Sick Day Management Tips for Parents
JDRF has prepared the following tips to help you better manage sick days--but be sure to talk to your doctor as well. These general guidelines will most likely need to be adjusted depending on the child and the nature and severity of the illness.
Monitor blood sugar levels more frequently
When you are under stress from illness or injury, your body releases hormones, which can cause blood sugar levels to skyrocket. Loss of
appetite, nausea, and vomiting, on the other hand, may result in extremely low blood sugar levels. Since you can't be sure how an illness will affect your
child's blood sugars, it is important to check them often. How often depends on the child and the seriousness of the illness, but a general target is at
least every 2-3 hours.
Don't stop taking insulin
People with type 1 diabetes should never completely stop taking their insulin, even when they're not eating anything. Insulin is
necessary to maintain normal metabolism, and without it, the body starts to burn fat, which can lead to diabetic ketoacidosis (DKA). Therefore, even if your
child is vomiting or unable to eat, he will still need to take insulin. To determine the proper dosage, use blood sugar numbers to guide you, or call your
doctor for help.
Check urine for ketones
This is very important for people with juvenile diabetes. The presence of ketones in the urine, regardless of blood sugar level, shows
that the body is in serious need of insulin. This could become a life-threatening situation if not corrected. If you find ketones in the urine, give your
child additional insulin and lots of fluids. If the ketones don't clear up in a few hours, call your doctor.
Be careful with over-the-counter medicines
Over-the-counter remedies for colds, allergies, upset stomachs, etc., may contain ingredients that raise or lower blood sugars, or that
imitate the symptoms of high or low blood sugar. Be sure to read the labels before you buy any over-the-counter medication. Some products recommend that
people with diabetes check with their doctors before using the product.
Have a game plan and don't hesitate to ask for help
Ideally, you and your doctor should come up with a strategy for managing sick days before your child ever gets sick. Put it in writing,
and then make adjustments as you gain experience with sick days. Discuss the possibility of using smaller, more frequent doses of short-acting insulin to
better avoid high blood sugars. For low blood sugars brought on by vomiting or loss of appetite, you'll need to replace carbsperhaps with liquids or soft
foods.
Call your doctor if: your child has a fever or illness that lasts longer than two days, or vomiting or diarrhea that lasts more than eight hours; your child's blood sugar is higher than about 250-300 mg/dl and you can't bring it down; you find ketones in the urine and they don't go away within a few hours; you child can't keep any food or liquid down; or any time that you just feel uncomfortable or confused about what to do. In order to communicate effectively with the doctor, be sure to keep accurate records of blood glucose readings, ketones, medication, fever, and all symptoms.
Remember that the care of diabetes is a group effort involving you, your doctor, and other members of your diabetes care team. These tips should not replace or supersede this team effort.
