Home care for Type 1 diabetes: vomiting and diarrhea; which statement indicates a need for further teaching?

Home care for Type 1 diabetes: vomiting and diarrhea; which statement indicates a need for further teaching?

• A. "I need to stop my insulin."
• B. "I need to increase my fluid intake."
• C. "I need to call my health care provider."
• D. "I need to monitor my blood glucose every 4 to 6 hours."

Answer: (A)

During vomiting or diarrhea, the priority is to prevent dehydration and ketoacidosis by continuing insulin and staying hydrated. Stopping insulin is unsafe because in type 1 diabetes insulin is needed to prevent lipolysis and ketone production; even with reduced food intake, the body’s stress response can raise blood glucose, and without insulin the risk of diabetic ketoacidosis increases. So saying that you should stop insulin shows a misconception and needs to be corrected with guidance to continue insulin and adjust only as advised by a healthcare provider. The other statements describe appropriate actions: increasing fluids helps prevent dehydration, contacting a healthcare provider is important if symptoms persist or if you’re unsure how to adjust treatment, and checking blood glucose every 4 to 6 hours helps ensure you catch rising glucose or ketones early.

During vomiting or diarrhea, the priority is to prevent dehydration and ketoacidosis by continuing insulin and staying hydrated. Stopping insulin is unsafe because in type 1 diabetes insulin is needed to prevent lipolysis and ketone production; even with reduced food intake, the body’s stress response can raise blood glucose, and without insulin the risk of diabetic ketoacidosis increases. So saying that you should stop insulin shows a misconception and needs to be corrected with guidance to continue insulin and adjust only as advised by a healthcare provider. The other statements describe appropriate actions: increasing fluids helps prevent dehydration, contacting a healthcare provider is important if symptoms persist or if you’re unsure how to adjust treatment, and checking blood glucose every 4 to 6 hours helps ensure you catch rising glucose or ketones early.