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Managing Illness-Summary

Managing diabetes can be challenging when your child is sick. The following chart summarizes the recommended response to varying levels of blood sugar, as well as the presence of absence of vomiting / diarrhea, and varying levels of ketones.

This chart summarizes the more detailed information outlined in this Managing Diabetes During Illness section.


BG
< 4.0 
mmol/L
BG
4.0 – 10.0 
mmol/L
BG
10.0 – 14.0 
mmol/L
 BG
> 14.0 
mmol/L
Decrease insulin

Push sugar fluids

Call diabetes nurse/doctor

With vomiting, diarrhea, or loss of appetite With vomiting, diarrhea, or loss of appetite  Check Urine or Blood for Ketones
Decrease insulin

Push sugar-containing fluids

Call diabetes nurse/doctor if:

* Dehydrated

* Vomiting > 2 times in 4 hours

* Frequent diarrhea

Usual insulin

Push sugar-containing fluids if on N/NPH

Call diabetes nurse/doctor if:

* Dehydrated

* Vomiting > 2 times in 4 hours

* Frequent diarrhea

Urine Ketones negative
Blood Ketones < 0.6
 
Urine Ketones positive
Blood Ketones 0.6-3.0
 
Blood Ketones > 3.0
 
With or without vomiting, diarrhea, loss of appetite: With or without vomiting, diarrhea, loss of appetite: With or without vomiting, diarrhea, loss of appetite:
Usual insulin

Push sugar-free fluids

Call diabetes nurse/doctor if:

* Dehydrated

* Vomiting > 2 times in 4 hours

* Frequent diarrhea

 

Give extra insulin

Push sugar-free fluids

Call diabetes nurse/doctor if:

* Dehydrated

* Vomiting >
2 times in 4 hours


* F
requent  diarrhea

* Ketones do not clear after 2 extra doses of insulin

Give extra insulin
Push sugar-free fluids
Contact medical help! Your child may have diabetic ketoacidosis
Eating normally, no vomiting, no diarrhea Eating normally, no vomiting, no diarrhea
Usual insulin

Push sugar-free fluids

Usual insulin

Push sugar-free fluids

References:

The above information was adapted with permission from The Alberta Children’s Hospital Diabetes Clinic information handouts.

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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