Sick Day Guidelines for Insulin Pump Therapy

During periods of short-term illness, it may be more difficult to maintain good control of your diabetes. Examples of minor illness are: dental surgery, colds, nausea/vomiting, sore throat, mild infections, diarrhea, fever.

However, you should call your health care professional if:

  • Illness persists without improvement for 24-48 hours.
  • Temperature rises above 100 degrees Fahrenheit.
  • Vomiting or diarrhea continues longer than 4 hours.
  • There are moderate to large amount of ketones in the urine.
  • Blood sugar levels continue to run less than 60 mg/dl,
    or above 240 mg/dl , (above 130 mg/dl during pregnancy)
    after taking extra bolus doses as prearranged with your doctor.
  • You have signs of ketoacidosis, dehydration or other serious problems such as:
    • increased drowsiness
    • abdominal or chest pain
    • difficulty breathing
    • fruity odor to the breath
    • dry cracked lips, mouth, or tongue
  • You have any uncertainty as to what to do to take care of yourself.


  • Never omit your insulin!
  • If you are ill and cannot eat, your need for insulin continues and may also increase.
  • Continue your usual basal dose of insulin along with your
    sensitivity insulin or supplemental insulin scale as prearranged
    with your doctor or healthcare professional.
  • You may need to temporarily increase or decrease your basal rate by using the temporary basal feature as prearranged with your doctor or healthcare professional.

Blood and Urine Testing

  • Check your blood sugar before your usual mealtime and every 2-4 hours if indicated.
  • Test your urine for ketones at least 4 times a day, or according to instructions from your healthcare professional.

Fluids and Diet

Always follow your physician/healthcare professional's sick day guidelines. Fluid intake is essential with any illness. You may need to drink 4 to 8 ounces of liquid every 30 to 60 minutes, and consume 10-15 grams of carbohydrate every 1 to 2 hours. If blood glucose is greater than 240 mg/dl, drink water, tea without sugar, instant broth, diet drinks, OR eat ice chips, sugar-free icicle pops, sugar-free gelatin, etc. If vomiting, start fluids 1 to 2 hours after and sip slowly.

Remember to utilize your resources at the Diabetes and Lipid Clinic of Alaska or go to the emergency department.

The information on this Web page is provided for educational purposes. You understand and agree that this information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You agree that Diabetes and Lipid Clinic of Alaska is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances through the use of this Web page. You agree to be solely responsible for your use of information contained on this Web page

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