advice please

[bev]

Hi all,
Quick question : Alex doesnt feel very well - sore throat etc - so not used to what to do if he doesnt want to eat later etc.. I am assuming i would give him some insulin if he goes high even without food, and if he is low dont bother with insulin? Any advice greatfully received!Will also be checking for ketones. Thanks. Bev

 

[AJL]

Hi Bev

Does your hospital provide information on sick day rules as they sometimes have leaflets that are very useful?

When I've been ill before and lost my appetite I've tended to do a google search of sick day rules for diabetics to gain some guidance - although this does differ from hospital to hospital

The following seems to link to some sensible suggestions

http://www.diabetesuffolk.com/ManagingDiabetes/Sick day rules.htm

I hope that Alex feels better soon

 

[insulinaddict09]

Hi all,
Quick question : Alex doesnt feel very well - sore throat etc - so not used to what to do if he doesnt want to eat later etc.. I am assuming i would give him some insulin if he goes high even without food, and if he is low dont bother with insulin? Any advice greatfully received!Will also be checking for ketones. Thanks. Bev

Hi Bev.. i was told by the hospital to still take small amounts of insulin and try to have some fruit juice.. small bowl of soup or icecream for the carbs... could you not phone your dsn for some advice?
when ill...and i have been sick for a week i test every couple of hours and take small insulin doses to keep levels down.
I hope Alex feels better soon

 

[Emmal31]

Hi Bev,
hope alex feels better soon. I've always been told never stop injecting even when Ill so if he doesn't feel up to eating he should have some fruit juice or something similar with an injection. My husband has just had an awful cold and I'm crossing my fingers I don't get it because I think there's something going around at the minute.

 

[bev]

Thanks all,

DSN - i wish i could get in touch with her! Think they finish at 4 o clock!
Anyway he said he may be able to have a little soup. Should i work out the full carbs for the soup or just give a nominal amount of insulin?
He seems fine other than he is feeling cold and he cant swallow properly. Bev

 

[runner]

Thanks all,

DSN - i wish i could get in touch with her! Think they finish at 4 o clock!
Anyway he said he may be able to have a little soup. Should i work out the full carbs for the soup or just give a nominal amount of insulin?
He seems fine other than he is feeling cold and he cant swallow properly. Bev

You could try NHS diret, or your GP out of hours service for advice?

 

[sasha1]

Thanks all,

DSN - i wish i could get in touch with her! Think they finish at 4 o clock!
Anyway he said he may be able to have a little soup. Should i work out the full carbs for the soup or just give a nominal amount of insulin?
He seems fine other than he is feeling cold and he cant swallow properly. Bev

Hi Bev,
Sorry Alex is'nt feeling well.
I've just looked at Nathan's sick day guidelines which the dsn gave him.
I'll type what it says down for you.
If your child is unwell the following advice may be useful. If you are at all concerned about your child contact the diabetes team or childrens ward as soon as possible.
NEVER OMIT INSULIN DOSES DURING ILLNESS EVEN IF THE CHILD IS VOMITING.
It is important to check your childs blood glucose more frequently during illness. This may need to be 1-2 hourly until the blood glucose is stable.
If your child has an illness with a temperature this may lead to an increase in blood glucose. You may need to increase the regular insulin doses during an illness with a high temperature; this can be by 20-50% for the duration of the illness. Once the blood glucose returns to normal insulin can be slowly decreased to normal doses. Rapid insulin can also be used to reduce blood glucose levels during illness.
If your child has diaorrhea/vomiting this can lead to a decrease in blood glucose levels(particularly in young children). Malabsorbation during this time may lead to a fall in blood glucose, therefore a reduction of insulin dose may be needed. The reduction in the dose is dependent on the level of hypoglycemia experienced.
Normal food can be substituted with easily digestible foods such as porridge, custard or rice pudding.
If your child is unable to tolerate any food or is unwilling to eat, food can be substituted with drinks.
Use sugary fluids if the blood glucose is below 10mmols (50mls lucozade or 100mls normal coke should be given every 40-60 minutes) and sugar free fluid should be used if the blood glucose is above 10mmols.
Always ensure your child has adequate fluids when unwell.
If your child is unwell you should always check the urine for ketones every 4 hours.
REMEMBER:
Fever can increase the need for insulin this can be by 20-50%
Decreased appetite and food intake can reduce the need for insulin

Hope this helps a little, hope alex feels better soon

Heidi
🙂

 

[aymes]

Have you been given sick day rules for times like these, if not do ask for them when you speak with your DSN, and go by what they've advised. Sick day rules would generally be along the lines of eat if possible and bolus for what you eat as you usually would, continue with basal doses as usual and expect to have to correct highs, and test for ketones regularly. Sick day rules may also advise increasing the basal if sugars are getting consistantly high but obviously don't do this unless you have been advised to by your care team. If you are concerned and can't get hold of a dsn then call nhs direct for advice as runner says.
Hope Alex feels better soon.

 

[Munjeeta]

Illness is never easy to juggle with diabetes... I would agree with the concensus not to stop administering insulin so do try and get some sort of food/ drink into him and cover it with insulin. I always got advised to use a sliding scale of insulin dosages depending on what I was eating/ what my blood sugar was when I took it but I'm afraid that was years ago when my mum still did my doses! I can be no more help than that. But I would agree with ringing NHS direct (or your doctor's surgery if they direct you onto an out of hours service - if this isn't the same thing as NHS direct...?) to get some more specific advice! Hope he feels better soon x

 

[bev]

Hi all,
Heidi, thankyou so much for typing all that information - very kind of you. I will keep that post if i can? Anyone know how to do that?

