U-M Pediatric
Diabetes

Getting sick with diabetes means you will need to pay more attention to your blood sugar to prevent further complications. Even if you cannot eat normally, you will need to take your insulin. You may need to increase or change your dosage because your blood sugar may go higher. If you are unsure of how much insulin to give, call the clinic or the on-call pediatric endocrinologist. You should test your blood sugar more often and keep good records about your blood sugar levels, medicines, temperature, and weight. You should also test your urine for ketones, especially if your blood sugar goes above 300. You should drink plenty of fluids to prevent dehydration. Drink water or other non-caloric drinks, about 4 to 6 ounces every half hour. You may also need to drink beverages with sugar, such as regular soda, if you cannot get 50 grams of carbohydrate through other food choices. The portions of these sweet beverages must be controlled as you don’t want your blood sugar to get too high. Talk with the diabetes care team about developing an action plan for your child in case they get sick. If you have any questions about your child’s health, do not hesitate to ask.

In most cases, you should be able to manage your diabetes with some minor adjustments to your normal routine. In some cases, you may need to contact the diabetes care team for additional guidance. These situations include: ​ • Severe low blood sugar - Glucagon needed OR blood sugar will not come up into a target range with appropriate treatment • Vomiting more than 3 times • Ketones - moderate to large • Unable to keep any fluids down - no fluid intake in 4 hours • Unsure of what to do

It is a good practice to keep a "sick day box" in your pantry with items you may not normally have on hand. This way, you will have supplies even if you do not have the energy to leave the house. ​ Some supplies you should have: • Milk of magnesia • A pain reliever (ibuprofen or acetaminophen) • Medicine to control diarrhea • A thermometer • Antacids If you cannot eat meals, you will need about 50 grams of carbohydrate every 4 hours. Food items you may want to keep on hand are: • Sports drinks • Instant cooked cereals • Small juice containers • Crackers • Canned soup • Instant pudding • Regular gelatin • Canned applesauce • Regular soft drinks, high in sugar

Being sick can affect your diabetes by causing high blood sugars and ketones. You should keep hydrated and monitor for ketones even if your blood glucose is low. Some symptoms of being sick like vomiting, diarrhea, and dehydration will affect your blood sugar in different ways.

If your child is unable to keep food down, you should avoid solid foods and instead give liquids in small amounts every 15-30 minutes. If you experience vomiting more than three times are or are having trouble drinking fluids, call the on-call pediatric endocrinologist right away for advice.

High blood sugars are not significant enough to keep your child home from school. The only symptoms you should keep your child home for are moderate to large ketones or abnormal vomiting. If you are unsure, ask the clinic for advice.

Some medications say you should call the doctor before administering if you have diabetes. These medications may raise the blood glucose slightly due to the sugar and flavorings included in the medication. They are fine to give to your child as long as you continue to monitor blood glucose and respond accordingly.