Chapter

Running an insulin pump service

John Pickup, Siobhan Pender, Julia Kidd and Nardos Yemane

in Insulin Pump Therapy and Continuous Glucose Monitoring

Published on behalf of Oxford University Press

ISBN: 9780199568604
Published online May 2011 | e-ISBN: 9780199607440 | DOI: http://dx.doi.org/10.1093/med/9780199568604.003.0003

Series: Oxford Diabetes Library

Running an insulin pump service

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• Patients are selected for continuous subcutaneous insulin infusion (CSII) because they meet clinical criteria (e.g. disabling hypoglycaemia and/or elevated HbA1c on multiple daily insulin injections [MDI]), general requireents (e.g. willing and able to perform pump procedures), and have no obvious contraindications, for example, unwilling or unable to perform pump procedures • A sequential approach to treatment by CSII is recommended where patients first undergo a pre-pump assessment (including renewed diabetes education, optimization on MDI, for at least adults), with only those not achieving good control being offered a trial of pump therapy • Basal insulin rates are about 50% of the total daily dose and meal boluses are set by the insulin: carbohydrate ratio and a correction factor based on the insulin sensitivity factor for the individual • Dietitians play a crucial role in the pump service in teaching carbohydrate counting, preventing weight gain, treating and avoiding hypoglycaemia, and promoting healthy eating • CSII is typically started as an outpatient; education and training are vital

Chapter.  5374 words.  Illustrated.

Subjects: Endocrinology and Diabetes

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