User guide

Hyperglycemia protocol
If one blood glucose reading is above 250 mg/dL (13.9 mmol/L):
• Take a correction bolus right away
•Test BG in one hour
If the second blood glucose is above 250 mg/dL (13.9 mmol/L):
• Take an insulin injection by syringe (not through the pump). The amount should be the same as if you
were taking a correction bolus.
• Change the entire infusion set system (new reservoir, infusion set, and cannula). Consider changing
the insulin vial if you believe that the insulin is no longer stable.
• Check urine for ketones and call your healthcare professional if ketones are present.
• Drink liquid with no calories every 30 minutes (for example: 8 oz. diet ginger ale, broth, water).
• Test blood glucose every 2 hours and keep taking correction insulin until blood glucose reaches target.
• Call your healthcare professional if your blood glucose and urine ketones remain high or you are
unable to drink.
Treating hyperglycemia from illness or infection through insulin pump therapy will be discussed on the
following pages.
Diabetes ketoacidosis (DKA)
DKA results from untreated hyperglycemia. DKA is a serious medical problem that needs treatment right
away. The insulin pump therapy uses only fast-acting insulin, so DKA can occur rapidly if insulin delivery is
disrupted. It is important that you understand these guidelines.
Preventing DKA
If you have nausea or vomiting, immediately check your blood glucose and ketones. If your blood glucose is
above 250 mg/dL (13.9 mmol/L) and/or ketones are present:
• Take an injection of fast-acting or regular-acting insulin with a syringe (not through the pump). The
amount should be the same as if you were taking a correction bolus. If ketones are present, more
insulin may be needed. Contact your healthcare professional for guidelines for insulin doses especially
when ketones are present.
• Change the entire infusion set system (new reservoir, infusion set, and cannula). Consider changing
the insulin vial if you believe that the insulin is no longer stable.
• Call your healthcare professional.
Introduction to pump therapy 17
Chapter 2