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Children's Hospital at Dartmouth Hitchcock (CHad)
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Managing Sick Days

Being sick happens to all of us! However, people with diabetes have special things to think about. Here are some pointers for when you are feeling under the weather.

The first thing you need to do is gather all the necessary information. This will help you and your parents decide if you need to call the doctor.

Your body will require more energy when you are sick. Some important things to remember:

  • Ketones: Always check your ketones if you are feeling ill.
  • Vomiting: If you are vomiting and have low blood sugar, an insulin reaction could occur. But, you may still have ketones.
  • Insulin: Be sure to keep a bottle of short-acting insulin (Humalog, Novolog, or Regular).
  • Blood glucose monitoring: You should do some extra monitoring on sick days (every 2-4 hours).
  • Extra snacks: You need to remember to feed your body an adequate amount of calories so you don't start using fat for energy. Check our list of recommended sick-day foods (PDF). Your body needs about 15 grams of carbohydrates an hour to stay nourished.
  • Past experiences: Try to keep good records of your sick days, so you can refer back to them in the future.
  • Doctor: Call your pediatrician or family doctor for non-diabetes-related illness, like a sore throat, earaches, rashes, etc.

Information courtesy of Understanding Diabetes by Dr. H. Peter Chase.

Important sick-day rules

  • Check blood glucose every 2-4 hours.
  • Check ALL urine for ketones.
  • DRINK 4-8 oz. of fluid per hour.
  • Take extra insulin—a "correction"—every 2-4 hours as directed.

Contact the Dartmouth-Hitchcock Pediatric Endocrinology team.

When to call your doctor

  • Blood glucose is more than 250 and not coming down with extra insulin.
  • You have vomited more than twice.
  • You've had diarrhea more than twice or for longer than 6 hours.
  • You can't keep fluids down.
  • You have moderate to large ketones.
  • You are having trouble breathing.
  • You have ANY questions.

What to tell the doctor

  • Your name and age
  • About how long you've had diabetes
  • Name of your diabetes doctor
  • Current problem
  • Blood sugar level
  • Urine or blood ketone result
  • Signs of low blood sugar or acidosis
  • How much food or liquid you're taking in
  • Usual insulin dosage, time and amount of last dosage
  • Last body weight (if known)
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