Sick days and insulin pumpsSSick days and insulin pumpsSick days and insulin pumpsEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemNAAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>If you child has an insulin pump, find out how to make sure they are getting enough insulin while they are sick.<br></p><p> <a href="/Article?contentid=1733&language=English">Insulin pump users</a>, just like those who receive insulin by injection, will have to take extra care during periods of illness to ensure neither <a href="/Article?contentid=1723&language=English">"low blood sugar" episodes</a> (hypoglycemia) nor <a href="/Article?contentid=1727&language=English">diabetic ketoacidosis</a> (DKA) develops. If your child uses a pump to deliver insulin, first make sure the <a href="/Article?contentid=1733&language=English">pump is working</a>. The illness could be caused by the pump not working properly.<br></p><h2>Key points</h2><ul><li>Make sure the insulin pump is working properly, as the illness could be caused by a malfunctioning pump.</li><li>You will need to determine the total daily dose of insulin to figure out how much more or less bolus of rapid-acting insulin to give.</li><li>To know how much total insulin your child received through the basal dose and bolus doses, check the memory of your child’s pump .</li><li>If your child is on an insulin pump and vomits more than twice within a four-hour period, contact your diabetes team immediately for advice.<br></li></ul>
Journées de maladie et pompes à insulineJJournées de maladie et pompes à insulineSick days and insulin pumpsFrenchEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemNAAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>Si vous enfant possède une pompe à insuline, apprenez à faire en sorte qu’il reçoive assez d’insuline pendant sa maladie.<br></p><p> <a href="/Article?contentid=1733&language=French">Les utilisateurs de pompe à insuline</a>, tout comme ceux qui reçoivent l’insuline par injection, doivent porter une attention particulière à leurs soins pendant une maladie afin de prévenir l’apparition d’une <a href="/Article?contentid=1723&language=French">hypoglycémie</a> ou d’une <a href="/Article?contentid=1727&language=French">acidocétose diabétique</a>. Si votre enfant utilise une <a href="/Article?contentid=1733&language=French">pompe pour recevoir l’insuline</a>, assurez-vous d’abord qu’elle fonctionne. La maladie pourrait être causée par un mauvais fonctionnement de la pompe.<br></p><h2>À retenir</h2><ul><li>Assurez-vous que la pompe à insuline de votre enfant fonctionne bien, car sa maladie pourrait être causée par un mauvais fonctionnement.</li><li>Vous devrez déterminer la dose quotidienne totale d’insuline pour connaître la quantité de bolus d’insuline à action rapide à administrer.<br></li><li>Pour savoir combien votre enfant a reçu d’insuline au total, avec la dose basale et les bolus, vérifiez la mémoire de sa pompe.</li><li>Si votre enfant utilise une pompe à insuline et qu’il vomit plus de deux fois sur une période de quatre heures, demandez immédiatement conseil à votre équipe de soins de santé du diabète.</li></ul>

 

 

