Sick Day Guidelines for Diabetes

You can help your child with diabetes stay well by getting the flu shot each year, washing your hands regularly and following the advice we provide here. These steps can help when your child has a fever, is vomiting or has any other illness symptoms that disrupt their normal routine.

Please call us with any questions. You can reach us 24 hours a day, seven days a week at (615) 322-7842.

Working with your pediatrician and your diabetes provider can help you make it through the winter season.

Follow these critical steps to keep your child's diabetes in control when they don't feel well.

• Check blood glucose (BG) every four hours around the clock until they are well.
• Give blood glucose correction (sliding scale) every four hours even if your child is not eating. Use Novolog, Humalog, or Apidra.
• Test every urine for ketones or test blood ketones every four hours.
• Offer fluids every 15 minutes while awake. If blood glucose is under 200, offer liquids with carbs. If blood glucose is over 200, offer sugar-free fluids.

Call (615) 322-7842 for any ONE of these reasons:

• Persistent vomiting (more than three times) with moderate to large urine ketones, or blood ketones greater than 1.5 mmol
• Altered behavior
• Persistent rapid breathing

When you call, be prepared to provide

• The past 48 hours of blood sugar levels
• Ketone levels
• Any other symptoms your child may be experiencing

• If blood sugar is over 240 with moderate or large ketones, give a correction for elevated blood sugar with a syringe and change the site.
• Always continue the basal rate.

Always give basal insulin (Lantus, NPH, or Levemir)!