Alex managed to eat some egg and bread - so he had some insulin. However, he looks awful now and is lying down (sucking his thumb - he will kill me for that!) - but we are checking for ketones and making him drink water etc.

Wish our team had told us how to treat a sick day! But i wanted to say thankyou to all of you who have taken the time to reply to post. I honestly do not know what we would do without you all.🙂 Bev

 

[sasha1]

Hi all,
Heidi, thankyou so much for typing all that information - very kind of you. I will keep that post if i can? Anyone know how to do that?

Alex managed to eat some egg and bread - so he had some insulin. However, he looks awful now and is lying down (sucking his thumb - he will kill me for that!) - but we are checking for ketones and making him drink water etc.

Wish our team had told us how to treat a sick day! But i wanted to say thankyou to all of you who have taken the time to reply to post. I honestly do not know what we would do without you all.🙂 Bev

Hi bev,
I also have a sliding scale of insulin/blood readings for when treating illness, that again the dsn gave me.. but cant find it..will hunt it down and post the details up on this thread A.S.A.P.
If you still concerned about alex in anyway in the mean time, either contact your childrens ward or NHS direct.
I know its easy to say but try not to worry, Nathan has been exactly the same as this and then a few hours later been bouncing around.
Take care hun
Heidi
🙂

 

[insulinaddict09]

Hi Bev... I hope Alex is feeling better today 🙂🙂🙂

 

[katie]

However, he looks awful now and is lying down (sucking his thumb - he will kill me for that!)

I probably shouldn't admit to this, but i sucked my thumb right up until year 6 of school 😉

I hope Alex is feeling better today xx

 

[runner]

Hi, Hope Alex is on the mend and you managed to get some sleep last night.

Hi all,
I will keep that post if i can? Anyone know how to do that?

Not sure how to save the post except to highlight or 'select' the text with your mouse or cursor, then 'copy and paste' it to a word processing programme. I assume this doesn't contravene any forum rules - perhaps moderators can enlighten us?

Alternatively, if Sasha still has the info on her programme, she could PM you and you can save it as a message there?

 

[Caroline]

Just wanted to say I hope Alex is feeling better.

 

[Patricia]

Hi bev, hope alex is feeling okay? We've had several bouts of illness in last six months, and have found every time that E runs higher anyway, so normal insulin is always a good idea. We've continued to give background at same level (on two occasions actually raising it for two days), then bolus AFTER he's eaten whatever he feels like eating... It's not ideal, I know, but how can you know what you want when you have a sore throat?

We've been surprised at how much insulin he's needed even though he didn't eat much -- because bg is raised with illness...

At the moment Oasis Summer Fruits is favourite here for liquid with illness: there is a sugar version and a light version -- both are good and useful in different situations! Anyway it's a refreshing drink if he likes it. Both of mine really want it when ill with throats, for some reason, maybe because fruit juice can feel just too strong. Of course if Alex likes fizzy there's also the usual suspects -- coke, lemonade, lucozade, which can feel better too for throats if a little flat...(mine don't do fizzy).

Anyway. Hope things are settled.

 

[Northerner]

... lucozade, which can feel better too for throats if a little flat...(mine don't do fizzy)...

When me and my sister were little, we only got lucozade when we were ill, so it was seen as a kind of treat with some kind of magical medicinal properties! I don't think they're allowed to claim things like that for it now!

 

[bev]

Alex has eaten some breakfast and he was high - 17.5mmols so i corrected and gave him normal amount for his breakfast. But he feels sick etc so if it all comes back up not sure what to do! I suppose i will just keep checking his levels every 2 hours and checking for ketones. The thing with children is they normally have these things and look really ill then 24 hours later are back to normal. Bev

p.s. lovely picture northerner!

 

[insulinaddict09]

Alex has eaten some breakfast and he was high - 17.5mmols so i corrected and gave him normal amount for his breakfast. But he feels sick etc so if it all comes back up not sure what to do! I suppose i will just keep checking his levels every 2 hours and checking for ketones. The thing with children is they normally have these things and look really ill then 24 hours later are back to normal. Bev

p.s. lovely picture northerner!

Hi Bev, i would just keep checking the bloods/ ketones every 2hrs or so.

If he does start vomiting.. could he perhaps sip lucozade/juice or sweet drinks so that he can still take his insulin? Ive been being sick for over a week and still took small doses every few hours to keep my levels down.
Would he have icecream if his throat is still sore?... it is a good source of carbs if you are not eating properly. I hope things pick up soon babe xx

 

[Patricia]

Yes, ice cream! If he feels like it. Good source of carbs, as insulinaddict09 says, and will feel good on his poor throat...

Also, if he *is* sick, at least the tendency to run high will help matters, a bit of a cushion for the insulin...

E had a thing for almost a whole week, throat and feeling a bit sick... Eventually went a bit cold-y, but did drag on...

Take care.

Northerner: in our house it was warm, liquid jelly (or Jello, in the States). LOVED IT. So sweet and comforting...