You Have Diabetes! New Diagnosis
Scared 15 year old…
• What are your fears?
• Who are your stakeholders?
Insulin Pump Therapy
Objectives
• Explore the benefits of pump therapy• Discuss Smart Pump features• Experience pumping
Diabetes Treatment Evolution
• Better simulates normal basal/bolus insulin delivery• User may increase, decrease, or stop insulin • Closest thing to working & thinking like a pancreas!
The Pump Mimics Normal Insulin Action
Barriers• Attached to device • Loss of privacy • Expense • Risk of site infections • DKA
Benefits • Customized basal rates • Temp basal options• Bolus options • IOB feature • ezBG and ezCarb does
the math for you• Sickday management • Decreased TDD• Stop insulin delivery
Ways to determine starting insulin dose
1. Current TDD on injections
2. Current TDD – 25 to 50%
3. Weight ÷ 4 X 0.9
Wolpert H, ed. Smart Pumping: A Practical Approach to Mastering the Insulin Pump. Alexandria, VA:American Diabetes Association; 2002.Walsh, J. Pumping Insulin Torrey Pines San Diego 2000
Your Total Daily Dose Your Wt ÷ 4 = ___ X 0.9 = _____units
Example: 150 ÷ 4 = 38 X 0.9 = 34 units
Determining Your Basal Rate
• 50% of TDD is Basal Need• Basal Rate is divided over 24 hrs
Wolpert H, ed. Smart Pumping: A Practical Approach to Mastering the Insulin Pump. Alexandria, VA:American Diabetes Association; 2002.Walsh, J. Pumping Insulin Torrey Pines San Diego 2000
TDD ÷ 2 = ____ ÷ 24hrs = __.___
Tools to Glucose Control Value of 1 unit of insulin
Sensitivity Factor (SF)Lowering of glucose per unit of insulin
Insulin to Carb Ratio (I:CHO)
Grams of carbohydrates per unit of insulin
Easy Math - 1800/500 Rules
1. 1800 ÷ by TDD = SF
2. 500 ÷ by TDD = I : CHO
3. SF = I:CHO = 1 :
Starting your pump
1. Set up a Basal Rate, an Insulin to Carbohydrate Ratio, & Insulin Sensitivity Factor.
2. Review ezCarbs & ezBG features
3. Insert infusion set