause loss
of appetite, nausea, or vomiting. The poor intake of food can lead to in low blood
sugar levels in someone taking the usual doses of insulin.
In a nutshell: Blood sugar levels can be very unpredictable on sick days. You can't
know exactly how the illness will affect your child's diabetes control. So it's important
to check your child's blood sugar levels often on sick days and adjust insulin doses
How Can I Be Prepared?
Your child's diabetes
health care team will include sick-day instructions in the diabetes management
plan. These might include:
Your doctor will give you specific advice about what to do when your child is sick.
Here are some general guidelines:
Stay on track. Unless the doctor tells you to make changes, be
sure your child keeps taking the same diabetes medicines. It's important for your
child to keep taking insulin during illness, even though food intake may be reduced.
The liver makes glucose
and releases stored glucose into the blood. So even if your child is not eating very
much, the body still needs insulin to process the glucose. In fact, some people need
more insulin than usual on sick days — and some with type
2 diabetes who don't take insulin might need some. Without insulin, the body starts
to burn fat, ketones build up in the blood, and diabetic
ketoacidosis can happen.
Keep a close eye on blood sugar and ketone levels. Check
blood sugar levels should often as directed by your doctor. Urine tests for ketones
are often positive during illness (even in kids without diabetes). But for kids with
diabetes, testing can provide an early warning sign that levels may be building up
enough to cause diabetic ketoacidosis. The diabetes treatment plan should guide you
as to when and how often to check ketones.
Pay special attention to nausea and vomiting. Kids with diabetes
occasionally catch a bug that causes nausea, vomiting,
or belly pain. But because these can also be symptoms of diabetic ketoacidosis, it's
important to closely monitor blood glucose and ketone levels and get medical help
according to the guidelines in the diabetes treatment plan.
Have your child drink plenty of liquids. Offer drinks that your child likes that won't
worsen symptoms like nausea. Your doctor can advise you about what to give to help
manage the illness and maintain control of the diabetes.
Use medicines wisely. Although doctors' opinions vary as to whether
they're really helpful, over-the-counter (OTC) medicines are often given to kids to
control symptoms of illnesses like a cold or the flu. These may contain ingredients
that raise or lower blood sugar or that imitate symptoms of high or low blood sugar
levels. Check with your doctor before giving an OTC medicine to your child. Guidelines
for using common medicines are often included in the diabetes management plan, including
what to check on the labels. If OTC medicines are given at the right dose, they generally
won't have a significant effect on diabetes control. But prescription drugs such as
glucocorticoids (like those given for a severe asthma
flare-up) can greatly raise blood sugar. Make sure you know the possible effects
of any prescribed drugs. Call your doctor if you think changes to the diabetes treatment
plan might be needed.
Take notes. When you talk to your doctor, keep information handy
about the illness, your child's symptoms, medicines and doses taken, food and drink
consumed, and whether your child kept it down. Also, note any weight loss or fever
and record blood sugar
and ketone level test results.
Help your child rest. Kids need rest when they're sick, so encourage
sleeping and resting as much as possible. Kids who usually manage diabetes on
their own might need help taking it easy for a day or two.
When Should I Call the Doctor?
Call your doctor if your child is sick and:
has a lack of appetite or can't eat or drink
has lasting vomiting or diarrhea
has low blood sugar because of poor food intake — but remember to try to
bring it back up (such as by injecting glucagon,
if necessary) before calling the doctor or rushing to the emergency
has blood sugar levels that are high for several checks or don't lower with extra
has moderate or large amounts of ketones in the blood or urine
might be having symptoms of diabetic ketoacidosis
Whenever you have questions or concerns, check in with your doctor. Together, you
can make sure that your child feels well again soon.