This whole week, my daughter, who has type 1 diabetes, has thrown up, won’t eat and sleeps a lot. She always want me to hold her, and her sugar level has been low as well. What could be wrong?

I very much hope that you have already been in touch with your daughter’s diabetes doctor or nurse, most especially if her urine has tested positive for ketones or if you have noticed the smell of ketones on her breath. It sounds as though she has some intercurrent infection, which may itself need treatment, and this in turn has led to a diminished appetite and a very small carbohydrate intake with a loss of stored reserves. This would explain why her blood sugar is low rather than much higher than normal which is what usually happens.

In these circumstances, she may well still need extra insulin, but because the blood sugar is already low extra glucose and fluids may have to be given intravenously. When this episode is over, you need to review how to manage sick days and how to get in touch with the nurse or the doctor right away without waiting for a week to get help.

DOB

[Editor’s comment: See sick day management for further advice.

SS]