My child has diabetes.What can I do when he or she is sick to help prevent the diabetes from going out of control?

My child has diabetes.What can I do when he or she is sick to help prevent the diabetes from going out of control?

Certain forms of illness are more likely to throw the diabetes out of control than others. Generally, those illnesses that provide quite intense stress to the body are more likely to cause the diabetes to go out of control than those that result in disability without general body stress.

Illnesses associated with fever, infection, rapid heart rate, loss of appetite, and disordered bodily functions such as diarrhea, vomiting, breathlessness, etc. are often associated with loss of glucose control. It is important to remember that when a child is not eating due to a generalized illness, he or she may require
as much or more insulin than he would take with a meal if he were eating. This is often very surprising to people with diabetes and their caregivers. When the body is under stress, it produces a variety of hormones that serve to counteract the stress, in part by raising the blood sugar.

In those without diabetes, this response is generally beneficial. However, in those with diabetes it can be counterproductive. Therefore, the key to helping the sick child with diabetes from losing glucose control is to check the blood sugar frequently, such as every 2 hours, and to administer insulin according to the blood sugar level if the blood sugar level continues to rise and without regard to the intake of food.

More insulin will be needed if the child is able to eat. Dehydration is a key contributor to worsening high blood sugar and therefore every attempt should be made to keep hydration up, with fluids that are not high in sugar (avoiding colas or juices, for example) as long as the blood sugar is high. Fluids that contain electrolytes, such as Pedialyte® or a similar product, are preferable to water alone in preventing dehydration.

Remedies to reduce the severity of the illness, or the symptoms from it, can also help to keep glucose levels under control, such as sponging or antifever medications to lower a high temperature, antinauseants, or antidiarrheals to reduce intestinal disturbances. Reducing or minimizing psychological stress can also play a significant part, so this would not be the time to 131 emphasize the homework that is not getting done or the test that might be missed!

It is important to remember that some illnesses are severe enough that they will throw the diabetes out of control in spite of a parent’s best efforts to do everything to prevent it. Therefore, if the blood sugar is climbing in spite of frequent testing and administration of additional insulin or if is clear that dehydration is occurring, professional help should be sought without any sense of guilt or failure.