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 injections2. 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