Always change site if two high blood sugars in a row after bolusing.
Take care of your diabetes first, your pump second.
Do not allow your pump to be separated from you (i.e. in the case of hospitalization, travel etc...)
Do not leave the pump off for more than two hours at one time -anytime- (if active during that time, it is OK to be off for 2 hours, if not active, blood sugar will climb rapidly during time off pump)
If you have to go off the pump for any reason: Add up basal plus bolus insulin in 4 hour "chunks" inject your Humalog every four hours around the clock until your pump can be resumed.
If blood sugar is over 14.0 mmol/L, check ketone, correct blood sugar as you have been trained but add two units of insulin, eat/drink and bolus for it. Drink fluids, do not exercise.
If blood sugar is over 20.0 mmol/L due to forgotten bolus, dislodged site etc. Lower it slowly-give yourself 4 hours to correct your blood sugar. Do not over-react and over-bolus!
If you have to treat a low twice in a row (within 30 minutes or so) disconnect or suspend pump until your blood sugar is above 6 mmol/L.
You do not bolus for food / drink eaten to treat low blood sugar. You have to bolus for everything else that you eat.
Humalog lasts about 4 hours, therefore if you want to do another correction in two hours, consider that half of the last bolus is still working. For example, you took 3 units correction of a high and are still at 12 mmol/L two hours later, you can correct or wait - but consider that 1.5 units still has some action in your system.
Test before each meal. You need to consider the following before giving your pre-meal bolus:
your current blood sugar level (+ or - )
carbohydrate content of your meal (+)
your planned activity after the meal (-)
Sports activities, you can disconnect infusion set or protect under clothing. Test every 45 minutes or so, eat and bolus as needed. Run a temporary basal rate during activity at about 50% of the basal rate for that time of day. You may also need to extend the temp basal for the next 4 hours. This is determined individually and through trial and error.
Choose sites that are not directly on waistbands; go above or below. You can use sites from above one hip to the other except for two inches around navel.
If in doubt-call Dr. J. R. Conway, Diabetes Clinic 1-800-717-0145
