INSULIN PUMP THERAPY NAPNN Fall Conference 9/10/2016 OBJECTIVES HOW TO DETERMINE IF SOMEONE HAS DIABETES WHAT IS DIABETES
|
|
- Giles Davis
- 7 years ago
- Views:
Transcription
1 OBJECTIVES INSULIN PUMP THERAPY BY THE DIABETES TEAM AT ASPIRUS KEWEENAW HOSPITAL DEBORAH GRUVER, MSN, FNP-BC, JENNIFER PEAVEY, RN, DE, CPT, CATHY TASKILA, MA Define Diabetes. Decide who should use an insulin pump. Define what an insulin pump is. Detail how insulin pumps are set up. Describe the different kinds of insulin that can be used in the insulin pump Define data collection and interpretation of the insulin pump Define basic steps to adjust CareLink report to obtain therapeutic blood sugar control Learn how the insulin pump is inserted and applied to patient Learn how Continuous Glucose Monitor is used in outpatient setting WHAT IS DIABETES HOW TO DETERMINE IF SOMEONE HAS DIABETES Type 2 is when the bodies ability to produce or respond to the hormone insulin is impaired. It is a combination of resistance to the action of insulin and insufficient insulin production. Type 1 occurs when the body loses its ability to make insulin Glycated Hemoglobin A1C of 6.5% or greater indicates diabetes Two fasting blood tests greater than 126 indicates diabetes A random blood test greater than 200 indicated diabetes (Healthy People 2020, 2016). (American Diabetes Association, 2016) WHAT IS AN INSULIN PUMP? WHAT IS AN INSULIN PUMP? Automated device that allows the user to input specific information and make corrections in dosing of insulin. Decreases the need to mathematically calculate insulin doses Decreases the risk of stacking insulin Decreasing the frequent daily injections Allows for specific plans based on food intake, activity, sick days, and sleep (American Diabetes Association, 2016) Allows for the release of small doses of rapid acting or fast acting insulin 24 hours per day (basal rates) Allows several different basal times to accommodate the users needs Allows for larger rates of insulin to be released for meal coverage (bolus rates) Use of bolus wizard to help the computer figure out the correct insulin requirements based on blood sugar number correction and food intake coverage (American Diabetes Association, 2016) 1
2 WHAT IS AN INSULIN PUMP? AUDIENCE QUESTIONS Before we start the section who has used an insulin pump? Who works with insulin on a regular basis? What are your expectations for us? DEBORAH WILL DISCUSS WHO SHOULD USE AN INSULIN PUMP Someone that tests their blood sugars at least 4 times daily Someone that has blood sugars that fluctuate daily or even weekly Someone that doesn t eat on a regular basis Someone that wants better control of food coverage and blood sugar number coverage Someone that has a flexible life style and work schedule HOW ARE INSULIN PUMPS SET UP? Jennifer Peavy, RN, DE, CPT will present this section INSULIN PUMP INITIATION SETTINGS FINDING THE TOTAL DAILY DOSE Pump Total Daily Dose Basal Rate Insulin-To-Carb Ratio Insulin Sensitivity Factor Max Basal Rate Max Bolus Rate Active Insulin BG Target Ranges (day and night) Reduced Injection Dose: TDD x 0.75= reduced dose Weight Dose: Weight x 0.23 units= weight dose Pump TDD: Reduced Dose + Weight Dose/2=Pump TDD Example 2
3 FINDING BASAL RATES FINDING TOTAL DAILY BOLUS UNITS, ICR, AND ISF Total Daily Basal: Pump TDD x 50% = Total Daily Basal (units/day) Initial Basal Rate: Total Daily Basal/24 hours= Initial Basal Rate (start time 12am) Example Total Daily Bolus Units: Pump TDD-Total Daily Basal= Total Daily Bolus (units per day) ICR (450 Rule): 450/Pump TDD= ICR (units/day) ISF (1700 Rule): 1700/Pump TDD= ISF(grams/units) ACTIVE INSULIN AND BG TARGET RANGES DIFFERENT INSULIN USED IN AN INSULIN PUMP Active Insulin: Definition Adults 4-5 hours, Children 3-4 hours BG Target Ranges Day Night Patient Specific Rapid Acting Insulin Humalog Novolog Short Acting Insulin Humulin RU 100 Humulin RU 500 (off label) DATA COLLECTION OF INSULIN PUMP FIRST OFFICE VISIT AFTER PUMP APPLIED Open insulin pump icon (downloaded on your hard drive) We use Medtronic, Omnipod and Animas. Open patient, click on devise meter first then download the blood sugar readings. Click on devise pump second. Click on reports Select dates you want to run the reports on (I try to do the last month) Generate reports and print to color printer for best results DEBORAH WILL REVIEW OF DATA FROM REPORT Next 6 slides based off a patient that comes to our Diabetes Clinic She started the insulin pump about 18 months ago She is elderly in her 80 s Prior to the insulin pump she was having a lot of highs and lows Starting hemoglobin A1C 10% Last hemoglobin A1C 7.2% 1am: 0.7 units/hr ; 3:30 am: 1.1 units/hr ; 8am: 2.4 units/hr ; 11 am: 2.2 units/hr 1:30pm: 1.2 units/hr ; 3 pm: 1.4 units/hr ; 4 pm: 1.8 units/hr ; 7 pm: 2.20 units/hr 3
