CWD SUPPORT GROUP
Sick-Day Guidelines
Call your doctor when illness increases your child’s blood glucose levels; causes urine ketones; if they are vomiting and unable to take fluids or food for 4 hours; if illness lasts more than 24 hours; if they are dehydrated; have severe abdominal pain, or have other unexplained symptoms. or is no improvement in 6-8 hours. Test blood glucose and ketones frequently, at least every 2-4 hours, until results are normal. When contacting the doctor, have the results of glucose and ketone testing, symptoms of illness, and body temperature. Continue a modified insulin regime, even if your child is unable to eat solid foods or is vomiting. Their insulin needs may stay the same or increase when they are ill. Ensure your child eats easily digestible foods and drinks fluids even if they are vomiting, has diarrhea, or has higher blood glucose levels. They should take in carbs every 3-4 hours to prevent low blood glucose while their insulin clears the ketones. If regular foods are not tolerated, try carbohydrate-containing liquids or soft foods. The following foods contain 15 g of carbohydrate in the amount listed.
1/2 cup regular soft drinks
1 double Popsicle
1/2 cup regular Jell-O
1 cup Gatorade
1 cup soup
1/2 cup fruit juice
1 slice toast
6 soda crackers
To prevent dehydration, have your child drink at least 8 oz. of fluid every hour. If drinking causes vomiting, limit fluid to 1-2 tablespoons every 20 minutes or suck on a Popsicle. Fluids with minerals, such as broth or Gatorade, help prevent dehydration. Limit your child’s activity if their blood glucose level is higher than 14 and ketones are moderate to large.
By Deb Thomas-Dobersen, RD, MS, CDE
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