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March 21, 2006

Sick Days

Question from Darien, Illinois, USA:

My 16 month old daughter was just diagnosed with rotavirus and spent three days in the hospital for it. She is better now. I'm worried about my son, who was diagnosed with type 1 in February 2005 and has been on a pump with NovoLog since January. What should I do if he starts to show signs of the illness? How long can rotavirus linger? Today, he has started running a low grade fever and doesn't have much of an appetite.

Answer:

Rotavirus is the most common diarrhea/vomiting virus found worldwide. It typically can cause moderate to severe vomiting and diarrhea which can lead to significant dehydration. For children with diabetes who have vomiting and diarrhea, it is important to push fluids. I usually recommend they drink Pedialyte or Gatorade and take insulin for the sugar content. Water is also a good choice, but should not be used exclusively to treat severe vomiting or diarrhea that leads to dehydration as it does not contain the electrolytes such as sodium and potassium which can be lost in vomit and diarrhea.

I would review your physician’s advice about sick-day management and review any changes that have been recommended to your child’s insulin dosing. Your child should also test ketones throughout the course of any illness and call your diabetes team immediately if those ketones are moderate or large.

Most of the time, rotavirus diarrhea and vomiting is easily taken care of at home and doesn’t lead to significant problems. If you have questions about your child specifically with any illness, you should be in close contact with your pediatrician through that illness.

MSB