Illness causes stress on the body. Stress hormones can raise blood glucose. Stress can also make the body less sensitive to insulin so more may be needed to keep blood glucose closer to target range.

If blood glucose is in target range (70-180 mg/dL) but your child is sick, check ketones at least twice a day. Check every few hours if blood glucose is 300 mg/dL or higher for more than 2 hours.

• Call our office if ketones are moderate-large.
• Frequent contact with our office may help to keep your child out of the hospital. However, if ketones are accompanied by altered mental state, labored breathing or dehydration go to the emergency department ASAP

Some insulin is ALWAYS needed.

• Do not skip basal/long-acting insulin even if your child is vomiting.
• If you child is using an insulin pump, more frequent correction boluses may be needed. If your child is using injections, call our office before giving correction boluses closer than 2 hours apart.
• If you are unsure how much your child will eat, it is okay to give insulin immediately after they are done eating. Check blood glucose/continuous glucose monitor reading before your child begins to eat and use that number in the correction equation even if giving insulin after the meal.
• If your child is only able to tolerate liquids, alternate between regular, carbohydrate containing liquids and sugar free liquids. Use the prescribed insulin to carbohydrate ratio to determine how much insulin to give for the amount of carbohydrate containing liquid consumed.
  • Ideas for carbohydrate containing liquids: Gatorade, Powerade, Pedialyte, popsicles, Italian ice, Jell-O, juice, soda

Maintain calories and hydration: 1 oz. fluid per year of age per hour.

If medicine is needed, give it! We can adjust the insulin.

Call out office/telenurse if you child:

• is unable to tolerate anything by mouth for more than 4 hours
• vomits or has diarrhea multiple times in an hour
• complains of abdominal pain
• has fruity smelling breath