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Insulin Pump Therapy

8.2 What to expect in the first months

The first months of insulin pump therapy are a lot of work. They can be frustrating at times. There’s a lot to learn, and you can expect your blood glucose to be above target or more unstable than usual. You’ll work closely with your diabetes team to manage these challenges.

What you’ll learn

When you start on insulin pump therapy, you’ll need to learn about many things:

  • how the insulin pump works, including its parts, programming, and features
  • how infusion sets (tubing and cannula) work, how to care for the insertion site, and how to find and fix problems with the site
  • how to adjust insulin according to how the pump gives basal and bolus insulin
  • how to accurately count carbohydrate
  • how to adjust insulin with the pump to stop low blood glucose from happening
  • when and how to use syringes or insulin pens to stop DKA from happening

What you’ll do

In the first many months of insulin pump therapy, here are some things you need to do:

  • Follow good self-management habits (like those in Section 1: Good habits to manage your blood glucose). This includes testing your blood glucose at least 4 to 10 times a day.
  • Have lots of appointments with your healthcare team, which could mean taking time off work or school. (After this time, appointments will be a few times a year.)
  • Deal with interruptions to work, school, sleep, or hobbies to test your blood glucose, ketones, and give yourself extra insulin when there’s a problem.

Setting basal rates

It takes a lot of time and effort to set your basal rates when you start on insulin pump therapy. It may involve doing the following things:

  • Skip meals and snacks, or follow a meal plan for a short time.
  • Do extra blood glucose tests. For example, do 3 to 4 tests overnight for many days and 3 to 4 tests between meals for many days.
  • Keep detailed records of your blood glucose, lifestyle, and insulin pump programming.

​You’ll repeat these actions and reprogram the insulin pump as often as you need to. For example:

  • when your insulin dose changes
  • when you need to fix blood glucose problems​