4 4
5 QUESTIONS ADJUST BASAL SETTINGS FROM REPORT What are some questions billing, safety, pain, supplies, etc. Medicare requirements Commercial insurance different Go through the report with the patient and discuss each page together Always review the basal review together to make sure the rates didn t change Include patient s basal rates before the visit and after the visit. In this patient consider not using blood sugar from 1 hour prior and rechecking blood sugar again Consider lowering night basal rate to bring up morning blood sugars to avoid hypoglycemia Check more blood sugars are night to avoid going into the night low. We recommend patients not giving a bolus after 9 pm. WHEN TO ADJUST CARB RATIO WHEN TO ADJUST THE SENSITIVITY LEVEL Adjust if 2 hour after blood sugars are high more than 50 points higher than the starting blood sugar number Any adjustments will affect all meals if it is only one meal can adjust the basal rate for that time frame or add a different sensitivity level during that time frame Calculate insulin dose for food: 45 carbs divided by 15 or 500 rule (type 1) = 3 units This is adjustable based on their needs rapid acting if not on a pump Different times of day the sensitivity may vary. This level is the amount your blood sugar will drop on one 1 unit insulin. The insulin pump can be set with 8 different sensitivity levels per day. Our patient has her set at 35. To figure out the math for this add up four days of total insulin divide by either 1500 or It varies depending on the insulin you are on. For example Average insulin used daily divided by 40 = 45 units. For every 1 unit of insulin her blood sugar will drop by 45. HOW THE INSULIN PUMP COVERS FOOD AND BLOOD SUGAR READING Calculate insulin dose for food: 45 carbs divided by 15 or 500 rule (type 1) = 3 units Calculate blood sugar coverage: Current BS# - Target divided by Insulin Sensitivity = correction dose Example divided by 35 = 1.7 units Combine the 2 insulin totals = 4.7 DEMONSTRATION OF INSULIN PUMP INSERTION Jennifer Peavy will demonstrate the set up on a live model. 5
6 RESERVOIR AND SET UP MENU INSULIN PUMP INSERTION Fill Reservoir with insulin Reservoir Set Up on Pump Menu Fill tubing Fill Cannula Pick Insertion Site (always rotate) Clean Skin Use the Quick Serter (re-usable) Use Disposable Infusion Set (MIO) (REMEMBER NO CIRCLE ON HOME SCREEN=INSULIN DELIVERY ) QUESTIONS CONTINUOUS GLUCOSE MONITOR Model walks around and shows everyone What are some questions pain, sleeping, showers, reimbursement, etc. Bill as office visit minutes must include greater than 50% of time on counseling and education. We have worked with Medtronic and Dexcom. There are two types a real time and intermittent. Today we will only discuss the intermittent. Benefits of continuous glucose monitoring include identifying shifting blood sugar numbers, how long the fluctuating blood sugars last, when they occur (what time of day), and which direction they occur high or low blood sugars. measure blood glucose with minimal invasiveness through continuous measurement of interstitial fluid (ISF) After a warm-up period of up to 2 h initialization) and a device-specific calibration process, each device s sensor will provide a blood glucose reading every 1 10 min for up to 72 h with the minimally invasive technology CONTINUOUS GLUCOSE MONITOR CONTINUOUS GLUCOSE MONITOR REPORT This discussion is only on the one you wear for 3 to 4 days. Why do you want to order one of these tests? Varying blood sugars Patient doesn t check their blood sugars (Talk about patient NA) Hemoglobin A1C doesn t match up meter blood sugars Any other reasons? Male patient in late 50 s new to the clinic Fluctuating blood sugars Hemoglobin A1C 7.4% What are is medications: Diabeta 2.5 mg 1 tab at breakfast and 3 tabs at supper Glucophage 500 mg 1 tab at breakfast and 1 tab at supper 6
7 WEARING THE CGM Must check blood sugars 4 times daily before meals and bedtime Record food and activity Record insulin injection times Don t change their life style 7
