Common Ailments and Diabetes
When is a cold not just a cold or an infection more than something that needs antibiotic cream? The answer is simple: when diabetes is present. While parents need not panic at the thought of an unrelated diabetes illness, they will need to take special care during those times, and understand the nuances of caring for a sick child with diabetes.
Head Colds and Viruses
Just because your child has the sniffles does not mean you have to dash to the emergency room. But when your child does battle minor ailments like a cold or mild virus, remember that her body is working extra hard and that means insulin needs can change. Any time your child is battling illness, be more vigilant. Check more often; think more carefully about boluses. The old wives' tale is that children always run higher when they are ill, but the truth is (like everything else in diabetes) each child's body reacts differently. Some run lower, some run higher, and a few lucky ones don't see any difference at all. Which is your child? You'll learn with time and experience.
If your child is ill enough to stay home from school or from playing with friends, it's not a bad idea to check her blood sugar every hour or so as long as the illness sticks around. In most cases, if your child is resting anyway, she won't mind too much. Even if she does, explain that while she is sick, you need to make extra sure she's okay. As the hours go by and things look fine and you realize it's just a cold, you can back off.
Just because your child's blood sugars don't seem to fluctuate with his first few illnesses, don't begin to take that for granted. Always check extra on sick days, no matter what pattern you've seen.
Strep and Other Infections
If your child is spiking a fever, complaining of a sore throat, or is just completely wiped out, call your pediatrician (as you would with any child). If your pediatrician diagnoses some kind of infection, check in with your medical team and refer to the sick day plan they should have given you during diabetes training.
Even a sick day plan is simply a foundation and never the entire picture, because each illness might affect your child differently. The time of year could factor in (heat can sometimes mess with blood sugars) and the length of the illness. Don't feel funny calling your team if your child is ill enough to cause you concern. They are there to guide you through such things.
When you call, your team will most likely set up a different insulin dose schedule, at least for the next half day and ask you to check in again if you still have concerns. Sometimes, they may just tell you to watch your child closely, do regular checks, and see how things progress.
Ketones must be checked at least every four hours during any illness. Do not let in-range blood sugars stop you from doing this, because ketones can develop during illness at any time. The sooner you spot them, the better you can react.
As you watch your child through the illness, you'll begin to notice patterns. If your child is running higher than usual, you'll want to decide (with your team at first) how much more insulin to give and for how long. You'll also want to up your child's target range to give some padding in case the extra insulin ends up being too much.
If your child runs low, you'll need to work with your team to lower doses, and keep your child sipping something with carbs in it.
If your child's sore throat is keeping her from eating, use a sports drink, soda, juice, or even ice cream to keep her carb intake up. It's not always fun forcing your child to sip or eat when she just doesn't feel like it, but you need to find a way.