Hyperglycemia in infections and how to treat diabetes when you are sick

Hello.

My daughter has all this bad week with a viral infection (let's call it flu, cold or something) for which I am giving it ibuprofen (without sugar).

The fact is that the girl is eating little and I still put it the same insulin and still uploaded !!We also do it corrections and it is as if the insulin was water ...

Since yesterday it has not dropped from 150 ... what do I do but basal more?But how much?

I get nervous about what is so long ... one thing is a bit and another this ...

Ah tb say that his pediatrician saw her and told me that he had no plates x what did not give me antibiotics.And the girl had fever last weekend and on Monday no longer

Good day,

It is common for infections to increase blood glucose.I pass a link that can guide you

Link

(Copy the link into the browser and remove the _ of the word diab_ets to work)

Hugs

I see that the text does not take the link (or is it my computer?) Maybe it is because the word "diabetes" appears in it, and the forum automatically marks, so that the entire link is not marked.@"Fer", can you see what happens and if you can fix it?Thank you

@"Mariah14", to see the page that I tell you, since it is not accessed from the link, copy from where it puts http to disease.And you hit it in the direction of the browser.It is the website of the Sant Joan de Deu hospital in Barcelona.

@imara Well, you are right, it is a "bug" that occurs when the web address you want to share contains the word diabetes ..., I copy here what you wanted to share and sign up to fix it.

The days of disease

In a child with type 1 diabetes, a relatively lower disease can cause rapid deterioration of metabolic control.An infection, surgery, an important injury or emotional alteration can also negatively influence.In these cases, the secretion of counter -regulatory hormones and blood glucose level increases.The production of ketones in the blood and urine is also stimulated.If they do not correct, these metabolic disturbances can progress rapidly and give rise to a diabetic ketoacidosis (CAD).

Attentively following the following guidelines Most children's diseases can be handled successfully at home.

never omit insulin injections

Patients with type 1 diabetes need basal insulin to live and fast insulin to eat.The insulin injections of children with diabetes must not vary during the disease days.Sometimes more additional rapid insulin injections (supplements) are required when presenting high blood glucose levels, with or without ketones in the urine.This can happen despite having taken less carbohydrates during the disease period.

In case of a gastrointestinal disease: the child may need a different handling.Nausea, vomiting and/or diarrhea that typically occur in gastroenteritis can cause low blood glucose concentration (less than 80 mg/dl).In this situation, the fast -acting and intermediate insulin dose can be reduced.If we find ketones in the urine when the blood glucose level is below 80 mg/dl will be due to the deprivation of carbohydrates (hunger or starvation ketosis).

Prevent dehydration

To prevent dehydration, it is recommended:

Encourage the child to drink many liquids.Liquids must contain salt and potassium to replace the loss of these electrolytes that occurs with a metabolic decompensation.The most convenient liquids during the disease days are: broth (rich in salt), water and oral serum.

Offer sugary fluids if the child does not tolerate the oral diet and its glucose levels remain low, such as carbonated drinks: Coca Cola® or lemonade, isotonic drinks such as Gatorade®, Aquarius®, Isostar®,… and juices offruit.

Non -sugary liquids, if the child can continue with his food plan and/or blood glucose is above 200 mg/dl.

Liquids that help oral rehydration when the child is sick

Grades:
* Regular dose unless the child does not want or cannot eat normally.In this case, the rapid action dose must be reduced or postponed until the child has eaten something.

This guideline is guidance and depends on the estimated capacity to eat and drink the child has.In case of doubt whether you will eat well or not, we must reduce the dose to 2/3 parts of the usual dose.The objective is to maintain the blood glucose level in a strip of 80 - 200 mg/dl and keep the chief free of ketones.Additional insulin ("reinforcement dose or supplements") is administered only in the rapid form of action (actrapid, regular humulin, humalog or novorapid).The reinforcement dose is calculated with a percentage of the usual total dose (average) of insulin (the sum of the doses of insulins: rapid, intermediate and/or prolonged action).

Example:
If the child's total daily dose is 30 units, an additional 10% dose would be 3 units, and an additional 20% dose would be 6 units.

When the blood glucose level is below 80mg/dl and your child has nausea, vomiting or diarrhea, and is not hungry, that is, the child's ability to tolerate liquids and/or eating, the dose of the dose ofIntermediate action insulin must be initially reduced by half or two thirds of the usual dose.In this situation, it is important to keep in mind that additional doses may be necessary.

Treat substantive disease

If we suspect that the disease process that is happening the child needs treatment should be consulted with his pediatrician.The pediatrician will be responsible for indicating the best treatment to solve the current situation of disease.Like any child of his age, the pediatrician may advise to follow a pharmacological treatment.Any medication can be used (antibiotics, analgesics, antitérmics, mucolytics, antitusigen, ...), but before returning home it is advisable to consult with the doctor or pharmacist if the drug contains sugars or if special care is to be taken.

signals and symptoms that require medical assistance

The child should be seen immediately by a doctor in any of the following circumstances:

Dehydration signals: dry mouth or tongue, cracked lips, sunken eyes, dry reddish skin, less urine or weight loss.

If you are unable to consume the recommended amount of liquids or carbohydrates.
or repeat for more than four hours.

If you start ketoacidosis symptomsDiabetics such as nausea, abdominal pain, vomiting, hyperventilation or drowsiness.

If the blood glucose level is greater than 250mg/dl and there are ketones in the urine for more than 12 hours or blood ketonemia is high.

If the blood glucose level cannot be kept above 80 mg/dl.

There what happens is that the tables do not appear, but that their info comes out often and is difficult to order.But at the moment it can serve ;-)

Thank you very much, @"fer"

.

Thank you so much!!!

How do you check ketones in urine?Correction does nothing sometimes (for example last night he had 202 and the corregi with 0.5 and did nothing, when supposedly its sensitivity factor is 230 or so ...) say that also increases basal insulin of 5, 5,5 to 6

To me they gave me strips for the pipi instead not to measure ketones in blood .. a lot of encouragement!When they are with more things, it's pffff

If you need, it increases another average basal, as long as you have a fever.
Anyway, in children you have to increase doses as they grow.

Ya @regina if I did that and fever did not have but it is seen that the infection, viruses or whatever was still giving war ... today it seems better ... x the least we put correction and low ...
And the basal dose goes if it has increased since it started!In March it started with 2.5 and is already in 5.5-6

@T1d is that I think the xa cc strips in blood is according to the glucometer ... not everyone has it