Insulin injection management during illnessIInsulin injection management during illnessInsulin injection management during illnessEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>Find out how to manage insulin injections while your child is sick.</p><p>​When children are sick, they still need their long-acting insulin at their usual times. In fact, they may need extra injections of <a href="/Article?contentid=1729&language=English">rapid-acting insulin</a> as often as every four hours if they have <a href="/Article?contentid=1723&language=English">high blood glucose (sugar) levels</a> or if <a href="/Article?contentid=1727&language=English">ketones</a> show up in their urine.</p><h2>Key points</h2><ul><li>To decide how much insulin to give, check blood sugar and urinary ketone levels every four hours.</li><li>To determine the total daily dose (TDD) of insulin, you must add all amounts of insulin from the past 24 hours including both long/intermediate and rapid-acting insulin.<br></li></ul>
Prise en charge des injections d’insuline durant la maladiePPrise en charge des injections d’insuline durant la maladieInsulin injection management during illnessFrenchEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>Apprenez à gérer les injections d’insuline pendant la maladie de votre enfant.</p><p>Lorsque les enfants sont malades, ils ont encore besoin d’une insuline à action prolongée donnée aux heures habituelles. En fait, ils peuvent avoir besoin d’injections supplémentaires d’<a href="/Article?contentid=1729&language=French">insuline rapide​</a> jusqu’à toutes les quatre heures si leur <a href="/Article?contentid=1723&language=French">glycémie est élevée</a> ou si des <a href="/Article?contentid=1727&language=French">cétones</a> apparaissent dans leur urine.</p><h2>À retenir</h2> <ul><li>Pour déterminer la quantité d’insuline à administrer à l’enfant, vérifiez toutes les quatre heures ses niveaux de glycémie et les taux de cétones dans son urine.</li> <li>Pour calculer la dose quotidienne totale, il faut additionner toutes les doses d’insuline administrées depuis 24 heures, y compris l’insuline à action prolongée, intermédiaire et rapide.</li></ul>

 

 

Insulin injection management during illness1751.00000000000Insulin injection management during illnessInsulin injection management during illnessIEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemHealthy living and preventionAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>Find out how to manage insulin injections while your child is sick.</p><p>​When children are sick, they still need their long-acting insulin at their usual times. In fact, they may need extra injections of <a href="/Article?contentid=1729&language=English">rapid-acting insulin</a> as often as every four hours if they have <a href="/Article?contentid=1723&language=English">high blood glucose (sugar) levels</a> or if <a href="/Article?contentid=1727&language=English">ketones</a> show up in their urine.</p><h2>Key points</h2><ul><li>To decide how much insulin to give, check blood sugar and urinary ketone levels every four hours.</li><li>To determine the total daily dose (TDD) of insulin, you must add all amounts of insulin from the past 24 hours including both long/intermediate and rapid-acting insulin.<br></li></ul><p>Because toddlers urinate at random times and not on command, it can be challenging for parents to regularly check urinary ketones. Your <a href="https://akhpub.aboutkidshealth.ca/article?contentid=2511&language=English">diabetes team</a>​ may provide you with a blood ketone metre to check ketone levels in your toddler’s blood instead of the urine.</p><h2>Adjusting insulin doses according to blood sugar and ketone tests</h2><p>To decide how much insulin to give, check blood sugar and urinary ketone levels every four hours.</p><p>Consult this table each time. The following illness scenarios offer courses of action depending on results of the blood sugar, urinary ketone, and blood ketone tests.</p><table class="akh-table"><thead><tr><th colspan="4">Illness scenarios and action steps</th></tr><tr><th style="width:177px;">Blood sugar</th><th style="width:326px;">Urinary ketones<br></th><th style="width:155px;">Blood ketones</th><th style="width:590px;">Action</th></tr></thead><tbody><tr><td style="width:177px;">Less than 6 mmol/L<br></td><td style="width:326px;">Negative or positive<br>(any amount)<br></td><td style="width:155px;">0 to 3 mmol/L</td><td style="width:590px;"><ul><li>If it is time to give insulin, reduce the dose of the long/intermediate-acting insulin and/or rapid-acting insulin by 10% to 20%.</li><li>Encourage your child to drink fluids that contain carbohydrates.<br></li><li>Speak to your doctor if further reductions are required, if your child refuses to drink, or if your child vomits.</li><li>If your child cannot eat or drink to treat a low blood sugar (hypoglycemia) this may be a time to give mini-dose glucagon.</li></ul></td></tr><tr><td style="width:177px;">6 to 14 mmol/L</td><td style="width:326px;">Negative or positive<br>(any amount)</td><td style="width:155px;">0 to 3 mmol/L</td><td style="width:590px;"><ul><li>Give the usual insulin (long-acting and/or rapid) at the usual time. Do NOT give extra.</li><li>Recheck blood sugar and urine for ketones in 4 hours.</li></ul></td></tr><tr><td style="width:177px;">More than 14mmol/L</td><td style="width:326px;">Negative or small<br>(if your ketone strips follow the plus [+] scale, then [-] or [1+] fall under this category)</td><td style="width:155px;">0 to 0.6 mmol/L</td><td style="width:590px;"><ul><li>Give extra rapid-acting insulin now, up to 10% of the total daily dose. Give this in addition to the usual insulin (long-acting and/or rapid) at the usual time.</li><li>Recheck blood sugar and urine for ketones in 4 hours.</li></ul></td></tr><tr><td style="width:177px;">More than 14 mmol/L</td><td style="width:326px;">Moderate or large<br> (if your ketone strips follow the plus [+] scale, then [2+] or [3+] fall under this category)</td><td style="width:155px;">0.7 to 3 mmol/L</td><td style="width:590px;"><ul><li>Give extra rapid-acting insulin NOW, at least 10% to 20% of the total daily dose. Give this in addition to the usual insulin (long-acting and/or rapid) at the usual time.</li><li>Recheck blood sugar and urine for ketones in 4 hours.</li></ul></td></tr></tbody></table><p>To figure out how much more rapid-acting insulin to give, add up the total daily dose (TDD) of insulin.</p><h2>How to figure out the total daily dose (TDD)</h2><p>To determine the total daily dose (TDD), you must add all amounts of insulin from the past 24 hours including both long/intermediate and rapid-acting insulin.</p><p>Here is an example to help you figure out how much rapid-acting insulin to give based on the TDD.</p><p>Consider a child taking the following:</p><ul><li>20 units of intermediate-acting and 4 units of rapid-acting insulin before breakfast</li><li>4 units of rapid-acting insulin before supper</li><li>7 units of intermediate-acting insulin before bed.</li> ​</ul><p>This child has a total of 20+4+4+7=35 units of insulin a day. Ten percent of 35 units is 3.5 units because (35 x 10)/100=3.5. Twenty percent of 35 units is 7 units because (35 x 20)/100=7).</p><p>This child should receive 4 to 7 units. Small children tend to be sensitive, so for them, you should start with dosages at the lower end of the range.</p>Insulin injection management during illness

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.