Sick days and insulin pumps1752.00000000000Sick days and insulin pumpsSick days and insulin pumpsSEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemNAAdult (19+)NA2016-10-17T04:00:00ZCatherine Pastor RN, MN, HonBSc;Vanita Pais RD, CDE;​​Sanjukta Basak MSc, MD CM, FRCPC;​​Ruth Slater Ph.D., C. Psych​000Flat ContentHealth A-Z<p>If you child has an insulin pump, find out how to make sure they are getting enough insulin while they are sick.<br></p><p> <a href="/Article?contentid=1733&language=English">Insulin pump users</a>, just like those who receive insulin by injection, will have to take extra care during periods of illness to ensure neither <a href="/Article?contentid=1723&language=English">"low blood sugar" episodes</a> (hypoglycemia) nor <a href="/Article?contentid=1727&language=English">diabetic ketoacidosis</a> (DKA) develops. If your child uses a pump to deliver insulin, first make sure the <a href="/Article?contentid=1733&language=English">pump is working</a>. The illness could be caused by the pump not working properly.<br></p><h2>Key points</h2><ul><li>Make sure the insulin pump is working properly, as the illness could be caused by a malfunctioning pump.</li><li>You will need to determine the total daily dose of insulin to figure out how much more or less bolus of rapid-acting insulin to give.</li><li>To know how much total insulin your child received through the basal dose and bolus doses, check the memory of your child’s pump .</li><li>If your child is on an insulin pump and vomits more than twice within a four-hour period, contact your diabetes team immediately for advice.<br></li></ul><p>Once you are certain that your pump is working properly, check your child’s blood glucose (sugar) and urine ketone levels at least every four hours around the clock.<br></p><p>To figure out how much more or less bolus of <a href="/Article?contentid=1729&language=English">rapid-acting insulin</a> to give, add up the <a href="/article?contentid=1751&language=English">TDD</a> of insulin and follow the chart below. You can find the TDD information in the pump's memory.</p><h2>Calculating the total daily dose</h2><p>The TDD is the basal dose plus the bolus dose. To know how much total insulin your child received through the basal dose and bolus doses, check the memory of your child’s pump and look at the amounts of the past few days before the illness started.</p><p>If food is being eaten at this time, the correction dose (10-20% of the TDD) will have to be added to the amount of bolus insulin suggested by the pump to account for the <a href="/article?contentid=1742&language=English">carbohydrates</a> consumed. During illness, the usual correction dose (the dose suggested by the pump) of rapid-acting insulin may not be enough and additional boluses equal to 10-20% of the TDD may be necessary.</p><p> <strong>Important: In this situation you should not use the bolus dose that the insulin pump suggests but rather calculate and give the bolus based on the TDD.</strong></p><p>For an illness during which there are consistently high blood sugar levels, the basal rate may also need to be temporarily increased. Start with an increase of 20%; depending on the results, you may need to make further increases. Please consult your diabetes​ team.</p><p>Always treat vomiting along with high blood sugar levels and urinary ketones as a <a href="/Article?contentid=1733&language=English">pump failure</a> until proven otherwise. Discontinue the pump immediately, ensure to rule out mechanical problems and perform a full infusion set change. In the meantime, use a pen or syringe to inject rapid-acting insulin equal to the amount of 10–20% of the total daily dose (basal plus bolus insulin).</p><p>Remember that children using pumps may get high blood sugar levels and DKA more quickly than those receiving injections because they do not have any <a href="/Article?contentid=1729&language=English">long-acting insulin​</a> in their body.</p><p>If your child is on an insulin pump and vomits more than twice within a four-hour period, contact your diabetes team immediately for advice, as you may need to go to the closest emergency room. Check the blood sugar and ketone levels at least every four hours and consult this chart to take recommended action.</p><table class="akh-table"><thead><tr><th colspan="4">Illness scenarios and action steps with insulin pumps</th></tr><tr><th style="width:193px;">Blood sugar level (mmol/L)</th><th style="width:190px;">Blood ketone level (mmol/L)</th><th>Urinary ketone level</th><th style="width:753px;">Action to take with the insulin pump</th></tr></thead><tbody><tr><td style="width:193px;">>3.9</td><td style="width:190px;">Any amount</td><td>Negative or positive (any amount)</td><td style="width:753px;">Decrease pre-meal bolus dose and/or program a lower temporary basal rate by 20–50% to maintain blood sugar levels in the 6–10 mmol/L range. If vomiting, contact your diabetes nurse or the on-call doctor, and consider mini-dose glucagon.</td></tr><tr><td style="width:193px;">4.0 - 14</td><td style="width:190px;">0 – 1.5</td><td>Negative or positive (any amount)</td><td style="width:753px;">Take usual insulin dose (same as for non-sick day).</td></tr><tr><td style="width:193px;">>14</td><td style="width:190px;">0 – 1.5</td><td>Negative to small (if your ketone strips follow the plus [+] scale, then negative or 1+ fall under this category)</td><td style="width:753px;">Take 10% of TDD now, in addition to dose needed for carbohydrate intake.</td></tr><tr><td style="width:193px;">>14</td><td style="width:190px;">1.5 – 3.0</td><td>Moderate to large (if your ketone strips follow the plus [+] scale, then 2+ or 3+ fall under this category)</td><td style="width:753px;">Take 20% of TDD now, in addition to the dose needed for carbohydrate.</td></tr></tbody></table> ​​Sick days and insulin pumps

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