Sick days with Type 1 Diabetes: a guide for parents

Every child gets ill sometimes. Coughs, colds and tummy bugs are part of growing up. When your child has Type 1 Diabetes, illness needs a little extra care, because it can affect blood glucose and ketones. Knowing your sick day rules makes those days much less stressful.

Why illness affects blood glucose

When the body is fighting an infection, it releases stress hormones that usually push blood glucose up, even if your child isn't eating much. Tummy bugs with vomiting or diarrhoea can sometimes make levels go low instead. That's why levels can be unpredictable when children are poorly.

Never stop insulin

Even if your child isn't eating, their body still needs insulin. Stopping insulin can quickly lead to diabetic ketoacidosis (DKA), which is dangerous. Your diabetes team will give you sick day rules explaining how to adjust insulin. Keep a copy somewhere easy to find.

Check more often

• Check blood glucose more often, including overnight, or keep a close eye on the CGM.
• Check ketones when your child is unwell or their glucose is high, as your sick day rules advise.
• Write down readings, ketones, insulin, food and drinks. It helps if you need to call for advice.

Fluids and food

Keep your child drinking little and often to avoid dehydration. If they can't manage normal meals, your sick day rules will suggest alternatives so they still get some carbohydrate when needed.

When to get help

Call your diabetes team's helpline or out-of-hours number if:

• ketones are rising or above the level in your sick day rules
• blood glucose stays high, or keeps going low
• your child can't keep fluids down
• you're worried or unsure what to do

Call 999 or go to A&E if your child is vomiting repeatedly, breathing fast or deeply, has tummy pain, is very drowsy or confused, or their breath smells fruity. These can be signs of DKA.

Be ready before illness strikes

• Keep ketone strips in date and in stock.
• Save your diabetes team's numbers in your phone.
• Have a sick day box ready, with sugary drinks for lows, sugar-free drinks for highs, and your written rules.

Free guide

Our free Sick Day Hero guide explains all of this to children, with Poppy Star, so they know what to expect and when to ask for help.

Please note: this article is general information written by a parent, not medical advice. Always follow the plan and advice of your child's diabetes team.

Gary RapsonMax's dad and the author of the Captain Lantus books. Max was diagnosed with Type 1 at 18 months old.