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February 3, 2001

Daily Care

Question from East Petersburg, Pennsylvania, USA:

What do you recommend for a 19 month old with type�1 diabetes and a severe stomach virus (vomiting, loose bowels) who is battling low sugar even after reducing insulin? It's extremely difficult to get her to drink or eat anything. Nothing is appetizing to her with her stomach upset.


E-mail is much too cumbersome a device to be of help in a situation like this, and you really need to talk to the doctor or the nurse on the diabetes team right away to decide whether the child needs any further modification of the insulin dose or to be seen and perhaps admitted to hospital. It will be important to have information on urine ketones as well as blood sugars before getting hold of them.

For the future it might help you to read a little about sick day management.


[Editor’s comment: You might try using the frozen Pedialyte, regular popsicles, lollipops, etc. Sometimes you can keep the blood sugar up by rubbing small amounts of jelly, gel cake frosting, or instant glucose on the gums at frequent intervals.

A 19 month-old who is vomiting and has loose stools is danger of becoming severely dehydrated. It is not unusual for children this age to require IV fluid replacement in this type of situation, regardless of whether or not they have diabetes. As Dr. O’Brien suggests, you need to work out “sick day strategies” in conjunction with your child’s diabetes team.