Chapter 4 The pump life
Siobhan Pender and
John Pickup
- • Exercise-induced hypoglycaemia can be avoided during insulin pump therapy by taking extra carbohydrate, by reducing the bolus insulin (if exercise is within 2 hours of a meal), or by reducing the basal rate (for prolonged and/or intense exercise). Patients should not exercise if the blood glucose is greater than about 15mmol/L and there are ketones
- • Bathing or showering is best done whilst the pump is temporarily disconnected from the infusion set, but waterproof pump cases can be used or the pump set on the bath side
- • Pump use does not disturb sleep—it can be placed in the bed, on a bedside table, or worn
- • Patients may chose to either wear the pump or disconnect it during sexual intimacy
- • Pump rests for a few hours and are useful for sunbathing, sports, and medical procedures
- • Insulin requirements often increase before menstruation, and the basal insulin rate should be increased at this time. A few women suffer hypoglycaemia, when the basal rate should be reduced
- • Simple ‘sick-day rules’ are important for those on continuous subcutaneous insulin infusion (CSII); insulin requirements usually increase during illness; guidelines are available for continuing CSII as an inpatient
- • Troubleshooting guides in the event of unexpected hypo- and hyperglycaemia on CSII are useful to detect problems and maintain strict glycaemic control
