Adjusting insulin when using an insulin pumpAAdjusting insulin when using an insulin pumpAdjusting insulin when using an insulin pumpEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+) CaregiversNA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Jennifer Harrington​, MBBS, PhD​Flat ContentHealth A-Z<p>Find out how to adjust your child's insulin doses at home when using a pump.</p><p>Adjusting insulin when using an insulin pump follows the same rules as when on insulin injections. You will also be looking for patterns in blood sugar levels that fall outside your target range at the same time of the day. Remember that when adjusting insulin doses based on patterns, you are trying to prevent the problem with blood sugar level rather than correcting it afterward.</p><h2>Key points</h2><ul><li>When using an insulin pump, look for patterns in blood sugar levels that fall outside your target range at a specific time, and adjust accordingly.</li></ul>
Ajuster l’insuline quand une pompe est utiliséeAAjuster l’insuline quand une pompe est utiliséeAdjusting insulin when using an insulin pumpFrenchEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+) CaregiversNA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Jennifer Harrington​, MBBS, PhD​Flat ContentHealth A-Z

 

 

Adjusting insulin when using an insulin pump3022.00000000000Adjusting insulin when using an insulin pumpAdjusting insulin when using an insulin pumpAEnglishEndocrinologyChild (0-12 years);Teen (13-18 years)PancreasEndocrine systemDrug treatmentAdult (19+) CaregiversNA2016-10-17T04:00:00ZCatherine Pastor, RN, MN, HonBSc;Vanita Pais, RD, CDE;Jennifer Harrington​, MBBS, PhD​Flat ContentHealth A-Z<p>Find out how to adjust your child's insulin doses at home when using a pump.</p><p>Adjusting insulin when using an insulin pump follows the same rules as when on insulin injections. You will also be looking for patterns in blood sugar levels that fall outside your target range at the same time of the day. Remember that when adjusting insulin doses based on patterns, you are trying to prevent the problem with blood sugar level rather than correcting it afterward.</p><h2>Key points</h2><ul><li>When using an insulin pump, look for patterns in blood sugar levels that fall outside your target range at a specific time, and adjust accordingly.</li></ul><p>These are the pattern rules you should follow when adjusting insulin doses when using an insulin pump:</p><ul><li> <strong>High blood sugar levels</strong> for three days in a row at the same time of the day; <strong>increase</strong> insulin dose.</li><li> <strong>Low blood sugar levels</strong> for two days in a row at the same time of the day; <strong>decrease</strong> insulin dose.</li></ul><h3>Adjusting bolus doses on an insulin pump using the insulin-to-carbohydrate ratio</h3><p>The I:C is the amount of carbohydrates (in grams) that one unit of rapid-acting insulin makes available to the body cells to consume. The I:C tells you how much rapid-acting insulin your child needs to cover a certain amount of eaten carbohydrates. Each child has a specific I:C that your dietitian will help you determine. The I:C is expressed as 1 unit: X grams of carbohydrates.</p><p>For example an I:C of 1:10 means that 1 unit of insulin makes 10 grams of carbohydrates consumed. Each child has a specific I:C that your dietitian will help you determine.</p><p>The blood sugar checks at two hours and four hours after a meal tell us how well the bolus for that meal worked. The bolus doses are working if the pre-meal blood sugar levels are within the target range.</p><table class="akh-table"><thead><tr><th scope="colgroup" colspan="2">Insulin-to-carbohydrate ratio (I:C) adjustment</th></tr><tr><th style="width:293px;">Current I:C <br>(unit of insulin : gram(s) of carbohydrates)<br></th><th>Increase or decrease the insulin to carbohydrate ratio by</th></tr></thead><tbody><tr><td style="width:293px;">From 1:1 to 1:15</td><td>1 gram of carbohydrates</td></tr><tr><td style="width:293px;">From 1:15 to 1:25</td><td>2 grams of carbohydrates</td></tr><tr><td style="width:293px;">More than 1:25</td><td>3 grams of carbohydrates</td></tr></tbody></table><p>To know when to increase or decrease, please see <em>Adjusting for high blood sugar levels</em> and <em>Adjusting for low blood sugar levels</em>.</p><h3>Basal rate adjustment</h3><p>Blood sugar levels checked more than four hours after a bolus usually tells how well the basal rate was working in the previous hours.