Sick-day guidelines for children with diabetes

Children with diabetes may need extra care when they have a cold or the flu. Here are some sick day rules for diabetes to help prevent high blood sugar when sick.

Author: Heather Rush, APRN, CPNP, CDE

Published: November 19, 2019 | Updated: October 4, 2022

Every child gets sick with a sore throat, cold or minor illness from time to time. When your child with diabetes is ill, there are simple sick-day guidelines you can follow to help manage blood sugar levels. Being prepared and taking extra measures may help you and your family have a healthier cold and flu season.

Sick-day guidelines for children with diabetes

Here are tips for families managing diabetes to stay healthy during cold and flu season:

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  1. Practice good hand-washingfor your family. The age-old question, “Did you wash your hands?” is still fashionable. Remind children to wash their hands before eating, after using the bathroom and in settings where they may touch a lot of surfaces (museums, playgrounds, stores). Teaching your child to practice hand-washing in a wide variety of settings can be the first defense against illness.
  2. Have your child and family vaccinated for the flu.
  3. If your child becomes ill, check blood sugar levels more frequently. High blood sugar readings may indicate the need to check urine for ketones; insulin adjustments may be needed.
  4. Stay hydrated. Furnaces and heaters can rob inside air of moisture. Help your child remember to drink plenty of water.
  5. If your child is ill, have a thermometer handy. If your child’s temperature is 100.4 F or above, call your pediatrician or primary care provider’s office to see if an appointment is needed.
  6. Check ketones if your child begins to vomit, has diarrhea, or is not eating or drinking as usual. If your child’s blood sugar is less than 200 milligrams per deciliter (mg/dL) and ketones are present in the urine, give your child small sips of a clear, sugary drink to raise the blood sugar. Recheck the blood sugar in 30 minutes to an hour. Once the blood sugar is over 200 mg/dL, you are able to give extra insulin for ketones.
  7. Need additional assistance? Call your diabetes educator.