Sick Day Checklist for Type 1 Diabetes

You’ve likely managed your share of sick days with Type 1 diabetes, but it’s always good to revisit the basics—and especially important to plan ahead if you use an insulin pump. Share this checklist with loved ones or caregivers who might support you when you’re not feeling your best.

1. Monitor Blood Glucose Frequently

• Check BG every 2–4 hours—even overnight if necessary
• Watch for highs (above 250 mg/dL) or lows (below 70 mg/dL)

2. Check for Ketones

• Test urine or blood ketones every 4–6 hours if:
  • BG stays above 250 mg/dL
  • You’re nauseated, vomiting, or have stomach pain
  • You feel tired, confused, or short of breath
• If ketones are moderate or high, call your healthcare provider right away

3. Insulin: Don’t Skip It — Especially If You Use a Pump

• Keep insulin going, even if you’re not eating
• For pump users:
  • Verify your infusion set is working properly (no kinks or clogs)
  • Change your site if BG remains high despite corrections
  • If you have moderate or high ketones, consider giving correction doses by injection (not via pump), and notify your care team
  • Have backup supplies ready: extra pump sites, insulin pens or syringes, and long-acting insulin in case you need to transition off the pump temporarily
• Use correction doses as prescribed to bring down high BG

4. Stay Hydrated

• Aim for 1 cup (8 oz) of fluid every hour while awake
• Alternate between:
  • Sugar-free fluids: water, broth, herbal tea
  • Carb-containing fluids: juice, regular soda, popsicles—if not eating much or if BG drops

5. Try to Eat or Sip Carbs

• Try to get 45–60g of carbs every 3–4 hours if tolerated
• If you can’t eat solid food, try:
  • Soup, pudding, applesauce, rice water
  • Jello, smoothies, or carb drinks (e.g., Gatorade, Glucerna)

6. Track Everything

Keep a log of:

• BG readings and ketone levels
• Food and fluid intake
• Temperature and symptoms (nausea, vomiting, diarrhea)
• Insulin doses and medication
• Pump site changes or malfunctions (if applicable)

7. Know When to Call for Help

Reach out to your care team or seek urgent help if:

• Vomiting/diarrhea lasts more than 4–6 hours
• You can’t keep fluids or food down
• BG stays above 300 mg/dL or rises rapidly
• You have moderate or large ketones
• You show signs of DKA: fruity breath, labored breathing, confusion
• Fever over 101°F persists for more than 24 hours

Sick Day Emergency Kit (Pump Users: Pack Extras!)

Have these ready in one easy-to-grab kit:

• Extra BG and ketone test strips
• Glucagon or Baqsimi (for severe lows)
• Rapid-acting and long-acting insulin (with syringes or pens)
• Infusion sets, cartridges/reservoirs, and batteries/chargers for your pump
• Sugar snacks and electrolyte drinks (e.g., Pedialyte, Gatorade)
• Thermometer, fever reducers, anti-nausea meds (as advised)
• Written instructions and your care team’s contact info