Hypoglycemia

• unplanned activity
• incorrect meal bolus amount
• basal rate set too high
• suspend mode OR
• temporary basal rate OR
• disconnect pump at Quick Release
  

Hyperglycemia

• basal rate too low
• missed meal bolus
• dislodged site, leakage etc
• pump malfunction
• poor site-too close to a muscle
• check the site for wetness or dislodged catheter
• test BG more often, if two high readings in a row, and are increasing after a bolus, change the site.
• check pump operations: run self test in set up screen.
• run 7.2 u test
• check batteries, reservoir , call 1-800 # on back of pump

Alarms

• no delivery (5 beeps)
• suspend mode (3 beeps)
• alarm: goes off if pump has not been touched for a set period of time.
• check reservoir
• cancel suspend mode
• you may have missed a bolus, check bolus history.
• re-set alarm for longer period of time 6-8 hours possibly
  

Itchy site

• sensitivity to adhesive
• leakage under adhesive
• site infection
• hair pulling
• irritation by cleanser
• site left in too long
• check site for redness
• change site and try new kind of tape
• use hypoallergenic soap cleanser, use mild soap
• use hair remover
• change site every 48 hrs
  

Showering

• want to keep the pump dry
• shower between site changes
• disconnect to shower at Quick Release (QR)
• put pump in a plastic pencil case,(the kind with 3 holes) use a rubber band through the holes in the pencil case & hang the pump while still attached, on the showerhead.
  

Sex

• concern over getting tangled up in the tubing
• disconnect at QR,
• between site changes
• always remember to reconnect pump
• always remember to check the site afterwards
  

Time off pump

• *swimming, etc
• *never longer than 1 hour
• *test blood sugar when reattach
• *give small "catch up" bolus of what you missed.
  

Blood glucose monitoring

• ketoacidosis can develop over 4-8 hours
• pump will not alarm if still delivering insulin, even if it is all pooling under the adhesive tape.
• MUST test before bedtime every night. If high, bolus and retest in 1 hour, if is still increasing, change site.
• if ill, test every two hours and at least once during the night.
• write down in logbook
  

Wearing the pump

• keep it secure
• clip on belt
• clip on bra
• sew in pocket into pajamas, secure with a piece of Velcro
• use fanny pack
• always wear medic alert and carry fast acting sugar (hard candies, honey, monojel)
  

by Jill Milliken RN CDE 2000