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Managing Sick Days With Type 1

Managing A Sick Child With Type 1 Diabetes


Updated June 10, 2014

Managing sick days when your child has type 1 diabetes demands more than homemade chicken soup and extra TLC. The presence of diabetes requires that you not only manage the symptoms of the virus or infection but also your child’s blood glucose. Here’s what you need to know to meet this challenge.

What Sickness Does to Blood Sugar

When you are sick, regardless of whether it is a cold, the flu or something more serious, your body will likely feel tired. But inside there is a battle going on. Your body senses the invader virus and works overtime by sending out hormones as the front line defense to try and defeat the enemy. That’s the good news. The bad news is that these hormones also cause a rise in blood glucose levels and can also dull the effects of your child’s insulin, making it harder to manage his or her blood sugar.

If the blood sugars are not regularly monitored and precautions taken during the illness to keep glucose levels in an acceptable range, ketones can develop. Ketones are a toxic by-product that develop when fat is used for energy because there isn’t enough glucose (food) or insulin to help the body process the glucose in the blood. Either way, blood sugars can rise to dangerous levels.

What You Can Do to Manage Glucose

  • Keep taking insulin
    Unless your doctor tells you otherwise, keep giving your child insulin. In fact, extra insulin may be needed to help bring glucose levels down.

  • Check blood sugar often
    You should aim for a blood test about every four hours. The only way to know for certain if your efforts to control glucose levels are working is to monitor it consistently.

  • Stick to the meal plan, if possible
    Eating can be a problem though, especially if your child can’t keep food down. You may have to revert to easily digested foods, such as crackers and applesauce or a fluids-only diet of juices, broth or non-diet soft drinks. Be sure to encourage your child to keep drinking fluids, especially if vomiting or diarrhea is present.

  • Test for ketones
    This is necessary if your child’s blood sugar is over 240mg/dl or he or she can’t keep anything down.

  • Consult with your healthcare provider
    If your child’s blood sugar is more than 240mg/dl for one day, he or she has moderate ketones, or has persistent vomiting and/or diarrhea, it’s time to call your healthcare provider.

Planning Ahead

Children tend to get sick more frequently than adults because their immune systems are not as strong. That means you need to plan ahead for the inevitable sick days that are to come.

Work out a sick day plan with your healthcare provider that includes:

  • The circumstances that would warrant a call to your healthcare provider.
  • The contact person and number when you need to consult with someone about your child’s symptoms. Be sure to ask about after-hours access and emergency procedures.
  • Possible adjustments to your child’s insulin routine. Discuss the possibility of using smaller doses of fast-acting insulin to reduce the risk of high blood sugar during illness.
  • A list of foods and beverages that you can give to your child when he or she is unable to keep to their food plan because of vomiting.

It’s also a good idea to keep a few sick-day foods stored away, such as frozen fruit bars, applesauce, gelatin and non-diet soft drinks so you have then when they are most needed.


When You're Sick. American Diabetes Association. Accessed: August 19, 2008. http://www.diabetes.org/type-1-diabetes/sick.jsp

Taking Care of Your Diabetes at Special Times. National Diabetes Information Clearinghouse. Accessed: August 19, 2008. http://diabetes.niddk.nih.gov/dm/pubs/type1and2/specialtimes.htm#1

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