NHS Forth Valley – Type 1 on Insulin Pen/Syringe Injections

This information is for adults with Type 1 diabetes who take multiple daily injections (e.g. background insulin and fast acting insulin) or a twice daily insulin injection (e.g. Novo mix, Humulin M3). Pregnant women and people under the age of 16 should follow different rules.

When you are unwell your body doesn’t behave normally to insulin. It is very important to keep checking your glucose levels when you are unwell and if they are above 14mmol, or you are feeling very unwell, to check your ketones.

Never stop taking your insulin

If you take fast acting insulin (e.g. Novorapid, Humalog) you may need to double your fast acting insulin dose if your ketones are above 1.5mmols.

If you take a mix insulin (e.g. Novomix, Humulin M3) and your blood glucose levels are above 14mmol and have ketones, contact the diabetes specialist nurses on 01324 566929 or NHS 24 on 111.

Medicine Sick Day Rules

When you are unwell with any of the following:

Vomiting or diarrhoea (unless only minor)
Fevers, sweats and shaking (unless only minor)

Then STOP taking the medicines indicated by your healthcare professional.

Restart when you are well (after 24-48 hours of eating and drinking normally).

If you are in any doubt, contact your pharmacist, doctor or nurse.

Download the sick day rules for Type 1 diabetes

Unwell? – Check blood glucose and check for ketones

What is my Blood Glucose?	What is my Blood Ketones	What should I do?
In target	0	Continue with usual insulin. Re-check in 2 hours.
In target	More than 1.5mmols	Eat more carbohydrate, and take usual insulin. Re-check in 2 hours.
Above target	Less than 1.5mmols	Take usual correction. Re-check in 2 hours.
Above target	More than 1.5mmols	Double your correction. Re-check in 2 hours.
Above target and unable to keep fluids down/breathless vomiting	More than 1.5mmols	Double your correction and go to the emergency department immediately