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​7.9000000000000062.5000000000000654.000000000000Flat 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​7.9000000000000062.5000000000000654.000000000000Flat 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 illnessFalse