Patient Guide to Managing Your Child's Type 1 Diabetes

Sick Day Management Tips when Your Child Has Type 1 Diabetes

How Illness Affects Your Child's Blood Glucose

Having a sick child can be challenging—getting time off work and securing a last-minute doctor's appointment isn't always easy. But when your sick child also happens to have type 1 diabetes, it presents a separate set of complications relating to insulin and blood glucose (blood sugar) management. This article covers some important considerations to keep in mind the next time your child with type 1 diabetes feels under the weather.

Checking Blood Glucose and Ketones
Even the most common ailments, such as a cold or flu, can cause your child's blood glucose levels to rise. Plus, some over-the-counter medications can cause blood glucose levels to increase even more.

Complicating matters, your child's blood glucose levels may actually drop too low if he or she is vomiting or has stopped eating.

You just can't be certain how an illness will affect your child's blood glucose—that's why it's important to check their levels more often than you normally would. A general guideline to shoot for is to check their blood glucose every 2 to 3 hours, but remember—that's a guideline. Your child may require more or fewer checks, depending on your health care professional's recommendations.

In addition to checking blood glucose levels, you also need to check for the presence of ketones in the urine. In people with type 1 diabetes, common illnesses can lead to diabetic ketoacidosis, a condition characterized by acidic blood caused by the release of too many ketones.

Ketones are released when your body doesn't have enough insulin, so it's important to check your child's urine regularly (usually every 4 hours) until there are no ketones detected. If ketones are still present, that's a sign that your child needs more insulin. There are 2 ways to check ketones: using urine ketone strips or a meter that's much like checking blood sugars but with a special test strip.

You can read more about ketoacidosis in our article about type 1 diabetes complications.

Insulin Adjustments During Sick Days
Oftentimes, your child may not want or be able to eat when sick. Even so, it's still essential that your child keeps taking insulin when he or she is sick. Without insulin, the body will resort to burning fat for energy, and this can lead to diabetic ketoacidosis.

Because illness can wreak havoc on blood glucose levels, you will likely need to adjust your child's insulin dosage. The degree of adjustment is completely unique to your child. Plus, the severity of the illness and treatments used also factor in (remember, some over-the-counter medications can affect your child's blood glucose).

Use your child's blood glucose levels as a guide when adjusting insulin. If you have any questions about how to adjust your child's insulin on sick days, call your health care professional.

Food and Drink Guidelines
Certain nutritional considerations on sick days may help prevent potentially serious complications of type 1 diabetes. Make sure your child is drinking plenty of fluids, as this will prevent dehydration and ketoacidosis. As a general rule, your child should drink small amounts of liquids—about a ½ cup—every hour. It's best for your child to drink slowly instead of in large gulps. Tea, broth, and of course, water, are ideal options.

If your child is unable to eat a normal meal, make sure he or she is taking in a certain amount of liquid or solid carbohydrates to prevent sudden drops in blood glucose. Fifteen grams of carbs every hour is a good amount to shoot for, but always follow the specific recommendations from your health care professional.

Below are some good examples of beverages and foods for sick days:

  • Sugar-containing beverages (sugar-free liquids may be consumed if blood glucose levels are elevated)
  • Fruit juice
  • Sports drinks
  • Jell-o
  • Popsicles
  • Broth-based soups
  • Saltines
  • Applesauce
  • Bananas
  • Toast
  • Graham crackers

When to Seek Medical Attention
When your child has type 1 diabetes and is sick, there are a number of situations that warrant medical attention. If your child is having problems breathing and/or has had at least 3 episodes of vomiting or diarrhea within a single day, call your doctor. Also, if large amounts of ketones remain in your child's urine after several hours, seek medical attention. Of course, if you have any questions or concerns about adjusting your child's insulin dosage, don't hesitate to call your health care professional.

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Meal Planning for Children with Type 1 Diabetes