8 FOOD LOG Saturday: Blood sugar 930 am 146 ate 11 am food 3 glasses of Pepsi 1 bowl of cream of wheat 1137 banana and milk plus more Pepsi biked 22 miles Blood sugar 522 pm 119 Blood sugar 1030 pm 220 ate cheeseburger, fries, and 2 cokes Diet affects blood sugars high fat high sugars/ weird swings What insulin would you use? What would you avoid? Blood sugar average looks good but it is not showing all of the highs and lows WHAT DID WE DO FOR HIM WHAT WE DID FOR THE PATIENT What would all of you do? Plan is somewhat difficult because of the major difference in his blood sugars during the week and weekend. On the Weekends half dose the Diabeta at Breakfast and Supper. During the week keep your Diabeta the same dose. Start Januvia 100 mg 1 tab per day (completed the patient discount card) Continue Metformin one tab at breakfast and half tab at supper. (decreased the dose his LFT's are elevated history of fatty liver). Cut back on Pepsi. Check blood sugars before a meal, then 2 hours after the meal. QUESTIONS REFERENCES What questions do you have? What did you learn today? American Diabetes Association. (2016). Diagnosing diabetes and learning about prediabetes. Retrieved from American Diabetes Association. (2016). Continuous glucose monitoring. Retrieved from BD. (2016). How to calculate your insulin sensitivity. Retrieved from Healthy People (2016). Diabetes. Retrieved from 8
9 CONTACTS Our phone number at the clinic s address: 9
Insulin Pump Management and Continuous Glucose Monitoring Systems (CGMS)
Insulin Pump Management and Continuous Glucose Monitoring Systems (CGMS) Faith Daily, RN, BSN, CDE, CPT Certified Diabetes Educator/Insulin Pump Trainer August 16, 2014 Why Pump Therapy? Mimics normal
More informationChallenges in Glycemic Control in Adult and Geriatric Patients. Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner
Challenges in Glycemic Control in Adult and Geriatric Patients Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner Provide an overview of diabetes prevalence; discuss challenges and barriers
More informationInsulin/Diabetes Calculations
Insulin/Diabetes Calculations Dr. Aipoalani St Lukes Endocrinology Goals Describe various calculations for insulin dosing Understand importance of the total daily dose (TDD) of insulin Be able to calculate
More informationInsulin Dose Adjustment REAL-Time CGMS Guidelines for Subjects on Pump Therapy
Insulin Dose Adjustment REAL-Time CGMS Guidelines for Subjects on Pump Therapy In addition to using the blood sugar logs to adjust your insulin doses every week, you should also use your continuous glucose
More informationBasal and Bolus Insulin 7/16/2014. Jackie Aday RN, BSN, CDE Jeni Neighbors RN, BSN, CDE. BASAL: Small amount of insulin infused every few minutes
Jackie Aday RN, BSN, CDE Jeni Neighbors RN, BSN, CDE Insulin Pump Therapy Open looped system in which a small amount of insulin is continuously infused through a cannula or needle (basal rate) Larger doses
More informationA Reference Guide for School Nurses. with the Medtronic MiniMed Insulin Pump
A Reference Guide for School Nurses with the Medtronic MiniMed Insulin Pump Table Of Contents I Table of Contents The Medtronic MiniMed Insulin Pump A Reference Guide for School Nurses For the 522, 722,
More informationHow To Manage Diabetes
INSULIN PUMPS PHYSIOLOGIC INSULIN SECRETION Daniel L. Metzger, MD, FAAP, FRCPC INSULIN PUMP INFUSION SETS BOLUS BASAL Breakfast Bed Dinner Snack Lunch Breakfast BRANDS OF PUMPS ADVANTAGES I ANIMAS MINIMED
More informationLet s Talk About Meters and Meds. Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014
Let s Talk About Meters and Meds Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014 How to monitor diabetes control: Hemoglobin A 1 C, or just A 1
More informationDesktop Guidelines for Insulin Adjustment
Desktop Guidelines for Insulin Adjustment Disclaimer and terms of use: This document and workshop (the Material ) has been prepared for informational and training purposes for employees of the Endocrinology
More informationThe Diabetes Self Management Insulin Pump Therapy Program
The Diabetes Self Management Insulin Pump Therapy Program Is part of a Nationally recognized program taught by CPT s Offers classes during the daytime in a three part series: PRE-PUMP CLASS SALINE START
More informationWhy is Insulin so Important?
