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Insulin Pump Therapy

Once You Have Your Insulin Pump

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You’ll have to learn:

  • about pump parts, programming, basic and advanced features
  • about infusion sets, caring for the insertion site, and troubleshooting site problems
  • how to adjust insulin according to basal/bolus insulin delivery with pump therapy
  • how to accurately count carbohydrate
  • how to adjust insulin with the pump to prevent low blood sugars
  • when and how to use syringes or insulin pens to prevent diabetic ketoacidosis (DKA) when on insulin pump therapy

You’ll also have to:

  • keep doing all the important self-management habits under the section “The Key to Blood Sugar Control”. This includes testing blood sugar at meals and bedtime (at least 4 times a day, sometimes up to 10!)
  • have many appointments and phone calls with your healthcare team during these first several months (you may need to take time off work or school). After this, you’ll also need visits at least a few times a year for maintenance checks.
  • lose time from work, school, sleep or recreation to stop and test blood sugars, ketones, and give extra insulin if an infusion set rips out, is kinked or anything interrupts insulin delivery. DKA can happen in 2 to 4 hours if your insulin delivery is interrupted.
  • when setting basal rates:
    • skip meals and/or snacks, or follow a set meal plan for a short time
    • do additional blood sugar tests. E.g. 3 to 4 tests overnight for repeated days and/or 3-4 tests between two meals for repeated days.
    • provide detailed blood sugar, lifestyle and pump programming records
    • repeat the above after any dose changes to make sure they are right
    • repeat this basal rate setting procedure (above) when troubleshooting blood sugar trends e.g. once a year or more often
  • re-program basal rates, insulin to carbohydrate ratios and insulin sensitivity factors as required

It is going to take a lot of effort and time, and it won’t always go smoothly—expect some frustrations along the way.

Knowledge Check

It might take several months of frequent glucose testing and food records to fully program a pump. However, after that:
 
 
 
 

Correct!The pump settings will occasionally need changing, and extra glucose tests and skipped meals/snacks or a set meal plan will be needed again.

The correct answer is D.The pump settings will occasionally need changing, and extra glucose tests and skipped meals/snacks or a set meal plan will be needed again. ​