Worked Examples: Sick Day Guidance for Type 1 Diabetes
Calculating extra insulin doses - ketones 28.8 mg/dl (1.6 MMOL/L) to 52.2 mg/dl (2.9 mmol/L)
Here is an example calculation to help you calculate extra insulin doses.
Zayd feels ill and thinks he might have the flu. Alex checks his blood glucose and ketones.
His blood glucose is 288 mg/dl and his ketones are 30.6 mg/dl (1.7 mmol/L).
Zayd checks the Insulin adjusting flowchart and sees he should:
- check his blood glucose and ketones every 2 hours
- stay hydrated with sugar-free fluids
- take an extra quick-acting insulin dose that is 10% of his total daily dose
Zayd already calculated his total daily dose here and found that it was 38 units. To calculate 10% of his total daily dose he divides his total daily dose by 10.
Extra dose = total daily dose ÷ 10
Extra dose = 38 ÷ 10
Extra dose = 3.8 units which is rounded to 4 units
Zayd takes an extra quick-acting insulin dose of 4 units, aims to recheck his blood glucose and ketones in 2 hours, and contacts his diabetes team.
Calculating extra insulin doses (ketones greater than 3.0mmol/L)
Here is an example calculation to help you calculate your total daily dose.
Zayd feels ill and thinks he might have the flu. Zayd checks his blood glucose and ketones.
His blood glucose is 288 mg/dl and his ketones are 55.8 mg/dl (3.1 mmol/L).
Zayd checks the Insulin adjusting flowchart and sees he should:
- check his blood glucose and ketones every 2 hours
- stay hydrated with sugar-free fluids
- take an extra quick-acting insulin dose that is 20% of his total daily dose
Zayd already calculated his total daily dose here and found that it was 38 units. To calculate 20% of his total daily dose he divides his total daily dose by 5.
Extra dose = total daily dose ÷ 5
Extra dose = 38 ÷ 5
Extra dose = 7.6 units which is rounded to 8 units
Zayd takes an extra quick-acting insulin dose of 8 units, aims to rechecks his blood glucose and ketones in 2 hours, and immediately contacts his diabetes team for urgent advice.
