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Question:

From Canada:

My 6 year old daughter had the flu yesterday. We gave her no insulin and her sugar didn't rise till 3:00. Could we not give her Humalog to take care of her immediate need, and then give her her NPH when I know she is up to eating? I find it very hard on everyone when you have to chase the insulin with food!

Answer:

Illnesses, such as the flu, put a stress on the body especially when someone has diabetes. Most of the time, this "viral" stress requires that the diabetic person will take his/her insulin as usual. As a matter of fact, extra insulin may even be required to control blood sugar. Blood sugars should be checked more often during illness; also it is very important to check urine for ketones every time your daughter urinates when sick. If insulin is not correctly given, ketoacidosis can develop rapidly. This is even more true if your daughter is not eating. If she is not able to eat, try giving her 1/2 cup of liquid that contains sugar every hour or with a spoonful every 5-10 minutes. This will keep your daughter hydrated, and replaces part of the calories she usually needs.

From your question, it's hard to tell you whether your daughter really needs more insulin (if her sugars are not running high during this time, she doesn't but she surely needs her lispro insulin [Humalog®] in multiple doses and NPH even at a reduced dosage according to home glucose and urine monitoring); as a matter of fact, she could be about to get ketones from "starvation" if you not replace her normal intake with fluids and carbohydrates. Ask your pediatrician or diabetes team for more information.

MS

Original posting 28 Jan 98

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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