My Sick Day Plan Page 4
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8Sick Day Insulin Adjustment
When you are sick, you may need to increase
For example, if you usually take 10 units
your rapid or short acting insulin doses or
rapid at breakfast, 8 units rapid at lunch, 12
even take an extra injection to lower high
units rapid at supper and 24 units of long
blood sugars and get rid of ketones.
acting insulin at 10 pm, your TDD is 10 + 8 +
12 + 24 = 54 units.
Important: The following section on
3. Your sick day adjustment will then be a
insulin adjustment is a guideline only.
percentage of your TDD. The adjustment
Check with your health care team before
could be 10%, 15% or 20% of your TDD,
using these guidelines.
based on your blood sugar and ketone levels.
See Table A.
What to do
4. You can calculate your extra insulin by doing
the math yourself. For example, if your TDD
1. When your blood sugar is higher than
is 54 units, 10% = 5.4 extra units (round to 5
14 mmol/L, you need extra rapid or short
units), 15% = 8.1 extra units (round to 8 units),
acting insulin.
20% = 10.8 extra units (round to 11 units).
2. Insulin adjustments are based on your total
OR
daily dose (TDD) of insulin. To get your
TDD, add your usual unit doses of pre meal
Use Table B on the following page to
and basal insulin.
determine what your suggested sick day
insulin adjustment is, based on your blood
sugar and ketone levels.
Table A
Extra insulin (using rapid acting or
Blood Glucose Level
Urine Ketones
short acting insulin ONLY)
14 to 16 mmol/L
Moderate to large
10% of TDD
16.1 to 22 mmol/L
Negative to small
16.1 to 22 mmol/L
Moderate to large
15% of TDD
22.1 or more
Negative to small
22.1 or more
Moderate to large
20% of TDD
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Sick Day Management for People with Type 1 Diabetes
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