“What medicines should diabetics take for fever?”
My son is 14 and he has type 1 diabetes. He's had a fever since this morning and I don't really know what he should have to bring it down. Before he was diagnosed, we would use children's Motrin to bring down his fever. What medicines can I give him to help bring down his fever that won't interact with his insulin?
3 Answers
He can take acetaminophen (Tylenol).
Hello
Tylenol and Motrin can be used, as they both do not affect blood sugar and do not affect insulin. It is likely that your son has a virus. If he has vomiting, you can check urine for ketones. Usually when children are sick, their blood sugars tend to rise, as the body produces more sugar to fight the infection. Adding about 20% extra to his usual insulin dose will help bring the sugars down. Hope he feels better.
Sincerely
Hariram Ganesh
Tylenol and Motrin can be used, as they both do not affect blood sugar and do not affect insulin. It is likely that your son has a virus. If he has vomiting, you can check urine for ketones. Usually when children are sick, their blood sugars tend to rise, as the body produces more sugar to fight the infection. Adding about 20% extra to his usual insulin dose will help bring the sugars down. Hope he feels better.
Sincerely
Hariram Ganesh
Type 1 diabetes is the commonest metabolic disorder in children. It is also called juvenile diabetes or insulin dependent diabetes mellitus. Insulin is required not only to control blood sugars but also for survival. In the abscence of insulin glucose is not transported to the tissues from the blood. The blood glucose stays high, because the body can not utilize glucose. In the abscence of insulin the body startes to convert fats and protiens to glucose raising the blood glucose level even much higher. As fats and protiens are converted into glucose, the remaining by-products form ketones causing acidosis. Once the blood glucose exceeds the renal threshold of 180 mg/dl, glucose starts to spill in the urine. This causes more water loss from the body, leading to even greater acidosis and dehydration. If left untreated, acidosis and dehydration will lead to diabetes ketoacidosis, coma and death.
During illness and stress the body makes hormones known as stress hormones` to fight the illnes. This can interfere with the action of insulin as the body becomes resistant to insulin action. Under stressful conditions the insulin requirement due to the stress hormones may be up by 20-30% of the daily insulin requirement. In people without diabetes, the body produces 20-30% more insulin to compensate for this state of insulin resistance, untill the stressful event or illnes is resolved. However in diabetic patients, especially type 1 diabetic patients, when they are sick their blood sugars increase requiring more insulin corrections to be given. During mild illness insulin requirement goes up by about 10%, and during moderate or severe illness that requirement may go up by 20-30% in their daily insulin regiment untill the illness resolves.
Animals fight infection using their immune system. The immune system takes some time to fully mature to overcome illnesses.That is why todlers get sick more often than older children and teen age children get less frequent cold infections than younger children. Children get cold infections and other illness about 4-8 times ayear. There is more frequency of cold and other illness in the younger age group up to 12 times a year (average of 6 per year). By the time the children are in their teen age years they may experience 4-5 cold a year.
The signs of illness can be, nausea, vomiting coughing, headaches, diarrhrea, fever, fatigue, ear pain chest pain etc. These things can be causes by common cold, flu, stomach flu, bacterial infections, viral infections, parasitic infections, immunological, metabolic, hormonal and other various medical conditions.
Fevere is a condition when the body temprature is above the normal range >98.6 degrees Fahrenheit (F), specifically greater than 100.4 F.
Mild fever is 100-102F
moderate fever is 102-104F
High feveris >104-106F
Hyperpyrexia (severe) is >106F
Most of the time fever is not a disease but a manifestation of a disease. It is a natural body's defense against infection, thogh there are also many non-infectious causes of fever. Fever is usually accompanied by other physical complaints. That is why people feel better when fever is treated. Fever may or may not require medical treatment. This depends on the patient's age, physical condition, and the underlying cause of the fever. Fever is generally not considered dangerous in it self, except when it is associated extreme external temoprature and medications.
Fever should be properly and promptly treated when it happens in diabetic patients, in youger children and any person when it is accompanied with symptoms such as weaknes, poor appetite, diarrhea coughing, ear pain vomitting or other serious issue.
