Sick Day Rules in Pregnancy for Hybrid Closed Loop YpsoPump
Feel unwell?
Check fingerstick blood glucose (BG) and ketones.
If ketones greater than 1mmol/L on blood test use sick day rules.
If ketones greater than 3mmol/L go to hospital as an emergency AND use these rules on the way.
1 Change infusion set and reservoir
2 Come out of auto-mode: It should be grey whilst in manual mode.
3 Start temporary basal rate
a) Open the main menu and tap the ‘basal rates’ icon
b) Tap the ‘temporary basal rate’ icon
c) Choose the percentage then tap the tick
Blood ketones 1.1 to 3mmol/L use 130% preset basal rate
Blood ketones greater than 3mmol/L use 150% preset basal
d) Select the period of time eg four hours then tap the tick
4 Give insulin bolus injection using pen every two hours until ketones less than 0.5mmol/L
Find total daily dose from previous day from CAMAPS
Menu – statistics – week – Total Daily Dose
Blood ketones 1.1 to 3mmol/L
Give 10% of total daily dose e.g. if total daily dose is 74 units give seven units
Blood ketones greater than 3mmol/L
Give 20% of total daily dose e.g. if total daily dose is 74 units give 14 units
If you can eat, try to have some carbohydrate with usual bolus insulin every two to four hours
Check ketones every two to four hours until less than 0.5mmol/L
Sip sugar-free fluids (at least 100ml/hour)
Return to usual regimen if:
- Blood ketones less than 0.5mmol/L for at least six hours AND
- Blood glucose 4 to 8mmol/L for at least six hours AND
- At least four hours since last injection giving using pen AND
- You are eating and drinking and feeling better
Go to hospital as an emergency if:
- Blood ketones greater than 3mmol/L OR
- Blood ketones not improving after two hours OR
- Blood ketones are still greater than 1mmol/L after six hours OR
- You are having hypos
- You continue to vomit/unable to keep fluids down