If your child is poorly

Children with diabetes do not get more illnesses than other people; but coughs, colds and flu or infections may affect blood sugar control and make it difficult to eat normally.

Signs that your child's blood sugar control is being affected by illness are: -

Increased thirst
Going to the toilet more often - perhaps getting up at night or a wet bed from a previously dry child
Ketones in the urine
Tummy ache/sickness
Tiredness/drowsiness

If this is the case

(1) NEVER STOP INSULIN INJECTIONS

	Always give the insulin at the usual times - blood sugars usually rise during illness. Blood sugars may be low initially, then high, or be low if there is vomiting and diarrhoea. The insulin may need to be increased and extra insulin may also be required.
(indate, clear, fast-acting insulin should be kept in the ridge for such emergencies-check date regularly).
(2) BLOOD TESTS The frequency of fingerprick tests may need to be increased to assess the effectiveness of any treatment - sometimes 1-2 hourly.
(3) URINE TESTS If blood sugars are 13+ mmol/L then test the urine for ketones. A positive ketone test usually means that more insulin is needed fairly quickly. If you are unsure or would like to discuss this first, please contact one of the diabetes team.
Some of the blood glucose meters allow you to test the blood for ketones. (4) FOOD Try with soup, custard, yoghurts, toast or ice cream if your child has a poor appetite.

Replace food with sugary fluids if not eating, (e.g. 2 fl.oz/50ml Lucozade, 100ml Lemonade or flattened Coke) every hour - encourage sips rather than large amounts at once or try sucking fruit pastilles.

Encourage your child to drink plenty of sugar-free drinks as well, particularly if he/she has diarrhoea and vomiting.

(5) GENERAL

Treat the illness exactly as you would for a child without diabetes e.g.: -

Check temperature
Give sugar-free Paracetamol according to instructions
Contact your GP and give antibiotics (sugar-free if possible) if prescribed.

(6) VOMITING

If vomiting is causing difficulty in managing diabetes, please consult your diabetes team. If small children have 2 or more episodes of vomiting, please seek advice as dehydration may become a problem.

(7) EMERGENCY

If your child has any of the following symptoms: -

Vomiting and unable to keep anything down
Blood sugar that keeps rising
Drowsiness with laboured deep breathing
Phone 999 immediately for an ambulance to take him/her to Accident and Emergency

IN SUMMARY

Never stop insulin, even more may be needed.

Test blood sugar more frequently.

Test urine for ketones, if ketones are present - more insulin may be needed.

Replace food with sips of sugary fluids if not eating.

Give general care for child with illness and contact GP.

Contact the diabetes team for help.

Disclaimer

This website is designed for use by the Leeds Paediatric Diabetes Team and children and parents referred to their service. Every effort has been made to make sure there are no errors on the website. If you think there are any inaccuracies could you please e-mail us so that we can check. kate.barker@leedsth.nhs.uk