A 13-year-old with type 1 diabetes has viral gastroenteritis, glucose 260 mg/dL and moderate urine ketones but can drink fluids. They ask whether to

Question

A 13-year-old with type 1 diabetes has viral gastroenteritis, glucose 260 mg/dL and moderate urine ketones but can drink fluids. They ask whether to stop insulin because oral intake is reduced. What is the best sick-day instruction?

Accepted Answer

Continue basal insulin with hydration and frequent glucose ketone monitoring

Answer

Stop all insulin until normal meals resume and ketones clear

Answer

Restrict fluids to reduce vomiting and recheck glucose the following day

Answer

Substitute a sulfonylurea temporarily for insulin during poor oral intake

Answer

Exercise vigorously to increase peripheral glucose uptake during illness

Type 1 diabetes sick-day care — USMLE Step 3 MCQ

A 13-year-old with type 1 diabetes has viral gastroenteritis, glucose 260 mg/dL and moderate urine ketones but can drink fluids. They ask whether to stop insulin because oral intake is reduced. What is the best sick-day instruction?