How to care for your sick child with diabetes

2014-01-08 12:55:36 by Janet Haas, RN, CDE, as posted on the inside.akronchildrens.org blog.

Mom helps daughter with diabetes monitor her blood sugar.With the flu season upon us, you may worry about your child with diabetes. Although diabetes doesn’t predispose children toward getting the flu, it may be slightly more challenging to manage their diabetes if they develop nausea and vomiting.

Feel free to call our Center for Diabetes and Endocrinology (330-543-3276) with questions about nausea and vomiting. For lesser concerns, such as fever, sore throat and earache, we encourage you to call your child’s primary care doctor.

While your child is ill, you should:



  • Check your child’s blood glucose every 2 hours. Target levels should measure between 100 and 200 mg/dL.

  • Check urine ketones.

    • If negative, check twice daily until your child is no longer sick.

    • If positive, check each time your child urinates until the test is negative.

    • If your child uses an insulin pump and has ketones, change the infusion site and give all corrections with a syringe until blood glucose is less than 200 mg/dL and urine ketones are negative.

    • Give your child plenty of fluids.

    • Keep giving insulin as normal while your child is sick – unless a doctor advises otherwise – even if your child isn’t eating. In some cases, more insulin may be needed.



If you need to call our diabetes center, please have answers ready for the following questions:



  • What is your child’s most current blood glucose reading?

  • What is your child's ketone level?

  • Is your child vomiting? If so, how often and when did the vomiting start?

  • Is she keeping down fluids?

  • How is he behaving?

  • Is she breathing abnormally?

  • Is he on a pump?

  • When was her last dose/bolus of insulin?


Take your child to the nearest hospital ER if he:



  • cannot keep down fluids

  • shows signs of dehydration (dry mouth or skin, no tears or failure to urinate within 8 hours)

  • has difficulty breathing

  • exhibits changes in mental status (including confusion and difficulty staying awake)

  • complains of chest pain


If your child is vomiting or having diarrhea, it’s easy for her to become dehydrated. Have her drink at least 4 ounces of fluid every hour.

If blood sugar is high, give carb-free fluids, such as plain water, Powerade Zero or sugar-free popsicles. If blood sugar is low, give regular popsicles or 4 ounces of fluid containing sugar.

You can alter these recommendations if urine ketones are present. Please consult our center for more information and request a chart with specific instructions on what to do when your sick child has certain levels of blood glucose and ketones.

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