During febrile illness, the body temprature is higher. It may also be accompanied with sweating. This process causes evaporation of water from the body, exacerbating dehydration. In type 1 diabetic patients fever can cause dehydraion by evaporating water through the skin. Fever raises stress hormones that cause insulin resistance leading to elevated blood sugars. It also increases level of dehydration by water loss from the kidneys and the skin. In paients with diabetes specially type 1 diabetes, treating any level of fever is very important, though, treating the underlying condition is also of greater importance. Diabetic patients should strictly follow the sick day rules to promptly and properly manage their diabetes.
Since dehydration is an important element of illness, hydration is the principal step in managing diabetes during fever or illness. For mild fever simple correction of blood sugars to <150 mg/dl every 3 hours and optimum hydration with about 8 ozs of fliud ( a cup) per hour may suffice. For moderate fever with out other symptoms, frequent insulin correction and more frequent hydration will be required. If the fever is high and there are other symptoms such as pain, vommiting, moderate to large ketones, diarrhea etc calling the doctor or going to the emergency room is the best option. During illness insulin regimen should be increased 10-30% depending on the severity of the codition.
Fever is a result of a substance called pyrogen, released from pathogens that triggers a release of prostaglandin E2 from inflammatory cells. It acts on the hypothalamus, to increase the body temprature to generate higher temperature in order to fight infection. Treatment of fever is therefore with anti-inflammatory agents and antipyretics..Though some fevers may not need treatment except treating the underlying cause. But becuase the fever may come with discomfort, treatment of the fever may be a good idea in theses cases. In youg children or patients with diabetes, fever should be treated early and properly. In type 1 diabetes, treatment of fever, hydration and adjusting insulin regimen is very important, besides treating the underline illness. In these patinets fever can cause dehydration and elevated blood sugar in a short time.
Treament of fevere involves anti-inflammatory agents and antipyretics. For moderate and mild fevers the nonsteroidal anti inflammatory such as Aspirin, Mortrin, advil, Ibuprofen about 10 mg/kg per dose 2-3 times daily depending on the response will be suffice. Tylenol (paracetamol) 10-15 mg/kg per dose every 4 hours a day until fever breaks, will be an option as well. Anti inflammatory agents may be better because they may lower the degree of inflamation. other symptoms of the illness and the cause of the illness should be adressed and treated proptly. Steroidal anti inflammatory such as hydrocortisone and prednisone are preserved for more severe inflammatory illnesses.
A diabetic patient can take any pain killer like a non diabetic patient, with some caveats and as long as the patient is not allergic to the medications.The only difference is some medications such as aspirin may lowere blood sugars witch is not a bad idea when some one is sick and the blood sugars are high. Some medications that are on some syrups may contain sugars that may raise the blood sugars. Those can be chased with insulin if the amount of grams of sugar are known in the dose to be taken. Alternatively sugar free medications can be bought if available. Reading medication labels can help figure out if they contain sugars and if they do, how many grams per dose they contain. In a very young child the syrups containing sugar may be important than a teen age or an adult. Those sugar containing syrups need to be covered with insulin if there are no other options. In the older children and adolescent who can not take pills or tablets they may not make a big difference and they can be dosed with insulin while taking them if necessary. These medications are reasonably safe to take on temporary bases as long as blood sugars are controlled and the person has no advers events towards any of these medications.
Some medications may also interfer with the function of diabetes related devices. Tylenol is known to interfer with the blood sugar sensor called Dexcom. However if you need to take Tylenol for pain or fever you should relay on the cappilary finger stick to monitor your blood sugars.
Going back to your son: Your son is 14 years old. And I am assuming he can swallow a pill. But if he can not swallow a pill, he can still take syrup for the fever. Fever need to be treated aggeressively to prevent dehydration and elevation of blood sugars. You should increase his insulin by 10-20% depending on the degree of his illness. You should also make sure he is well hydrated. Without proper hydration, no matter how much insulin he gets, it will not work. Let him drink at least about 8 ozs of fluid every hour. Correct his insulin every 2-3 hours to less than 150mg/dl.
