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T1DM Sick Day Rules — RACP Paediatrics MCQ

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ModerateEndocrinologyT1DM Sick Day RulesRACP Paediatrics

A 12-year-old boy with T1DM is unwell with vomiting. His blood glucose is 15 mmol/L and ketones are 3.5 mmol/L. He is conscious and drinking. What sick-day management advice should have been given?

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Correct answer: B — Never omit insulin; give supplemental rapid-acting insulin doses based on ketone levels, increase fluid intake, and monitor BGL and ketones frequently

Sick-day management in T1DM: NEVER omit insulin (even if not eating). Give supplemental rapid-acting insulin (5-10% of total daily dose) if ketones are elevated. Monitor BGL and ketones every 2 hours. Increase fluid intake. Hospital assessment if persistent vomiting, rising ketones despite supplemental insulin, or altered consciousness.

Reference: ISPAD – 2024 – Sick Day Management in T1DM