Injections

If you use Basal/Bolus Injection Therapy (lantus +novolog at each meal and/or snack):

  • Take a correction bolus dose of rapid acting insulin if more than 2 hours since last meal bolus or correction bolus. 
  • If less than 2 hours since last bolus, wait the full 2 hours and repeat blood sugar. If blood sugar still high, give correction bolus. 
  • Drink water. 
  • Exercise a little bit—as long as no nausea or vomiting. 
  • Check repeat blood sugar 2 hours after bolus and see table for further instructions.

What to do if you have high blood sugars and are on Basal/Bolus Therapy:

Blood glucose

Target (70-140 mg/dl)

140-299 mg/dl

>300 mg/dL

Should I check ketones?

No.

No. Unless you are very sick with bad cold, flu or stomach bug.

Yes, if first thing in the morning or second blood sugar at least 2 hours since previous blood sugar >300.

What do  I do if I have trace to small ketones?

Not applicable.

Not applicable.

Drink water.

Is a correction needed?
*******

No.

Yes. If you have moderate to large ketones call your diabetes care provider.

Yes.  If you have moderate to large ketones call your diabetes care provider.

When do I check a repeat blood sugar?

3-4 hours

2 hours

2 hours

If after all of this your blood sugar is still >300, call the clinic or your diabetes care provider.

Important Things to Remember

  • If you are giving correction doses for high blood sugars in the evening, check a blood sugar at 2-3a.m. to make sure you did not give too much insulin that may cause a low while you are sleeping.
  • If you have repeated episodes of vomiting, call clinic emergency line or your diabetes care provider’s emergency line.