In an Emergency

We are always available for emergencies, including when managing your child’s diabetes is complicated by illness. If you need to speak with the physician, please call the division of pediatric endocrinology (beeper: 401-350-0520). If your child is experiencing an emergency, please call our office (beeper: 401-350-0520) and bring your child to the emergency department.

If you are unsure about management of your child’s diabetes when your child is ill, follow the instructions below:

What to Do:

  • Never skip insulin. Call the physician for dosing information (beeper: 401-350-0520).
  • If your child is vomiting or cannot eat, do not give him or her the usual dose. Call the physician for instructions.
  • Monitor your child’s blood glucose every 3 to 4 hours.
  • Check urine ketones at least 2 or 3 times per day.
  • Prevent dehydration. Continue to give your child liquids throughout the day.

Guidelines:

  • Ketones: Test urine for ketones if your child is ill or if blood glucose is over 250 mg/dl for several tests.
  • Vomiting: Vomiting can be due to an infection or ketones. Your child may have low blood glucose with vomiting and still have ketones in the urine.
  • Insulin: Keep a bottle of fast acting insulin (Humalog or Novolog) available, and be sure it is not past the expiration date.
  • Blood glucose testing: Test blood glucose every 3 to 4 hours.
  • Fluids: Drink plenty of fluids. If you child’s blood glucose is less than 180 mg/dl, drink fluids containing sugar (for example, ginger ale or juice).

Call the doctor if:

  • The urine test shows moderate or large ketone numbers.
  • Your child is vomiting and unable to keep fluids down.
  • Your child is dehydrated. Symptoms include dry mouth, flushed skin, cracked lips, and sunken eyes.

Call the doctor and go to the emergency room if:

  • Your child’s breathing is labored (fast or deep).
  • Your child is confused, drowsy or sleepy.
  • Your child is extremely weak or having abdominal pain.

Nutrition Management:

  • It is important to plan ahead for times when your child is not feeling well and not eating normally. Keep a “Sick Day Cupboard” stocked.
  • Keep a copy of a “Sick Day Meal Plan” ready with suggestions. Ask your dietitian for help in planning one.
  • If your child can eat, try replacing the usual amount of carbohydrates at meals and snacks with those from the list below.
  • If your child cannot eat or cannot keep food down, call the physician (beeper: 401-350-0520). Give fluids every one to two hours. This may mean taking teaspoon-size sips at a time. Depending on the blood glucose levels, you may try giving sugar-containing liquids such as fruit juices, regular popsicles, tea with sugar or honey, regular gelatin, and regular ginger ale. If your child is vomiting or has diarrhea, include salty fluids like chicken broth or consommé, and good sources of potassium such as orange juice.

Sick Day Food Suggestions   Amount and Food Item, Approx. Grams of Carbohydrates

½ cup applesauce (natural or unsweetened) 15

½ cup applesauce (sweetened) 25

½ cup apple juice 15

1 cup chicken noodle soup (canned) 10

½ cup cooked cereal (oatmeal, Cream of Wheat) 15

½ cup fruit yogurt (light) 11

½ cup fruit yogurt (regular) 22

½ cup gelatin (for example, Jell-O) (regular) 20

½ cup gelatin (for example, Jell-O) (sugar-free) 0

½ cup grape juice 20 1 tbsp. honey 15

1 tbsp. Hershey’s chocolate syrup 12

½ cup ice cream 15

1 Popsicle (regular) 15 ½ cup pudding (regular) 25

½ cup pudding (sugar-free) 15

½ cup orange juice 15 ½ cup soda (regular) 12

½ cup soda (diet) 0 6 saltine crackers 15

½ cup sherbet 30

1 tbsp. sugar 12

1 slice of toast 15