When your child has diabetes, even a minor cold or fever can be a huge burden, right? Unlike a normal illness, when a child with diabetes gets sick, their blood sugar levels can suddenly fluctuate. But don't worry! With a little planning and advice from your doctor, you can definitely manage these sick days well. Let's take a look at some of the details.
How does a child's body sugar level change when they become ill?
When a child is sick, it means that their body is under a lot of stress. In a child with diabetes, this stress can cause their blood sugar levels to fluctuate unpredictably. Sometimes the sugar levels may go up, and other times they may go down.
Why does sugar level increase like this? (Hyperglycemia)
When a child is sick, in response to stress, their body produces more of certain hormones, called `stress hormones`. These hormones cause the blood sugar level to increase. Also, the insulin that the child takes at this time may not work properly. To be precise, the sensitivity to insulin decreases. Then, the child may need more insulin than usual. Even a slight fever or cold can cause this condition, so you need to be careful about high blood sugar levels (`Hyperglycemia`).
Then, can sugar levels drop? (Hypoglycemia)
Yes, absolutely. Some illnesses can cause a child to have a loss of appetite, stomach pain, nausea, and vomiting. This can cause the child to eat less or even refuse to eat. So, if a child taking insulin does not eat as much as usual, their blood sugar levels can suddenly drop (`Hypoglycemia`). At this time, the child will need less insulin than usual.
Imagine your child has a stomach ache, is vomiting, and won't eat anything. If you give him the same amount of insulin he needs for the day, his blood sugar levels could drop too low due to lack of food, which could be dangerous.
How can we prepare before a child gets sick?
There is a saying that "preparation is the best medicine." This is also very important when a child with diabetes gets sick. This preparation will help you work without panicking.
- Know your child's diabetes care plan: Your doctor may have given you a "Diabetes Care Plan" when treating your child for diabetes. It has specific instructions for what to do on "sick days." For example, how to adjust your insulin dose and how to check your ketones. Be sure to read and understand this carefully.
- Keep extra glucose and ketone test strips: You may need to check your blood sugar and ketone levels more often during your sick days. So, keep extra test strips at home so you don't run out. You don't have to rush at the last minute.
- Keep these things ready in the kitchen:
- Sugar-free fluids: It is very important to prevent dehydration when your child is sick. Keep plenty of fluids, such as water, chicken soup (made without oil), vegetable broth, unsweetened tea, and unsweetened soda.
- Give sugary drinks if your blood sugar level drops: Keep things like regular soda (which contains sugar) and fruit juice (fresh is better) ready to give quickly in case your blood sugar drops.
- Special drinks: Sometimes your doctor may recommend sports drinks like Pedialyte or Gatorade. These also provide the body with the necessary electrolytes.
- Light food for the stomach: Keep some light, easily digestible foods on hand, such as crackers, bread, yogurt, and porridge.
- Keep a thermometer within easy reach: This is essential for regularly checking your child's temperature.
What should I do when my child is sick?
When your child is sick, your first and most important guide is your child's diabetes care plan. Follow the doctor's instructions exactly as they are written. In addition, these general tips will also help you:
- Check your blood sugar levels frequently: You may need to check more often than usual, perhaps every 2-3 hours. Do as your doctor tells you.
- Do not stop giving insulin: This is very important! Even if the child does not eat, the body's sugar level can still rise, so insulin is needed. However, the dosage may need to be changed. Maybe increase it, maybe decrease it. Talk to the doctor and decide. Doctors may also recommend giving insulin to children with ``Type 2 Diabetes`` who do not take insulin every day.
- Check for ketones: Check your child's urine or blood for ketones. Abdominal pain, nausea, and vomiting can be a simple stomach upset, or they can be signs of a dangerous condition called Diabetic Ketoacidosis (DKA). That's why it's important to check for ketones.
- Encourage fluid intake: Give your child as much fluid (sugar-free) as possible to prevent dehydration. It is best to give them small amounts of fluids frequently.
- Be careful when giving medicine: Some over-the-counter cough and cold medicines may contain sugar. Some medicines can also affect blood sugar levels. Therefore, before giving any medicine to your child, ask the pharmacist or doctor whether the medicine affects diabetes and whether it contains sugar.
- Record everything: This is very important. Write down your child's symptoms (fever, cough, vomiting, etc.), medications given and their dosages, what they eat and drink, weight loss, how much fever they have, blood sugar levels, ketone levels, all of this along with the time in a book. These notes will be very helpful to the doctor in treating them.
- Help your child get enough rest: Rest is essential for the body when they are sick. Make sure your child sleeps well and rests, rather than letting them play, run, or jump.
When do you need to see the doctor?
While you can sometimes take care of your child at home, sometimes it's important to see a doctor right away. If you have any of these symptoms, call your doctor right away or take your child to the hospital:
- If the child has an appetite, does not want to eat or drink anything.
- If you have persistent vomiting or diarrhea for more than two hours.
- If your blood sugar level is very low (`Hypoglycemia`) and you cannot control it even with something containing sugar.
Important: If your child's blood sugar drops, try home remedies (e.g., giving sugary drinks) before calling your doctor or going to the hospital. If your child's blood sugar does not return to normal, call the emergency room (1990 in Sri Lanka) or take your child to the nearest hospital.
- If your blood sugar level remains high (hyperglycemia) and does not decrease despite insulin administration as per your care plan.
- If you have moderate or high levels of ketones in your urine or blood.
- If you think your child has symptoms of `DKA (Diabetic Ketoacidosis)` (e.g., rapid breathing, fruity breath odor, excessive sleepiness, confusion).
Never think twice, if you have even the slightest doubt, talk to your doctor. That's the safest thing to do.
What else do we need to know? (A little about prevention too)
Just as it is important to take care of your child when they are sick, it is also important to help them stay as healthy as possible.
- Get your child's vaccinations on time: Get all your child's vaccines on time, especially the Pneumococcal Conjugate Vaccine (PCV) for pneumonia, the annual flu shot, and the COVID-19 vaccine if eligible. These protect your child from many diseases.
- Teach your children to wash their hands regularly: The best way to prevent the spread of germs is to wash their hands properly. Make sure your child washes their hands with soap and water before eating, after using the bathroom, and after playing outside.
- Stay away from people who are sick: Illnesses like colds and flu spread very quickly. So, avoid taking your child to places where people are sick.
What we need to remember from all this (Take-Home Message)
It's true that you need to be a little more careful when your child with diabetes gets sick. But that doesn't mean you can't control it. The main thing is to not panic, and to be prepared in advance.
- Be sure to know your child's diabetes care plan and the rules for sick days.
- Check your blood sugar and ketone levels regularly.
- Never stop taking insulin (without medical advice).
- Give the child plenty of fluids.
- If you have any doubts about anything, don't delay in talking to your doctor.
With your love, care, and this awareness, you can definitely manage the sick days well and help your child recover quickly. You are not alone, and your medical team is always there to help you.
Diabetes, children, illness, blood sugar, insulin, ketones, DKA, hypoglycemia, hyperglycemia, diabetes care plan, sick day rules
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