You should treat his fever with what you use to do before and what works for you. Aspirin and may lower blood sugar. But that may not be a bad thing unless he is sick and he is experiencing low blood sugars (some 20% of patients may experince this, though, the majority (80) will have high blood sugars when they are sick). You can use Motrin pill, tablet or syrup which ever works for you. If the syrup contains sugars and you can not find any sugar free Motrin, you can give him the Motrin syrup if he does not swallow a pill and give some insulin for the sugar. If you have it and you need it you can give him and monitor blood sugars and take appropriate action untill the fever breaks. Remember he can take any of the medications he use to take as long as you are on top of his diabetes. If blood sugars are higher correct them and if they are low give him some fast acting sugars to raise the blood sugar.
Remember hydration is very important. You can hydrate him with sugar free or sugar containing drinks as long as you controll the blood sugrs. If you have difficulties handling it or things are getting worse or he looks sick or he is vomiting >2 times or he is not drinking enough, you should call your doctor or take him to the emergency room for intravenous hydration.
Please work with your doctor or diabetes educators. They should be able to help you when you need them.
Good Luck
During illness and stress the body makes hormones known as stress hormones` to fight the illnes. This can interfere with the action of insulin as the body becomes resistant to insulin action. Under stressful conditions the insulin requirement due to the stress hormones may be up by 20-30% of the daily insulin requirement. In people without diabetes, the body produces 20-30% more insulin to compensate for this state of insulin resistance, untill the stressful event or illnes is resolved. However in diabetic patients, especially type 1 diabetic patients, when they are sick their blood sugars increase requiring more insulin corrections to be given. During mild illness insulin requirement goes up by about 10%, and during moderate or severe illness that requirement may go up by 20-30% in their daily insulin regiment untill the illness resolves.
Animals fight infection using their immune system. The immune system takes some time to fully mature to overcome illnesses.That is why todlers get sick more often than older children and teen age children get less frequent cold infections than younger children. Children get cold infections and other illness about 4-8 times ayear. There is more frequency of cold and other illness in the younger age group up to 12 times a year (average of 6 per year). By the time the children are in their teen age years they may experience 4-5 cold a year.
The signs of illness can be, nausea, vomiting coughing, headaches, diarrhrea, fever, fatigue, ear pain chest pain etc. These things can be causes by common cold, flu, stomach flu, bacterial infections, viral infections, parasitic infections, immunological, metabolic, hormonal and other various medical conditions.
Fevere is a condition when the body temprature is above the normal range >98.6 degrees Fahrenheit (F), specifically greater than 100.4 F.
Mild fever is 100-102F
moderate fever is 102-104F
High feveris >104-106F
Hyperpyrexia (severe) is >106F
Most of the time fever is not a disease but a manifestation of a disease. It is a natural body's defense against infection, thogh there are also many non-infectious causes of fever. Fever is usually accompanied by other physical complaints. That is why people feel better when fever is treated. Fever may or may not require medical treatment. This depends on the patient's age, physical condition, and the underlying cause of the fever. Fever is generally not considered dangerous in it self, except when it is associated extreme external temoprature and medications.
Fever should be properly and promptly treated when it happens in diabetic patients, in youger children and any person when it is accompanied with symptoms such as weaknes, poor appetite, diarrhea coughing, ear pain vomitting or other serious issue.
During febrile illness, the body temprature is higher. It may also be accompanied with sweating. This process causes evaporation of water from the body, exacerbating dehydration. In type 1 diabetic patients fever can cause dehydraion by evaporating water through the skin. Fever raises stress hormones that cause insulin resistance leading to elevated blood sugars. It also increases level of dehydration by water loss from the kidneys and the skin. In paients with diabetes specially type 1 diabetes, treating any level of fever is very important, though, treating the underlying condition is also of greater importance. Diabetic patients should strictly follow the sick day rules to promptly and properly manage their diabetes.
Since dehydration is an important element of illness, hydration is the principal step in managing diabetes during fever or illness. For mild fever simple correction of blood sugars to <150 mg/dl every 3 hours and optimum hydration with about 8 ozs of fliud ( a cup) per hour may suffice. For moderate fever with out other symptoms, frequent insulin correction and more frequent hydration will be required. If the fever is high and there are other symptoms such as pain, vommiting, moderate to large ketones, diarrhea etc calling the doctor or going to the emergency room is the best option. During illness insulin regimen should be increased 10-30% depending on the severity of the codition.
