Kids on Insulin Pumps
The Insulin Pump is Just a Tool to Deliver Insulin
The insulin pump uses only fast-acting insulin (much like the pancreas!) This is the one major difference between insulin pump therapy and injection therapy.
Here's what you need to know:
Background (basal) insulin needs:
Rather than taking one or more shots of longer-acting insulin, the insulin pump delivers the patient's basal insulin - this is the dosage that meets the patient's needs for insulin without food. The patient and the physician decide on the dosage, the patient programs the basal rate, and the insulin pump delivers the insulin in tiny, regular pulses.
Meal and correction doses (bolus doses):
The patient uses the insulin pump to deliver meal and supplemental doses (called "boluses") according to the meal content and blood sugar reading.
Now you can match insulin delivery to the way you want to eat. The MiniMed Paradigm insulin pump gives you a variety of bolus delivery options: Normal, Square Wave™, and Dual Wave™. Since your body absorbs different foods at different rates, the MiniMed Paradigm insulin pump allows you to set insulin delivery precisely to match every food and every combination of foods you eat. A Square Wave bolus lets you spread insulin delivery over the time period you specify. It's perfect if you're eating pizza. Having pineapple on your pizza? Use the Dual Wave bolus—helpful when you eat both quickly absorbed foods, like pineapple, and slowly absorbed foods, like the rest of the pizza, in combination.
Insulin Pumps and Scheduling:
Kids using insulin pumps will not necessarily be following a daily schedule like some campers on injection therapy, because they don't have longer-acting insulin in reserve dictating when or how much to eat, or when to take another shot. Of course, this doesn't mean that "insulin pumpers" should not follow the camp schedule and respect the needs of their fellow campers.
Things to be Aware of With Kids on Insulin Pumps
Hyperglycemia and DKA:
Be aware that when insulin potency or delivery is impaired or compromised, a patient's blood glucose will rise more rapidly than that of a patient on injections. This is because the insulin pump patient has no longer-acting insulin in reserve. Some possible causes of hyperglycemia are:
- A clogged, leaking, or dislodged infusion set
- Insulin that has lost its potency
- Insulin that has not absorbed properly
IMPORTANT: Nausea is often a symptom of impending DKA. Hyperglycemia should be resolved using the following steps:
- First, give insulin by injection,
- Next, check for ketones, change the infusion set, and then
- Check BG in 1 hour to verify that it is coming down. Seek medical attention if blood glucose is not coming down or ketones are positive.
Hypoglycemia:
The causes and treatment for hypoglycemia are the same as with injections.
What to Know About Every Activity
Disconnecting:
There are many times when a camper may want or need to remove the insulin pump - for changing clothes, showering, bathing or swimming, for example.
The rule of thumb is that the insulin pump can be removed for up to one hour without the need for supplemental insulin. If the camper removes the insulin pump for more than one hour, he/she should be given a supplemental bolus dose.
Remember that it is important to increase blood sugar testing frequency when the insulin pump is disconnected.
Showering:
The insulin pump can be disconnected for showering.
Swimming and Water Sports:
Medtronic Diabetes makes the watertight SportGuard™ hard case, designed to help protect 5xx series insulin pumps during these activities. Some children may be used to disconnecting the insulin pump for these activities.
Field Trips and Camping Out:
In addition to their emergency kits, insulin pump users should remember to bring extran insulin pump insulin, reservoirs, infusion sets and Serters™ (automatic insertion devices)
Troubleshooting the Insulin Pump
Insulin Pump Alarms and Error Messages:
Many insulin pump alarms and error messages can be resolved by following on-screen instructions. If the insulin pump continues to alarm, follow the instructions on the alarm card. Or call Medtronic Diabetes's free, 24-hour help line at 1-866-948-6633 (toll-free) or 818-576-5555 (this number is also listed on the back of the insulin pump) for assistance anytime of the day or night.