Adam wakes up in the morning. He:

• checks his blood sugar—it’s high, over his target.
• gives a correction dose of insulin, as recommended by the pump
• asks safety questions:
  • Is my site intact, and are there any problems that I can see?
  • Does my insulin reservoir have enough insulin for the day ahead?
  • Does my battery icon show that my battery won’t die during the day?

Adam:

• disconnects his insulin pump and has a shower
• reconnects his pump and finishes getting ready

Adam gets his breakfast ready. He:

• adds up the grams of carbohydrate he’s about to eat, and inputs the number into his pump
• thinks about his day ahead:
  • Am I planning to exercise?
  • Do I have a long drive today (lots of sitting)?
  • How do I feel?
  • Anything else happening today that might affect my blood sugar?
• gives bolus insulin for his breakfast, based on what dose the pump has suggested and the activities planned for the day

Adam checks his safety kit. Does he have enough supplies in it? He adds another infusion set to his kit because he used one yesterday when the cannula was kinked.

Adam checks his blood sugar—it’s still high. He:

• checks his blood ketone level—ketones are present.
• follows the guidelines for preventing DKA when ketones are present. He gives a bigger than normal correction bolus with a syringe, based on calculations in his handout.
• checks his infusion set, and finds that he didn’t connect it properly after his shower—he reconnects it properly

Adam checks his blood sugar—it’s coming down.

Adam checks his blood sugar—it’s slightly over target. He:

• adds up the grams of carbohydrate he’s about to eat, and inputs the number into his pump
• reviews the pump suggestion for meal bolus and correction insulin. He decides it is appropriate.
• gives his insulin for lunch

Adam checks his blood sugar. He is in target. He:

• thinks about his planned exercise after work.
• sets a temporary reduced basal rate on his pump, starting 2 hours before he plans to exercise.

Adam checks his blood sugar. He is slightly above target. He:

• makes sure he has his safety kit
• ignores his pump’s suggestion to give a correction
• starts his exercise

After half an hour, Adam stops and checks his blood sugar—it’s low normal. He:

• eats a small snack for the extra carbohydrate he needs for exercise and to prevent a low blood sugar
• checks his blood sugar 30 minutes later—it’s high normal

Adam:

• checks his blood sugar—it’s in target
• adds up the grams of carbohydrate he’s about to eat, and inputs the number into his pump
• he isn’t planning any activity after supper, so he doesn’t have to make any adjustments
• gives bolus insulin for supper

Adam checks his blood sugar—it’s above target. He:

• gives a correction bolus, as recommended by the pump
• takes a last look at the pump before going to bed. He:
  • checks the site
  • thinks about whether he should reduce his basal rates overnight, given his afternoon exercise: based on other times he’s exercised, he decides to reduce basal rates by 10% overnight
  • sets his alarm for 2 a.m. to check his blood sugar​​​​​​​​