Sick days aren't easy for anyone, but for kids living with type 1 diabetes (T1D), getting sidelined by an illness presents an extra set of challenges. Even a mild cold can affect blood sugar levels and make the condition more difficult to manage.
Fortunately, there are steps you can take to handle your child's sick days with confidence. Here are several ways to care for your child living with T1D when they have a minor illness.
Be vigilant about blood testing
Blood sugar can be unpredictable when your child with t1d is under the weather. That's why it's vital to monitor glucose levels frequently during sick days.
According to the Centers for Disease Control and Prevention, blood sugar levels can fall when people are sick, due to their reduced appetite. At other times, glucose levels may actually go up when people living with t1d come down with colds, the flu, and other illnesses. This can be caused by stress hormones that fight infections, which may also raise blood sugar, according to the Association of Diabetes Care & Education Specialists.
To keep your child safe and meet the challenge of unpredictable blood sugar during sick days, it's a good idea to use advanced diabetes technologies, including continuous glucose monitors (CGMs) and testing supplies. CGMs can allow you to track your child's blood sugar levels right from your phone, helping you rest assured that their diabetes is under control even if they're not feeling their best.
If you're relying on fingerstick tests, you may need to be a little more hands-on. According to EndocrineWeb, "a general guideline to shoot for is to check their blood glucose every two to three hours." It's a good idea to also consult your family's personal healthcare professional, as they might advise you to check more or less frequently.
Watch out for ketones
When people with t1d get sick, they can be at risk of developing diabetic ketoacidosis (DKA), a dangerous condition that occurs when too many ketones build up in the blood, Diabetes Education Online explained. Accordingly, it's vital to check for ketones frequently during your child's sick days, using either urine test strips or fingerstick tests.
Any increase in ketones should be reported to your healthcare professional, Dr. David Dugdale of the University of Washington advised in Diabetes Forecast. "If it is more than 'low,' the patient should get specific instructions on how to turn things around," he explained.
Stay on track with insulin
If your child living with t1d is having trouble eating or holding down food, you might be tempted to skip giving them their insulin because you're afraid of a low blood sugar reaction. However, it's important to resist that temptation!
People with t1d need to keep taking insulin when they're sick, both to process the glucose that naturally occurs in their bodies and to stave off complications like DKA. You might need to fine-tune the dosage for your child, especially when it comes to bolus (short-acting) insulin, to avoid low blood sugar. But make a point to never skip long-acting basal or "background" insulin doses.
Ensure your child is hydrated
Everyone should stay hydrated when they're sick, but it's especially important for people with t1d to maintain their intake of fluid. This is because high blood sugar can result in dehydration, according to Diabetes.co.uk. And dehydration can quickly lead to a number of other issues.
On sick days, encourage your child to drink one cup of water (or other calorie-free, caffeine-free liquid) every hour. Of course, that can be easier said than done. If your child finds it hard to drink that much at once, try giving them a few sips of water every 15 minutes, the American Diabetes Association advised.
Keep easy-to-digest carbs handy
It's smart to keep healthy foods on hand that can be a source of carbohydrates and are easy to digest, like soda or Jell-O (both of which contain sugar). Best of all, there's an added benefit to this: These foods will not only help your child avoid low blood sugar, but they can also help prevent dehydration.
The National Institute of Diabetes and Digestive and Kidney Diseases compiled a list of other foods to keep on hand during sick days, such as crackers, dry toast, and sherbet. Even if your child isn't wanting to eat or drink, it's important they have a bit of these foods, as it can help keep their energy levels up and ensure their glucose levels don't dip too low.
Ask about over-the-counter medicines
Many over-the-counter medicines (which you can buy without a prescription) effectively relieve symptoms of a cold, flu, and other illnesses. But some of these medicines may have ingredients that can raise or lower blood sugar, so it's important to stay vigilant while shopping.
As the parent of a young one living with t1d, it's a good idea to regularly check in with their doctors and follow their advice about taking over-the-counter medicines. You've successfully navigated their diabetes management up to this point — you can handle this, too!
Looking for more tips around helping kids with t1d during sick days? You can find tons of useful information on the Health Insights blog.