Why Sick Days Are Different
Illness can raise or lower blood sugars in kids with diabetes. Stress hormones can make sugars rise and insulin work less well; poor appetite, vomiting, or eating less can lower sugars. A clear sick-day plan helps you adjust testing, insulin, and fluids to keep your child safe.
Quick Action Guide
🚨 Call Doctor Now If
- • Your child can’t keep fluids down for >2 hours
- • Repeated vomiting or diarrhea
- • Low blood sugar you can’t raise, or severe highs despite insulin
- • Moderate/large ketones or signs of DKA (belly pain, nausea, vomiting)
- • Signs of dehydration or your child is very drowsy
✅ Do This Right Away
- • Check blood sugars more often
- • Keep giving insulin (may need more or less)
- • Check urine or blood ketones if nauseated, vomiting, or sugars high
- • Encourage frequent sips of fluids to prevent dehydration
- • Track symptoms, meds, fluids, sugars, ketones
How Blood Sugars Change During Illness
Highs (Hyperglycemia)
- • Stress hormones during illness can raise sugars
- • Insulin may not work as well
- • Your child may need more insulin than usual
Lows (Hypoglycemia)
- • Eating less than usual can lower sugars
- • Vomiting/poor intake may mean less insulin is needed
- • Talk to your care team about dose adjustments
Be Prepared Before a Sick Day
Checklist
- • Review your child’s diabetes care plan (sick-day section)
- • Extra glucose and ketone test strips on hand
- • Working thermometer to track fevers
Pantry & Fluids
- • Sugar-free fluids: water, broth, soup, sugar-free soda/tea
- • Sugar-containing options for lows: juice or regular soda
- • Oral rehydration/sports drinks (e.g., Pedialyte, Gatorade)
- • Gentle foods: crackers, simple soups
What To Do When Your Child Is Sick
Monitoring
- • Check blood sugars more often than usual
- • Check ketones if sugars are high or with belly pain, nausea, vomiting
- • Track symptoms, insulin doses, fluids, urine output
Insulin & Medicines
- • Keep giving insulin; doses may need adjustment
- • Some kids with type 2 may need insulin temporarily
- • Ask pharmacist/doctor how OTC meds may affect diabetes
Hydration & Rest
- • Offer frequent sips to avoid dehydration
- • Alternate sugar-free and sugar-containing fluids as needed
- • Encourage rest and reduce activity
Record-Keeping
- • Note sugars, ketones, meds/doses, foods, fluids, fever, weight
- • Share your log with the care team if you call
⚠️When Should I Call the Doctor?
- Not hungry or unable to eat/drink
- Vomiting or diarrhea lasting more than 2 hours
- Low blood sugar you can’t raise (call 911 if severe)
- High blood sugars that don’t come down with insulin
- Moderate/large ketones or signs of DKA
Prevention: Fewer Sick Days
Vaccination & Hygiene
- • Keep vaccinations up to date (PCV, yearly flu shot, COVID-19 when eligible)
- • Teach and practice frequent handwashing
- • Avoid close contact with people who are sick
Daily Management
- • Follow the diabetes care plan consistently
- • Keep testing supplies and sick-day items stocked
Frequently Asked Questions
Q: Should I stop insulin if my child isn’t eating?
A: No. Keep giving insulin, but doses may change. Follow your sick-day plan and contact your care team for adjustments.
Q: When should I check ketones?
A: Check when sugars are high or any time there is belly pain, nausea, or vomiting, or if your child seems unwell.
Q: Which drinks are best?
A: Use sugar-free fluids to prevent dehydration; use juice or regular soda to treat lows. Oral rehydration drinks can help replace fluids and electrolytes.
⚠️ Medical Disclaimer
This article provides general information about sick-day care for children with diabetes and is not a substitute for professional medical advice. Follow your child’s diabetes care plan and contact your pediatrician or diabetes team with concerns. If your child has severe symptoms or suspected DKA, seek emergency care.