In this section, you’ll learn:

• what a regular day is like on insulin pump therapy
• what kinds of decisions a person on insulin pump therapy needs to make

​The following timeline shows a typical day in the life of Adam, a person on insulin pump therapy.

7 a.m. Wake up​

Adam wakes up in the morning. He:

1. Checks his blood glucose—it’s high, over his target.
2. Gives himself a correction dose of insulin, as his insulin pump recommends.
3. Asks himself safety questions:
   • Is my site intact, and I can see any problems?
   • Does my insulin reservoir have enough insulin for the day ahead?
   • Does my battery icon show that my battery has enough charge for the whole day?

7:30 a.m. Shower

Adam is going to take a shower. He:

1. Disconnects his insulin pump before he showers.
2. Reconnects his insulin pump after he showers and finishes getting ready for the day.

8 a.m. Breakfast

Adam gets his breakfast ready. Just before he eats, he:

1. Adds up the grams of carbohydrate he’s about to eat and inputs the number into his insulin pump.
2. Thinks about his day ahead and asks himself:
   • Am I planning to exercise?
   • Do I have a long drive today (lots of sitting)?
   • How do I feel?
   • Is anything else happening today that might affect my blood glucose?
3. Gives bolus insulin for his breakfast, based on what dose the insulin pump suggests and what he plans to do that day.

8:30 a.m. Before leaving for work

Adam checks his safety kit. He:

1. Checks if the kit has enough supplies.
2. Adds another infusion set to his kit because he used one yesterday when the cannula was kinked.

10:15 a.m. Mid morning

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

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

11:15 a.m. Late morning

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

12 p.m. Lunch

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

1. Adds up the grams of carbohydrate he’s about to eat and inputs the number into his insulin pump.
2. Reviews the insulin pump’s suggestion for meal bolus and correction insulin and decides it makes sense.
3. Gives his insulin for lunch.

3 p.m. 2 hours before exercise

Adam checks his blood glucose. He’s in target. He:

1. Thinks about his planned exercise after work.
2. Sets a temporary reduced basal rate on his insulin pump, starting 2 hours before he plans to exercise.
   

​5 p.m. Exercise

Adam checks his blood glucose. He’s slightly above target. He:

1. Makes sure he has his safety kit.
2. Ignores his insulin pump’s suggestion to give a correction.
3. Starts his exercise.

After 30 minutes, Adam stops and checks his blood glucose—it’s low normal. He:

1. Eats a small snack for the extra carbohydrate he needs for exercise and to stop low blood glucose from happening.
2. Checks his blood glucose again 30 minutes later—it’s high normal.

6:45 p.m. Supper

Before Adam eats he:

1. Checks his blood glucose—it’s in target.
2. Adds up the grams of carbohydrate he’s about to eat and inputs the number into his insulin pump.
3. Doesn’t make any adjustments because he isn’t planning any activity after supper.
4. Gives himself bolus insulin for supper.
   

9 p.m. to 7 a.m. Evening and overnight

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

1. Gives a correction bolus, as his insulin pump recommends.
2. Checks his insulin pump and plans his night before he goes to bed by:
   • Checking the site.
   • Thinking about lowering his basal rates overnight since he exercised that afternoon. He decides to lower his basal rates by 10% overnight.
   • Setting his alarm for 2 a.m. to check his blood glucose.​
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