مريض سكري نوع أول عنده نزلة معوية، يأكل قليلاً، سكره ٢٨٠ والكيتونات في البول متوسطة. ما النصيحة الصحيحة؟

A client with type 1 diabetes has gastroenteritis, is eating little, has glucose 280 mg/dL and moderate urine ketones. What advice is correct?

1. Stop insulin while not eating so that glucose does not drop
2. Drink only water and avoid any fluids containing sugar
3. Continue insulin and check glucose and ketones every 2–4 hours
4. Ignore the ketones, as they are expected with any stomach bug

Answer: C) Continue insulin and check glucose and ketones every 2–4 hours. On sick days stress hormones raise glucose even with little food, and stopping insulin in type 1 diabetes causes DKA. Insulin continues with frequent monitoring and fluids, and the provider is contacted if ketones rise or vomiting persists.