Insulin Pumping 101: Prep Before You Pump!

Posted by ids on Wed, 03/19/2014 - 11:43 in

- Lisa Foster-McNulty RN, MSN, CDE

As any great painter, chef or presenter knows, the key to success is in the preparation. The same can be said for anyone with diabetes considering insulin pump therapy.

If you are thinking about switching over to an insulin pump, it’s a good idea to have some essential skills and abilities in place first. Basal is background or long-acting insulin, meant to offset the body’s natural glucose production. Bolus is mealtime or rapid-acting insulin, meant to cover the blood sugar rise caused by food.

Here are some other diabetes self-management practices that may help make your transition to pump therapy more successful:

  • Blood glucose levels must be checked a minimum of four times per day.
  • You should have at least a basic understanding of carbohydrate counting.
  • It’s also a good idea to know how to self-adjust mealtime insulin doses while you’re still on injections. Doses should be based on the carbs you are eating as well as how much insulin is needed to “correct” a blood glucose that is off target.
  • We also suggest keeping records in either a written or electronic/downloaded form so that you and your healthcare team can determine your optimal insulin doses.
  • Finally, get comfortable using the “basal/bolus” terminology and understand what it refers to.

Expectations of Insulin Pump Therapy

Another part of preparing for pump therapy is having appropriate expectations. An insulin pump doesn’t automatically give insulin to normalize blood glucose levels. It is a tool that makes it easier for you to perform that job. The pump does not automatically measure your blood glucose…you still need to do that. A pump is also not a license to eat as much as you want, whenever you want. Eating too frequently (and making poor food choices) can make it darn near impossible to control blood glucose levels, so a healthy meal plan is still a priority. And remember, there is always a learning curve when starting on a pump. It typically takes several weeks (or longer) to fine-tune the pump settings and get comfortable with all the pump’s features.

Positive Features of Insulin Pump Therapy

What an insulin pump will do is eliminate the need for long-acting insulin. This is because tiny doses of rapid-acting insulin are delivered by the pump every few minutes. Insulin pumps also eliminate the need for injections, replacing them with a cannula that is inserted just below the skin every couple of days (don’t worry…it’s virtually painless). They assist with mealtime insulin dosage calculations, keep extensive records for you, allow very precise dosing, enable extended delivery of mealtime insulin (for slowly-digesting foods) and permit hour-to-hour adjustments to basal insulin levels.

Before Getting Started on an Insulin Pump

Before starting on a pump, ask your healthcare team for a transition plan:

  • What to do with your long-acting insulin the day before and the day of your training
  • What type of insulin to obtain for use in the pump
  • What to read/watch prior to the training and what to bring to the training
  • A back-up plan to follow in case of an emergency

Your healthcare team will play a key role every step of the way, from preparing for an insulin pump to getting up and running. Your physician (or Nurse Practitioner or Physician’s Assistant) will write the orders for the pump and supplies, and refer you for education and training. A Certified Diabetes Educator (CDE) can meet with you to be sure you have the knowledge you need to become a successful pumper. You’ll need to learn how to troubleshoot common problems, and when to reach out for help.

Remember, insulin pumps are merely tools for improving diabetes management and improving quality of life. It is your ability to use it successfully that makes the difference!

Whether you're considering insulin pump therapy, or you already wear a traditional pump, the Omnipod insulin pump can make managing your diabetes easier. Click here to learn more and try a free demo for yourself.

NOTE:  Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.

Lisa Foster-McNulty, MSN, RN, CDE
Director of Patient Care and Education, Integrated Diabetes Services LLC
Lisa-McNultyIn many cases, developing diabetes leads one towards a career in diabetes education. For Lisa Foster-McNulty, the opposite occurred. Lisa became a diabetes educator in 1995 while working in home healthcare and achieved CDE certification in 1998. She went on to lead the Home Care Network’s Diabetes Educator Team in 2000, before taking on a management role with an outpatient diabetes management program in a Philadelphia-area hospital system. A few years later, Lisa discovered that she would need to apply her clinical skills on herself when she was diagnosed with diabetes. When she and her husband decided to have a baby, Lisa chose to go on an insulin pump. Soon afterwards she began using a continuous glucose monitor and has been doing so ever since. Since 2008, Lisa has served as Co-Chair of the Education Committee for her local affiliate of the American Association of Diabetes Educators.