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When your child is ill
Why the glucose level rises during illness
When a person is ill, particularly during a fever, the body needs more energy, and therefore glucose, to fight the infection. Normally extra insulin is produced to cope with the rise in glucose, but in those with diabetes the body cannot meet the extra demand for insulin. This happens even when appetite has been completely lost and the person cannot eat at all.
Many people with diabetes make the mistake of thinking that, because they are eating very little, they should cut down or even stop their insulin.
This is wrong. In fact your child may need more insulin than normal.
Children, whether or not they have diabetes,often get ill. Here are some suggestions to follow if your child is unwell:
- Make a plan Have a plan of what you will do when your child is ill BEFORE it happens. Your GP, Practice Nurse, DNS or the staff at your diabetes clinic will be able to help you. Even with a great plan you may still need their help so keep the phone number of your clinic, DNS or Practice Nurse handy
- Keep taking the diabetes treatment It is ESSENTIAL that your child keeps taking his or her insulin. Missing an insulin injection means that blood glucose will continue to rise but the body will not be able to use it as fuel. Instead, fat will start to be broken down. Breaking down a lot of fat results in ketones in the blood. At high levels ketones are dangerous and can cause ketoacidosis leading to diabetic coma
- Keep drinking It is very important not to become dehydrated when ill. This happens particularly easily if the child is being sick or has diarrhoea. Take small quantities of fluids such as sugar-free drinks, tea or clear soup every 15-30 minutes
- Keep eating too
Your child must continue to eat when ill.
Try normal meals if possible but if he or she doesn't feel like it then small meals and eating more frequently are a good alternative. Soft foods and liquids are often the easiest to eat when unwell. Foods you could try include:- A bowl of soup
- A glass of milk/mug of milky drink
- A glass of fruit juice
- A small carton of ordinary fruit yoghurt
- A small bowl of ice cream
- A small bowl of jelly
During the day, you should encourage your child to eat one portion of one of these foods each hour.
If he or she is being sick and cannot keep anything down, then take regular sips of sugary drinks such as Lucozade® or ordinary lemonade.
Testing and illness
- Measure the blood glucose level regularly When your child is ill you must measure their blood glucose regularly - at least four times a day. Record the results, as you may need to discuss them with your child's GP or healthcare team
- If sugars are rising You may need to increase testing to every two hours so you can spot in plenty of time if you need to adjust the insulin dose. Your child may need extra soluble insulin between the usual insulin injections
- Measure ketone levels If you have been given a meter that measures ketones as well as blood glucose then you should test their level if your child's blood glucose is over 16.7 mmol/L or if he or she is vomiting. These will tell you if there is a risk of diabetic coma
Abbott Diabetes Care produces a meter suitable for ketone testing. You should discuss ketones with your GP or nurse if you have further questions.
If your child is vomiting and has consistently high ketones or blood glucose levels you may need to go to hospital. Seek medical advice or go straight to Accident & Emergency.
