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.