Typical situations

Sick day

When the child is ill, the need for insulin can rise by up to 50 %. Basal insulin is never skipped entirely, not even when the child is vomiting.

Basic rules

In a feverish infection, insulin need can rise by up to 50 %
Give correcting rapid-acting insulin doses and, if needed, a sugary drink as well
Measure blood sugar more often, even every 1–2 hours
Over 15 mmol/l → measure blood ketones
If the child eats little, ketones can appear even when blood sugar is normal or low

Source: Lastentalo

Vomiting or a stomach bug

Do not stop insulin, even when the child is vomiting

Always measure both blood sugar and ketones. From those you can see whether this is a stomach bug or DKA starting. Dehydration can confuse the sensor, so confirm from the fingertip if needed.

Source: Lastentalo

When food does not appeal

Offer small portions of 10–20 g of carbs every 1–2 hours
For a child who feels sick, a cold sugary drink in small sips usually stays down best
If the child throws everything up and blood sugar is low: syrup or honey on the inside of the cheek

Source: Lastentalo

When to go to hospital

Go more readily than with a normal cold

If the child cannot eat or throws everything up and blood sugar or ketones keep rising despite extra insulin, go to hospital. There the child can get intravenous fluids if needed.

Source: Terveyskylä

Sources: diabetes.fi (Diabetesliitto, the Finnish Diabetes Association) and terveyskyla.fi (Diabetestalo / Lastentalo). This app does not replace the individual instructions you receive from your clinic. Insulin doses, correction factors and sick-day rules are always agreed with your own care team.

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