Fever is a result of a substance called pyrogen, released from pathogens that triggers a release of prostaglandin E2 from inflammatory cells. It acts on the hypothalamus, to increase the body temprature to generate higher temperature in order to fight infection. Treatment of fever is therefore with anti-inflammatory agents and antipyretics..Though some fevers may not need treatment except treating the underlying cause. But becuase the fever may come with discomfort, treatment of the fever may be a good idea in theses cases. In youg children or patients with diabetes, fever should be treated early and properly. In type 1 diabetes, treatment of fever, hydration and adjusting insulin regimen is very important, besides treating the underline illness. In these patinets fever can cause dehydration and elevated blood sugar in a short time.
Treament of fevere involves anti-inflammatory agents and antipyretics. For moderate and mild fevers the nonsteroidal anti inflammatory such as Aspirin, Mortrin, advil, Ibuprofen about 10 mg/kg per dose 2-3 times daily depending on the response will be suffice. Tylenol (paracetamol) 10-15 mg/kg per dose every 4 hours a day until fever breaks, will be an option as well. Anti inflammatory agents may be better because they may lower the degree of inflamation. other symptoms of the illness and the cause of the illness should be adressed and treated proptly. Steroidal anti inflammatory such as hydrocortisone and prednisone are preserved for more severe inflammatory illnesses.
A diabetic patient can take any pain killer like a non diabetic patient, with some caveats and as long as the patient is not allergic to the medications.The only difference is some medications such as aspirin may lowere blood sugars witch is not a bad idea when some one is sick and the blood sugars are high. Some medications that are on some syrups may contain sugars that may raise the blood sugars. Those can be chased with insulin if the amount of grams of sugar are known in the dose to be taken. Alternatively sugar free medications can be bought if available. Reading medication labels can help figure out if they contain sugars and if they do, how many grams per dose they contain. In a very young child the syrups containing sugar may be important than a teen age or an adult. Those sugar containing syrups need to be covered with insulin if there are no other options. In the older children and adolescent who can not take pills or tablets they may not make a big difference and they can be dosed with insulin while taking them if necessary. These medications are reasonably safe to take on temporary bases as long as blood sugars are controlled and the person has no advers events towards any of these medications.
Some medications may also interfer with the function of diabetes related devices. Tylenol is known to interfer with the blood sugar sensor called Dexcom. However if you need to take Tylenol for pain or fever you should relay on the cappilary finger stick to monitor your blood sugars.
Going back to your son: Your son is 14 years old. And I am assuming he can swallow a pill. But if he can not swallow a pill, he can still take syrup for the fever. Fever need to be treated aggeressively to prevent dehydration and elevation of blood sugars. You should increase his insulin by 10-20% depending on the degree of his illness. You should also make sure he is well hydrated. Without proper hydration, no matter how much insulin he gets, it will not work. Let him drink at least about 8 ozs of fluid every hour. Correct his insulin every 2-3 hours to less than 150mg/dl.
You should treat his fever with what you use to do before and what works for you. Aspirin and may lower blood sugar. But that may not be a bad thing unless he is sick and he is experiencing low blood sugars (some 20% of patients may experince this, though, the majority (80) will have high blood sugars when they are sick). You can use Motrin pill, tablet or syrup which ever works for you. If the syrup contains sugars and you can not find any sugar free Motrin, you can give him the Motrin syrup if he does not swallow a pill and give some insulin for the sugar. If you have it and you need it you can give him and monitor blood sugars and take appropriate action untill the fever breaks. Remember he can take any of the medications he use to take as long as you are on top of his diabetes. If blood sugars are higher correct them and if they are low give him some fast acting sugars to raise the blood sugar.
Remember hydration is very important. You can hydrate him with sugar free or sugar containing drinks as long as you controll the blood sugrs. If you have difficulties handling it or things are getting worse or he looks sick or he is vomiting >2 times or he is not drinking enough, you should call your doctor or take him to the emergency room for intravenous hydration.
Please work with your doctor or diabetes educators. They should be able to help you when you need them.
Good Luck