</p> <table class="akh-table"><thead><tr><th scope="colgroup" colspan="2">Basal rate adjustment</th></tr><tr><th style="width:237px;">Current basal rate <br>(units of insulin/hour)</th><th>Increase or decrease the basal amount by <br>(units of insulin/hour)</th></tr></thead><tbody><tr><td style="width:237px;">Less than 0.3 </td><td>0.025</td></tr><tr><td style="width:237px;">0.3–0.5</td><td>0.05</td></tr><tr><td style="width:237px;">0.5–2</td><td>0.1 </td></tr></tbody></table><p>To know when to increase or decrease, please see <em>Adjusting for high blood sugar levels</em> and <em>Adjusting for low blood sugar levels</em> below.</p><h3 id="topic7">Adjusting for high blood sugar levels</h3><table class="akh-table"><thead><tr><th scope="colgroup" colspan="3">Adjusting for <u>high</u> blood sugar level checked 2 to 4 hours after a previous bolus using an insulin pump</th></tr><tr><th style="width:277px;">Situation: <br>Blood sugar level is <u>high</u> three days in a row</th><th style="width:347px;">Action:</th><th style="width:450px;">Example:</th></tr></thead><tbody><tr><td style="width:277px;">before breakfast </td><td style="width:347px;"> <strong>Increase</strong> the basal insulin amount four hours before breakfast</td><td style="width:450px;">If your child’s basal insulin amount is 0.4 units/hour, set the basal rate to 0.45 units/hour at 4 a.m. if breakfast is at 8 a.m.</td></tr><tr><td style="width:277px;">before lunch</td><td style="width:347px;"> <strong>Decrease</strong> the insulin-to-carbohydrate ratio (I:C) for breakfast</td><td style="width:450px;">If your child’s I:C is 1:10 (1 unit of insulin: 10 grams of carbohydrates), decrease the ratio to 1:9 specifically for breakfast</td></tr><tr><td style="width:277px;">before dinner</td><td style="width:347px;"> <strong>Decrease</strong> the I:C for lunch</td><td style="width:450px;">If your child’s I:C is 1: 10 (1 unit of insulin: 10 grams of carbohydrates), decrease the ratio to 1:9 specifically for lunch</td></tr><tr><td style="width:277px;">before bedtime</td><td style="width:347px;"> <strong>Decrease</strong> the I:C for dinner</td><td style="width:450px;">If your child’s I:C is 1:10 (1 unit of insulin: 10 grams of carbohydrates), decrease the ratio to 1:9 specifically for dinner</td></tr><tr><td style="width:277px;">2 to 4 hours after bedtime snack</td><td style="width:347px;"> <strong>Decrease</strong> the I:C for the bedtime snack</td><td style="width:450px;">If your child’s I:C is 1:10 (1 unit of insulin: 10 grams of carbohydrates), decrease the ratio to 1:9 specifically for the bedtime snack</td></tr></tbody></table><h3 id="topic8">Adjusting for low blood sugar levels</h3><table class="akh-table"><thead><tr><th colspan="3">Adjusting for <u>low</u> blood sugar levels checked 2 to 4 hours after a previous bolus using an insulin pump</th></tr><tr><th style="width:278px;">Situation: <br>Blood sugar level is <u>low</u> two days in a row</th><th>Action:</th><th style="width:438px;">Example:</th></tr></thead><tbody><tr><td style="width:278px;">before breakfast </td><td> <strong>Decrease</strong> the basal insulin 4 hours before breakfast.<br></td><td style="width:438px;">If your child’s basal insulin amount is 0.4 units/hour, set the pump to release 0.35 units/hour at 4 a.m. if breakfast is at 8 a.m.</td></tr><tr><td style="width:278px;">before lunch</td><td> <strong>Increase</strong> the insulin-to-carbohydrate ratio (I:C) for breakfast</td><td style="width:438px;">If your child’s I:C is 1:10 (1 unit of insulin: 20 grams of carbohydrates), increase the ratio to 1:22 specifically for breakfast</td></tr><tr><td style="width:278px;">before dinner</td><td> <strong>Increase</strong> the I:C for lunch.</td><td style="width:438px;">If your child’s I:C is 1:10 (1 unit of insulin: 20 grams of carbohydrates), increase the ratio to 1:22 specifically for lunch</td></tr><tr><td style="width:278px;">before bedtime</td><td> <strong>Increase</strong> the I:C for dinner</td><td style="width:438px;">If your child’s I:C is 1:10 (1 unit of insulin: 20 grams of carbohydrates), increase the ratio to 1:22 specifically for dinner</td></tr><tr><td style="width:278px;">2 to 4 hours after bedtime snack</td><td> <strong>Increase</strong> the I:C for the bedtime snack</td><td style="width:438px;">If your child’s I:C is 1:10 (1 unit of insulin: 20 grams of carbohydrates), increase the ratio to 1:22 specifically for the bedtime snack</td></tr></tbody></table>Adjusting insulin when using an insulin pump

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