Diabetes In Children

When A Child With Diabetes Gets Sick

Even “normal” illnesses like colds and flu can cause special problems for a child with diabetes.

• Some illnesses interfere with the way insulin works, so the child will need extra insulin.
• If a child can’t eat or is vomiting, it may be hard to keep blood sugar up.

Get A Written Plan

Get an action plan from your diabetes team to have ready in case your child gets sick. This plan should tell you:

• When you should do extra blood tests
• How to adjust insulin doses
• When to check for ketones in the urine
• What symptoms or test results mean you should call the doctor
• What foods to give a child who can’t face solid food or can’t keep it down
• What medications to have on hand to settle the stomach

Testing For Ketones

Ketones appear as a by-product when the body burns its own fat, because insulin is so low that the cells can’t use glucose. Excess ketones in the blood spill over into the urine. Test the urine with tablets or strips that change color:

• Whenever blood sugar levels are above 240
• If the child is vomiting
• If the child is ill, regardless of the blood sugar level

Tell the doctor if this test indicates moderate or large amounts of ketones. This can be an early warning of the dangerous condition called ketoacidosis.

If there are signs of ketoacidosis (frequent urination, rapid deep breathing, and sweet-smelling breath, plus large amounts of ketones) call the doctor or take the child to the Emergency Department.

Food And Drink On Sick Days

Children who are too sick to eat their regular food need:

• Fluids, especially if they are urinating more often than usual
• Sugar, to prevent the body from using fat and muscle for fuel (unless blood sugar is over 240)

Goals For Fluids

• A 50-pound child should drink at least 4 ounces of fluid an hour when sick.
• A 100-pound child should drink at least 8 ounces of fluid an hour.

If The Child Is Nauseous…

If the child has vomited and can’t keep anything down, start by giving him or her ice chips, then slowly increase the amount of fluid.

• Shake the bubbles out of regular (non-diet) soda and have the child sip it to replace fluid and provide sugar.
• Give Emetrol (available without prescription) to settle the stomach, or use phenergan suppositories if the child can’t keep anything down. If you are unsure of the dose, call the diabetes team.

Never skip an insulin shot, no matter how sick the child feels.