Diabetes: Sick Days

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KEY POINTS

• Diabetes weakens the immune system, so people with diabetes are more likely to get sick. Diabetes is harder to control when you are sick.
• Your healthcare provider will work with you to develop a sick-day plan designed especially for you. The plan should include how often to check your blood sugar when you are sick, what to do if you have symptoms, what foods and liquids are safe to eat and drink, and when and how to contact your provider.

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How does illness affect diabetes?

Children with diabetes are more likely to get sick. This is because diabetes weakens the immune system, which the body’s defense against infection.

Diabetes is harder to control when your child is sick. The body releases hormones to help fight the illness. These hormones affect the way your child’s body uses insulin, which can cause a rise in blood sugar. This means blood sugar can get very high during an illness. If high blood sugar is not treated, it can make your child very sick and become a life-threatening medical emergency.

How do I prepare for illness?

It is good to be prepared for illness with a sick-day plan. Your healthcare provider will work with you to develop a plan designed especially for your child. The plan may include:

• When and how to contact your provider
• How often to check your child’s blood sugar when he is sick (you will need to check it more often)
• How your child should use insulin or other diabetes medicines
• What to do if your child has a fever
• What to do if your child feels sick to the stomach or is throwing up
• What foods and liquids are safe to eat and drink

Your child may also need to check for ketones in the blood or urine. If the body does not make enough insulin, sugar cannot move out of your child’s blood and into the cells. Your child’s blood sugar can get very high and his body burns fat instead of sugar for energy. This makes byproducts called ketones. When ketones build up to dangerous levels, it is called ketoacidosis. This can cause coma or death if not treated right away. Ketoacidosis may happen with type 1 diabetes. It rarely happens with type 2 diabetes.

How can I take care of my child when he is sick?

• Follow your sick-day plan.
• Have your child’s sick day plan written down where family and caregivers can find it so everyone knows what to do.
• Unless your healthcare provider tells you not to, make sure your child keeps taking his medicines when he is sick. If your child is unable to take his diabetes medicine, call your provider.
• If your child’s stomach is upset, it’s best to eat soft, plain foods and drink plenty of fluids. If your child doesn't drink enough, he may get dehydrated. Ask your healthcare provider about the best food and drink choices when your child is sick and write them on your child’s sick-day plan. Keep your provider informed about how your child is doing (whether he’s getting worse or better and what his blood sugar readings are).

How can I keep my child from getting sick?

You can help prevent some infections if you:

• Keep your child up to date on immunizations. For example, make sure he gets a flu shot every year.
• Teach your child to wash his hands often with soap and water. He should wash for at least 20 seconds (long enough to sing the whole “Happy Birthday” song twice) or use an alcohol-based hand cleaner.
• Teach your child to stay at least 6 feet away from people who are sick, and avoid touching his eyes, nose, or mouth when out in public.
• Take care of your child’s health. Make sure he gets at least 7 to 9 hours of sleep each night. Help your child learn ways to manage stress. Make sure he exercises according to healthcare provider's instructions.
• Keep surfaces clean--especially bedside tables, surfaces in the bathroom, and toys for children. Some viruses and bacteria can live up to 48 hours or more on surfaces like cafeteria tables, doorknobs, and desks. Wipe them down with a household disinfectant according to directions on the label.
• Check your child’s skin every day for signs of rash, injury, and infection.

For more information, contact:

• American Diabetes Association
  800-342-2383
  http://www.diabetes.org/