Glucose levels should be checked more frequently. If not wearing a sensor, then do a finger prick check every 2 hours when unwell. Check for ketones if the blood glucose is 14mmol/l or above. Extra insulin will be required if glucose or ketone levels are high.
If a blood glucose meter displays ‘HI’ then the glucose level is greater than 33mmol/l. Remember to seek advice if you have any questions or concerns.
Sick day rules
If you are unwell for any reason, the general rule is to keep dietary intake as near normal as possible. Small and frequent snacks of carbohydrate-containing foods and drinks should be tried. If unable to eat, try to take sips of fluid containing sugar to replace the normal diet and prevent low blood glucose levels. Also encourage plenty of sugar free fluids to prevent dehydration.
General advice
Advice on adjusting insulin doses
In general, more insulin is required if glucose and/or ketone levels are high. This can be given either as a correction dose calculated by your app or pump, or by giving either 10% or 20% of your Total Daily Dose (TDD) of insulin that would be given on a normal day. If using insulin injections, the TDD is calculated by adding long and short acting insulin together. If using a pump, your pump will have a record of TDD.
You can find out how much insulin to give, when to use an injection rather than your pump, and when to seek help by using: If you are uncertain about how to calculate 10% or 20% of TDD, then refer to the table below for a rough guide on doses or contact us for help.
You can find out how much insulin to give, when to use an injection rather than your pump, and when to seek help by using: If you are uncertain about how to calculate 10% or 20% of TDD, then refer to the table below for a rough guide on doses or contact us for help.
A rough guide to additional insulin doses required based on 10 to 20% of Total Daily Dose (TDD).
The table below provides advice on when to give extra insulin and how much (available in a bigger format here). The table is a bit complicated to follow and you may find it easier to use the DOT Tayside Sick Day Rules interactive tool.
Table demonstrating how to adjust insulin for various levels of blood glucose and ketones. Click on the table to zoom in.
