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 3.5 mmol/L (60 mg/dl),
    or above 13 mmol/L (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 13.5 mmol/L (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.