Getting the Most Out of Your Pump

Below are some best practices for using your pump.

Frequently Asked Questions

Methods to reduce post-meal Blood sugar spikes

  • Test 15-20 minutes prior to bolusing and enter the accurate glucose reading into the pump!
  • Bolus for carbs 15-20 minutes prior to eating. This is the most effective way of preventing a glucose spike!
  • Give the first bolus time to work before eating more carbs! Wait at least 2-3 hours between meals and snacks.
  • If pre-meal glucose is elevated, decrease the carb amount in the meal.
  • Most carbs raise the BG far more quickly than "rapid" insulin can lower it.
  • Since 100% of carbohydrates convert to glucose after 15 minutes to 2 hours, we focus on them in controlling glucose levels.
  • Eating healthy carbs that are non-processed, made out of whole grains, or have more fiber content, will result in less glucose spiking.
  • These foods take a longer time to digest, keep us full for longer, provide many more vitamins and minerals and tend to be lower in calories.
  • The less processed the food is, the healthier it is! You will see a difference in the blood sugars.

Adjusting Basal Rates

  • Basal rate changes are most likely needed if blood sugars are remaining high or low in patterns.
  • Consider making a small change in basal pattern.
  • Change the basal rate that begins 1-2 hours before the blood sugar change is seen.
  • Watch and see how effective that change was before making another one.
  • Ideally, 50% of total daily insulin is from basal rate and 50% is from boluses (meal and correction boluses).

Food Effects and Charting

  • Consider charting for 1-2 weeks to see how various foods affect your BGs.
  • Be as specific as possible – include name of food, amount of carbs, serving size, specifics of bolus used.
  • Test BG before eating, 2hrs and 4hrs after eating to see the food effect.
  • Most people eat a small number of foods over and over again.
  • You will benefit from knowing what effect your favorite foods have on your BGs.

Special Boluses (Dual-wave or Combination)

  • This type of bolus allows you to deliver part of the insulin immediately and the remainder of the bolus spread out over time.
  • Enough insulin can be given for more rapidly absorbed carbs and the rest can be spread out to cover carbs and fat that are absorbed in several hours.
  • Foods that are ideal for this type of bolus are: pizza, lasagna, fried foods and high fat Chinese food.
  • A portion is delivered immediately (normal bolus) and another portion is delivered gradually (square wave bolus).
  • The initial 1-hour peak occurs but is diminished.
  • There is a second delayed/blunted peak and a longer duration of action.
  • Pizza or Chinese Food= 90 grams total.
  • 40 % of bolus now.
  • 60 % spread out over 4-6 hours.
  • The pump does the math.

Temporary Basal Rates

  • Temporary basal rates are very useful tools in adjusting the basal rate to provide more or less insulin over a period of time.
  • High blood sugar with ketones
  • Illness with high or low blood sugars
  • Pre or post exercise
  • Travel
  • Hypoglycemia