Information about Injections and Pumps During Illness

If you use Injection Therapy:

If you/your child are on injection therapy and have moderate or large ketones (or have vomited), call your diabetes provider immediately. If your ketones are small, trace or negative (and you have not vomited), drink water and continue to test blood sugar and ketones every 2-3 hours. 

If you/your child are on basal/bolus injection therapy, continue to take correction doses of insulin as needed every 2-4 hours. In general, we do not recommend taking insulin for carbs that come from the drinks that are used to keep you/your child hydrated during sick day management. Please call the diabetes team if you have any questions.

If you use Pump Therapy:

CHECK YOUR URINE FOR KETONES EVERY FEW HOURS. 

Blood Sugar

<70mg/dL

70-299 mg/dL

>300 mg/dL

Ketones are Positive.
(Moderate to Large)

Call the Clinic.
Continue normal basal rate.


Encourage sips of juice or glucose gel.

Call the clinic. We may suggest an increase basal rate to 150% for 2 hours.

CHANGE YOUR SITE!  Call the clinic- we may suggest giving a double correction and consider increasing basal rate to 200% for 2 hours.

Ketones are Negative.

Continue normal basal rate, call the clinic if vomiting occurs.

Continue normal basal rate, call the clinic if vomiting occurs.

Give a correction dose of insulin. Call the clinic if vomiting occurs.


  • Check your blood sugar every two hours.
  • Check your ketones until they are negative.
  • Sip on fluids.
  • For BG<180 use fluids with sugar, for BG>180 use fluids without sugar. In general we do not recommend taking insulin for the carbs found in these drinks when they are used for hydration during sick day management. Please call your diabetes team with any questions.
If unable to stop vomiting, if ketones get worse, or if ketones don’t get better, call the clinic emergency line at 203-764-6747.