<s>[INST] 10 1/2 year old female. type 1 diabetic for 5 years. has ongoing stomach pain and headaches with moderate to large ketones continuously over this time. running low grade fevers now with sporadic sugars from extreme lows to extreme highs? any suggestion for pain [/INST] OK, this is an emergency, because child Chat Doctor.  So It's very urgent to do a blood gas in order to know the Child's PH and bicarbonate. If pH is less than 7.3 and bicarbonate is less than 16 then your child is having DKA (diabetic ketoacidosis) and this situation can't be treated at home, and she needs to be admitted .if the blood gas is normal and the fever and abdominal pain suggest other cause like food posing or urinary tract infection, then you need to increase the total daily insulin by 10% .you look this up more by searching (diabetic child sick day management) I hope this helps </s>