POSSIBLE REASONS TO CHANGE FROM INSULIN PENS TO AN INSULIN PUMP
Despite care your child has repeated episodes of hypoglycaemia.
Reduced awareness of hypoglycaemia
Rise in blood glucose levels in the early hours of the morning.
Inspite of an intensive multiple insulin regime your child has vast fluctulations in blood sugar.
HbA1c over 8.5%.
In order for the pump to be right for your child you must be motivated to succeed.
Able to problem solve and manage.
Willing to test your child's level several times a day (we test a minimum of 6).
You must be competent at carbohydrate counting.
You must be competent at adjusting insulin doses for carbohydrate, blood sugars and lifestyle.
Benefits of having an Insulin Pump:
Less frequent severe hypos.
Hypo awareness.
Improved glucose levels.
Better quality of life.
Within 3 months of using a pump you should see the benefits.
The Basics of Insulin Pumps:
You will be taught the basics of your child's pump by your diabetes team and the pump manufacturer's instruction book or even one of their representatives.
You will learn:
How to insert batteries;
How to set time and date;
How to switch pump on/off;
How to give a bolus;
How to set basal rates;
How to fill up a cartridge;
Different insertion devices.
INFUSION SITE MANAGEMENT
It is best to avoid heavily used sites or lumpy sore areas.
Make sure you rotate your child's infusion sites.
It is advisable not to put the infusion directly on the belt line or under a waistband.
Insert a new infusion set at least 5cm away from the old one.
Change infusion set every 2 - 3 days.
Always check your child's blood glucose level 2 hours after inserting cannula to ensure it is working.
It is best not to change the cannula too late as you need to ensure all is well before your child goes to bed.
A good time to change the site is before a meal so that the meal bolus insulin dose will clear any tissue or blood left in the cannula.
Check for any bending or kinking.
Infusion sites are sometimes painful after inserting, it may sting but if it still is hurting your child after a couple of hours change the cannula again.
If there is blood in the tubing, your child's infusion set must be changed.
Tea tree cream is great to help heal the scars.
TO PREVENT INFECTION:
Always wash your hands before you open any package.
Wash your hands before you remove the old site.
Any sign of redness, pain or discomfort change set.
CHECKING THE BASAL RATE:
Your child's basal rate should be checked regularly to ensure it is meeting your child's body requirements for background insulin. Your DSN will be able to advise.
ACTIVITY AND EXERCISE:
Temporary Basal Rates
One of the perks of the insulin pump is that during exercise, illness any lifestyle change you can programme a temporary basal rate but adjusting insulin rates is hard and is often trial and error as each child is different.
Eddie, my son is 13 and during light activity he has a temporary basal rate of anything from 50% - 100%, but I must stipulate if in doubt ask your DSN. His basal during exercise is approximately 70% and his basal after exercise is 100%.
During medium activity Eddie has a bolus rate of approximately 50%, basal during 50% and basal after 100%.
During heavy activity, this is more than an hour's exercise eg cross country running Eddie has a bolus of 30%, basal during 10 - 30% plus he eats a small 15g snack of carbohydrate. His basal rate after is approximately 50%.
This is intended as a guide only, so please contact your DSN for your child's requirements.
