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The NDSS is administered by Diabetes Australia
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Sick days during pregnancy, for women with type 1 diabetes

Everyday illnesses such as the flu and infections can cause your blood glucose levels to rise. If you get sick while you are pregnant, you will need to be careful and check your blood glucose levels more often and check your blood or urine for ketones. You may also need to increase your insulin doses or have small frequent doses to prevent ketoacidosis.

Talk to your diabetes health professionals about what to do when you are sick, when to check for ketones and the signs of ketoacidosis. Ask them to develop a sick day management plan with you. This will help you to manage your blood glucose levels when you are unwell. Make sure you have in-date ketone monitoring strips and that you know what to do if you find ketones present.

Managing sick days

  • Develop a sick day management plan with your diabetes health professionals and follow this plan if you are unwell or have morning sickness.
  • Check your blood glucose levels at least every 2 hours when you are unwell. If you are using continuous or flash glucose monitoring, it’s important to also check your glucose levels with finger-prick blood glucose monitoring.
  • Check your blood (or urine) for ketones. If your blood ketones are 0.6mmol/L or more (or urine ketones 1+ or more) follow your sick day management plan and continue to check blood glucose and ketone levels every 1–2 hours.
  • Discuss hypo management with your diabetes health professionals. If your blood glucose level is low, treat the hypo then check your blood glucose level again in 10–15 minutes to make sure it is back in the target range. If your blood glucose level is still below 4mmol/L, re-treat the hypo.
  • Take your long-acting insulin (or keep basal insulin going if you are using an insulin pump) even if you are vomiting or not eating. Talk to your diabetes health professionals about adjusting your insulin dose in this situation.
  • Make sure you continue to drink plenty of fluids. If your glucose levels are low, include carbohydrate-containing fluids. If your glucose levels are high, choose carbohydrate-free fluids. Refer to your sick day management plan.
  • See your doctor to find out the cause of the illness.
  • Seek urgent medical attention (call your doctor, credentialled diabetes educator or local emergency medical service) or go to the Emergency Department of your nearest hospital if:
    • your blood ketone reading is 1.5mmol/L or more (or your urine ketones are 2+ or more)
    • you are vomiting and unable to keep food or fluids down for more than 2 hours
    • you have high blood glucose levels that are not improving after 2 hours or your ketones are rising, despite following your sick day management plan
    • you are worried about high blood glucose levels
    • you are showing symptoms of ketoacidosis
    • you are having trouble keeping your blood glucose levels above 4mmol/L or you have had a severe hypo (where you can’t treat the hypo yourself and need help from someone else).