Childr Health Information

Sick-day diabetes care CHI 1054

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Topic: Diseases & Conditions

This handout was written to answer some of the questions most often asked about what to do when your child with diabetes is sick.  Feel free to ask your child’s health care provider to go over any information you do not understand.

When your child is not feeling well because of an upset stomach, a cold or the flu, you should follow these guidelines.  When a child is sick, his or her diabetes may take some extra care.  This is because illness can increase your child’s blood sugar.  Also, he or she may not feel like eating while sick.

Should my child continue to get his or her insulin?

Yes!  Your child should always take insulin.  Not taking insulin could lead to dangerous Diabetic Ketoacidosis (DKA).  DKA causes an imbalance of body water & electrolytes and can make your child very sick.  On sick days, you should call your child’s doctor before giving his or her insulin.  Your child may need more or less insulin than usual because of the illness.

When should I call the doctor?

You should call the doctor right away if your child:
1. is vomiting or not able to eat
2. has a blood sugar over 400 two times in a row, or one blood sugar over 500
3. has moderate or large ketones
4. requires a sick day diet for longer than one day

What should my child eat while sick?

Your child should try to follow his or her regular meal plan.  If your child is unable to eat or refuses to eat, you may give liquids instead of his or her regular foods.

Remember, your child must eat or drink something even if he or she is not hungry.  The insulin your child takes will lower his or her blood sugar.  To keep blood sugar in balance, your child will need to eat carbohydrates (carbs).  Here are some guidelines to follow:

1. If your child is on Lantus/Levemir insulin or on an insulin pump, you will need to give them some carbs at mealtimes and give insulin for the carbs eaten.  Remember, you’re giving insulin for the carbs they did eat or drink.
2. If your child is on NPH or premixed insulin, he or she must eat the fruit, bread, and milk exchanges.  Your child needs the carbs from these foods.  See the carb exchange list below for some options if your child does not feel like eating these regular foods.  The meat, fat and vegetable exchanges do not need to be eaten.  They either do not contain any or very little carbs.  It is important for you to call the diabetes doctor before giving your child his or her insulin.  The doctor may want to give less or more insulin than usual to prevent low or high blood sugar.

Carb exchange list  (about 15 grams of carb each)

½ cup 7-up or Sprite
½ cup apple juice or other 100% fruit juice
1 cup Gatorade
½ cup cooked cereal
1 ¼ cup chicken noodle soup
1 slice toast
1 tablespoon jelly
½ cup regular Jell-O (not sugar free)
6 saltine crackers
½ of a twin popsicle (Jell-O)

3. To keep your child from becoming dehydrated, have him or her drink (at least) an ounce (two
     tablespoons) of caffeine-free fluid every 20-30 minutes.  If your child has had all the sugar-
     containing liquids he or she is allowed, then sugar-free liquids may be taken.
4. It is recommended that your child be offered liquids high in salt (such as chicken or beef broth),
     and high in potassium (such as fruit juices).  These liquids will help replace the salt and potassium
     your child loses as his or her blood sugar increases.

Are cold and cough medicines sugar free?

Many of the cold and flu medicines you can buy over the counter contain sugar and/or alcohol.  Sugar and alcohol can interfere with your child’s diabetes control.  Before giving any medicine to your child, you should check with your diabetes doctor first.

This handout is for general information only and should not be considered complete. For specific information about sick day diabetes, please ask your child’s health care provider.

Additional information and resources are available in the MeadWestvaco Family Resource Center at Dayton Children's.  The center is open Monday 9:00 am - 8:00 pm; Tuesday - Friday 9:00 am - 4:00 pm; Saturdays 9:00 am–2:00 pm. The center is closed on Sundays and holidays.  Please call 937-641-3700 for more information.

Copyright The Children's Medical Center of Dayton.  This material is for educational purposes only.  It cannot be reproduced or distributed without permission from Dayton Children’s.

PDF: Diabetes - Sick Day CHI 1054

PDF: Dia de enfermedad en diabeticos CHI 1054

Derechos de autor(c) de The Children's Medical Center, ano 1999. Este material unicamente tiene fines educativos. No puede ser reproducido, distribuido ni modificado sin previa autorizacion de The Children's Medical Center of Dayton, One Children's Plaza, Dayton, Ohio, 45404-1815. Llame al 937-641-3666 para solicitar autorizacion o para obtener un juego maestro para copias. Para obtener mas informacion puede visitar (consulte la seccion de informacion legal).

La informacion contenida en este material es unicamente informacion de tipo general. No debe considerarse como completa. Para obtener mas informacion acerca de los complementos para leche materna, por favor pidala a su doctor.
Corregido: 1994, 2000, 2002, 2010
Revisado: 2004, 2007

The information contained in this handout is for general information only and should not be considered complete. For specific information about bathing your baby, please ask your doctor or nurse practitioner.

Additional information may be located in the Family Resource Center, 2nd floor, near the Outpatient Surgery Center. Hours of the center vary; please contact the Family Resource Center at 937-641-3700.

Copyright(c) The Children's Medical Center of Dayton. This material is for educational purposes only. It cannot be reproduced or distributed without permission from Dayton Children's.
Revised: 1994, 2000, 2002, 2010
Reviewed: 2004, 2007


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