Children with diabetes should not experience more illness or infections than their siblings or peers without diabetes.
However, it is likely that any illness will have an impact on diabetes control. In general, illnesses associated with a temperature will cause the blood glucose levels to rise. Many families notice that insulin requirements increase a few days before their child has symptoms of an illness, and that this increased requirement persists several days after the illness has stopped. Alternatively, illnesses where there is diarrhoea or vomiting are likely to cause the blood glucose level to drop and there is often difficulty in maintaining adequate carbohydrate intake. These problems may lead to a need for a reduction in the insulin dosage.
Never stop your insulin
The insulin dose may need to be increased or decreased depending on the glucose and ketone level
Encourage fluids to prevent dehydration
Increase the frequency of monitoring of both blood glucose and blood ketone levels. High blood glucose levels and ketones are an indication that more insulin is needed
Ketones are very dangerous!
Ketones are acids which can quickly make you feel very unwell. They may make you vomit or you may become breathless.
If ketones persist you may develop Diabetic Ketoacidosis (DKA). DKA may cause you to become extremely unwell and you may require urgent hospital treatment.
Ketones may still be produced when you are ill, even if your blood glucose levels are low therefore always check for ketones if you feel unwell, regardless of your blood glucose level.
As previously stated the first rule is:
NEVER STOP TAKING YOUR INSULIN even if you are not eating (if not eating see dietary management below).
What else do I need to do?
Test your blood glucose and blood ketones levels more often than usual.
How much insulin should I take?
Children and young people may not feel like eating when they are unwell. This does not matter – continue to give quick acting boluses of insulin for any carbohydrate eaten/drunk if their blood glucose levels are within or above their target range and/or to correct high blood glucose levels.
If your child is vomiting they are advised to eat a light diet e.g. toast, crackers etc. If blood glucose levels are dropping or are low because of nausea and/or vomiting or refusal to eat encourage your child to have drinks containing glucose. Some examples are below, aim for 20 grams per hour.
Each of these contains 10grams carbohydrate:
Fruit juice (unsweetened) 1 small glass (100ml)
Coca Cola (not diet) 150mls
Lemonade (fizzy/sweetened) 150mls
Ice cream 1 briquette/scoop
Jelly (ordinary) 2 tablespoons
Yoghurt (fruit) ½ small carton (60mgms)
Please contact the Diabetes Team or use your red box access if experiencing any of the following or you are concerned:
Diabetic Ketoacidosis (DKA)
Contact the PDSNs on 01908 996522 for support and guidance. However if the PDSN is not available you should ring Ward 4 on 01908 996367 and speak to the nurse in charge.