Sick Day Checklist for Children with T1D
Use this checklist when your child is feeling unwell, has high blood sugar or shows signs of illness.
Every diabetes clinic or hospital may have its own guidelines, but general sick day rules often include:
1. Monitor Blood Glucose and Ketones
Check blood glucose every 2-4 hours
Check ketones every 2-4 hours, especially if:
Blood glucose is consistently over 13.9 mmol/L (250 mg/dL)
Your child has a fever, vomiting, diarrhoea or infection
Your child has symptoms like tiredness, nausea or rapid breathing
Record all readings and share them with your diabetes team, if advised
2. Continue Insulin
NEVER stop insulin, even if your child isn’t eating
Follow your clinic’s advice for:
Correction doses
Temporary basal rate changes (if using a pump)
Adjustments for missed meals or vomiting
3. Keep Your Child Hydrated
Offer frequent sips of fluids every 15-30 minutes:
Water or sugar-free fluids (if blood sugar is high)
Sugary fluids like juice, cola or oral rehydration solution (if blood sugar is low or normal)
Monitor for signs of dehydration: dry lips, dark urine, sunken eyes
4. Watch for Signs of Diabetic Ketoacidosis (DKA)
Call your clinic or go to the hospital if your child has:
Moderate to high ketones that don’t improve with insulin
Vomiting that doesn’t stop
Breathing that is rapid or deep
Fruity-smelling breath
Lethargy, confusion or drowsiness
Inability to keep fluids down
5. Know When to Call Your Diabetes Team
If ketones are moderate or high
If vomiting continues for more than 4 hours
If your child shows signs of DKA
If you’re unsure how to adjust insulin
If fever, illness or dehydration worsens
If your baby or toddler shows signs of illness, even without high sugars
6. Sick Day Kit Essentials
Keep the following supplies stocked and easily accessible:
Blood glucose meter & strips
Ketone testing supplies (urine strips or blood ketone meter)
Fast-acting insulin and delivery supplies (pens/syringes/pump backup)
Fluids: water, juice, electrolyte drinks
Easy to digest carbs: crackers, applesauce, glucose tabs
Phone numbers for your diabetes clinic and emergency contact
Tip: Review this checklist with your care team once a year and update it as your child grows or treatment changes.
