at what point should you take a diabetic with a fever to the hospital?

Question

he's type 1 diabetic.
fever of 100.9 degrees F right now.

the problem with phoning his doctor is that it's saturday, and she's not in until monday.

the reason I am asking is because we have been told by doctors that getting the flu could be lethal for a type 1 diabetic. I wasn't saying that I thought diabetics couldn't get the flu.

"For people with diabetes, the flu can be more than aches and pains. It can mean longer illness, hospitalization, even death. Because diabetes can make the immune system more vulnerable to severe cases of the flu. In fact, people with diabetes are almost 3 times more likely to die with influenza (“the flu”) or pneumonia."

his blood sugar this morning was over 400 (he forgot to take his lantus last night). he took a little bit of insulin, and a couple hours later it had dropped into the 300s. He took some more insulin and we will be checking his blood sugar soon. He also took some ibuprofen, which lowered the fever to 100.

Answer 1

For the fever part take him in when you would take any other child. (i'm assuming this is a child. if he's not i'm sorry, though the same thing goes)
As for having a fever with diabetes is a little trickier. the most you can do is keep a close eye on him. Make sure he checks for ketones OFTEN. and keep bloodsugars in close range. When a child is sick they often require more insulin than usual. If you can call the endo's office, there should be a doctor on call for emergancies. What's most important for him is to stay hydrated. If he starts to vomit, an not able to keep anything down, he'll become dehydrated (in my case, when i get sick, and throw up, i become dehydrated and unable to kick off the ketones). This is when it becomes dangerous and you should take him in. I hope this is helpfull. just keep an eye on him, if he develops ketones and cant kick them , take him in for fluids.

EDIT:
you ARE right to be worried. Diabetes plays a BIG roll when a child is sick due to the diabetes or not. dont listen to those ignorant fools who think it's nothing.Any kind of sickness even just a common cold can throw diabetes dangerously out of whack. Personally, out of personal experience, it's better to go to the hospital when in doubt, than end up in trouble at home. If you do decide to take him to the hospital, they won't turn you away. So don't hesitate if you have a gut feeling, just take him in.Also, if since he is still taking insulin he MUST eat whether he feels like it or not. it doesnt have to be much.. even just saltines, or a grahm cracker. but SOMTHING must go in.
Another EDIT:
Somtimes for the flu its good for a diabetic to go in whether he's seriously ill or not. They can hook him up to an iv and keep him hydrated and monitored.and he'll get better faster, making it safer for him. Remember, even people who have no other problems go in for the flu. DO NOT hesitate. (and i'd advise against simply calling the ER. you never know who you are talking to. often front desk people have no clue what they are talking about.)

Answer 2

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Answer 3

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Answer 4

If this is a child, then you should take him to the ER because 400 is way too high for his Glucose to stay.

If the person is an adult, then if it were me, and I am a diabetic, not type one, but all diabetics have increased risks associated with the flu. The Glucose running high can do a lot of damage in a short period of time. When any diabetic is sick their Glucose naturally runs high. Watch everything you feed him or he should if he's an adult. Bringing down his Glucose is a must. Eating only protein until it comes down is a must, as all carbs will just keep it high.

Depending on where you live, I live in Utah. If I had this high of Glucose I would call my doctors office and many have an on call service that will pick up the call and have either his own doctor call him back or one who is covering for that doctor. If that didn't work, I know that here in Utah, if I called any community hospital and ask for the ER, then asked to speak with an ER nurse, I'd be able to at least ask them if they felt I needed to come to the hospital or not. They'd want to know how long he's been vomiting or having diahrea, or both. How long has he had a fever. Has he been able to eat. Is he still taking Insulin if on Insulin. Is he showing any signs of dehydration, because that can easily cause a diabetic to go into a diabetic coma. How to tell if he's dehydrated. The easiest way I know of is you pinch the skin on the top of the hand together, then let go. If it molds and stays like you pinched it for more then ten seconds, dehydration is a concern. When you pinch the top of the hand in someone who is well hydrated, their skill will quickly return to what it was before you pinched it together, in dehydration it molds and will take much longer to return to normal. Compare it to your own hand. Pinch together the skin on top of your hand if you are not sick. Then do his and see if his returns to normal as quickly as it did on your hand.

If I had insurance and I had the flu with a Glucose of 400 and was unable to eat for more then 24 hours I'd definately go to the ER.

If you are afraid your insurance won't pay for it, call the companies 24/7 line and ask for concent to go to the ER, then they have to cover it.

Without being around him, online non of us who are diabetics can be sure nor can a nurse online be sure what you should do.

I'd call the doctor anyway, if I didn't hear back in an hour and my child or whomever the HE is, I'd call the ER and at least ask them if they felt I should bring him in. I know the major thing with flu is the dehydration, because the more dehydrated one is the more their Glucose rises and the risk of a diabetic coma is what they want to avoid.

Answer 5

The sick rule for diabetics with fever is to try and eat 15 grams of carbohydrate every hour and anytime there is a fever such as this one, I would call the local emergency room and expalin the symptoms and how much medicine and food has been eaten by the patient if any today and ask them if they think that you should brign this patient in to be assessed by medically trained staffed. I am a diabetic, and you have to be very careful with taking medicine and not eating and you also have to be careful with getting sick. If you think that this is the start of the flu, then by no doubt get him on to the hospital and let them check him out, you would rather be safe than sorry. Get him taken care of ASAP>
God Bless and Good Luck,

Answer 6

100.9 is not high at all. I would be more concered with the blood sugar level. Forgot to take his insulin, sounds like when he relized he should of been a bit more aggressive with his insulin. As far as not calling the doctor because it is the weekend that is not true. You should not go to a hospital w/out calling the dr. first. Some insurance carriers will not cover the er if you showed up on your own.

Answer 7

Feed a cold, starve a diabetic. Check his blood sugar. What is that running? Get it under control and 90% of the time the fever will subside.

So it's been a while. What happened?

I was right wasn't I? Next time, to get the fever down faster, use Humalog, and more of it. Lantus will not drop a bg quickly.
If you gave him 20-25 units of Humalog, he'd be around 180 mg/dl in 2 hours. His fever would be gone.

Who's the jerk that thumbs downed me?

Answer 8

Overall, there is no direct connection between a fever (which can happen for various reasons) and diabetes. But Flu can be a cause for concern - please call some medic friend if your doctor is not available.

There are 2 "jabs" that are compulsory for diabetics. One is the Flu-jab - which helps prevent the flu for about 1 year. Second is the Pneumonia VACCINE (pneumococcal vaccine) - which immunizes you from development of pneumonia in the lungs. Please ask your doctor for more details.

In England these two injections are mandatory for diabetics and are provided free of charge to all diabetics. (PREVENTION of illnesses saves them more money for Healthcare in the long-run.)

Answer 9

The usual dosage for insulin, which the doctor's don't usually tell you, is 1 unit for every 10 that he is over. So, if his blood sugar is 200, you would give him 10 units to bring it down to 100. Get him in a cool bath immediately to pull his fever down, or wipe him down with a cool cloth. Also, you could place a cool cloth, NOT COLD, on the back of his neck, this would also rapidly reduce his fever so that he can get some rest. This should help everything.

Answer 10

There is always a doctor on Call. Call the regular number and they will have someone call you back.

Sounds like you have everything under control.Less than 101 isn't really very bad. Make sure he is well hydrated.

His sugar is on the way down.You both did well.