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What to do when your child is sick

Children and young people with diabetes generally don't get sick more often than other children if their diabetes is well managed. However, illness can have a significant impact on diabetes. The stress hormones produced during illness can cause changes to blood glucose levels. Levels can go high or low depending on the type of illness. Infections that cause fever and pain often cause high blood glucose levels. Gastroenteritis (vomiting and diarrhoea) can cause low blood glucose levels. Vomiting can also be a sign of not enough insulin.

If your child is sick:

When to call for advice

When calling the diabetes doctor they will want to know

Mini-Dose Glucagon

If the blood glucose levels cannot be maintained above 4, the diabetes doctor may advise the use of mini-dose glucagon. This is when a small dose (or doses) of glucagon are given using an insulin syringe. It can be used for the following situations:

You can read a transcript of this video here.

Mini-dose glucagon must only be used on the advice of a doctor. Sometimes children need to be admitted to hospital if the blood glucose levels cannot be maintained above 4.

Effect of other medications

If your family doctor prescribes medication for your child, remember to ask your doctor whether this will affect the blood glucose levels (oral or injected steroids are the medications most likely to affect blood sugars). If these types of medication are necessary, please call the diabetes doctor for advice on changing the dose of insulin for your child.



Ketones can cause the blood to become acidic and high levels of ketones can cause your child to become very unwell with severe dehydration. This is called ketoacidosis and is a very serious illness. The symptoms include:

If your child has these symptoms take them directly to Starship Children's Emergency Department for urgent assessment. If out of the Auckland area, take your child to the nearest Hospital Emergency Department.

When to test for ketones

You can read a  transcript of this video here.


If your child needs surgery or any procedure which requires fasting, they still need insulin. It is important that the diabetes team is involved in the planning of any surgery. Ideally, it is easiest to manage insulin when surgery is scheduled early in the morning. It is often advised that surgery is done at a hospital experienced in dealing with children with diabetes such as Starship. Preferably, children with diabetes should be first on the list.

Sick day management kit

When you get home from hospital put together a sick day management kit and check it every 6 months to make sure items are not expired and you have these things available:

Think you've got it sorted now?

If you have read through the information above and watched the videos, and you feel confident that you understand this topic, print off and fill in the evaluation form below (you might need to ask someone to print this off for you) and return to the nurse on your ward. If you have any questions, note them down on this form and your diabetes nurse specialist will discuss them with you.

Sick Days Advice for Newly Diagnosed Families: Evaluation

Click on the image for a printable version of this document

Sick Days Evaluation

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