Insulin Therapy Why is Insulin so Important? If the glucose stays in your blood it doesn t do your cells (body) any good The glucose has to get inside the cells for the body to use it What Does Insulin
More informationSmart Pumping with Insulin Pumps
Smart Pumping with Insulin Pumps Rita Ketay RN, CDE, Ed.M, BC-ADM Dartmouth Hitchcock Medical Center During this discussion we will: * Review the DCCT recommendations; * Define smart pumping ; * Discuss
More informationGet Primed on Pumps: A beginners guide to Insulin Pump Therapy
Get Primed on Pumps: A beginners guide to Insulin Pump Therapy Advantages of insulin pump therapy There are many advantages to using an insulin pump. Anyone can do it with the right training and support.
More informationTaking Insulin Pumps to School. Rachel Calendo, MS, RN, CPNP, CDE, Martha Cuevas, RN, BSN, CPT
Taking Insulin Pumps to School Rachel Calendo, MS, RN, CPNP, CDE, Martha Cuevas, RN, BSN, CPT Insulin Pumps Today A micro-computer, about the size of a pager Programmed to deliver both a preset amount
More informationBOLUS INSULIN DOSAGES H. Peter Chase, MD and Erin Cobry, BS
CHAPTER 6: BOLUS INSULIN DOSAGES H. Peter Chase, MD and Erin Cobry, BS WHAT IS BOLUS INSULIN? Bolus insulin dosages refer to the quick bursts of insulin given to cover the carbohydrates in meals or snacks
More informationDiabetes. New Trends Presented by Barbara Obst RN MS August 2008
Diabetes New Trends Presented by Barbara Obst RN MS August 2008 What is Diabetes Diabetes is a condition characterized by high levels of glucose. The glucose circulates in your blood and serves as the
More informationInsulin Initiation and Intensification
Insulin Initiation and Intensification ANDREW S. RHINEHART, MD, FACP, CDE MEDICAL DIRECTOR AND DIABETOLOGIST JOHNSTON MEMORIAL DIABETES CARE CENTER Objectives Understand the pharmacodynamics and pharmacokinetics
More informationAlternative method for delivering insulin using continuous subcutaneous insulin infusion (CSII) open loop system
ISHP Spring CE Conference April 12, 2015 St. Luke s Medical Center Randi Lynn Griffiths, PharmD Clinical outpatient pharmacist Boise VA Medical Center Boise, Idaho Alternative method for delivering insulin
More informationDiabetes Self Management Training Insulin Pump Follow Up
701 East Marshall Street, West Chester, PA 19380 www.chestercountyhospital.org 610.431.5000 Diabetes Self Management Training Insulin Pump Follow Up Patient Name: Visit Date: Time: To prepare for your
More informationBlood Sugar and How to Manage It
PO Box 70735, SW Station Washington, DC 20024-0735 800-717-0060 office / 202-889-0502 fax Young Marines Diabetes Care Plan Child s Name: Date of Birth: Age: Unit: Event: (Drill, Encampment, SPACES, NDSP,
More informationThe Basics of Insulin Pump Therapy
The Basics of Insulin Pump Therapy Table of Contents The Basics of Insulin Pump Therapy Introduction Welcome... 3 Chapter 1 Balancing Glucose and Insulin............................. 10 Section 1: Glucose,
More informationA Simplified Approach to Initiating Insulin. 4. Not meeting glycemic goals with oral hypoglycemic agents or
A Simplified Approach to Initiating Insulin When to Start Insulin: 1. Fasting plasma glucose (FPG) levels >250 mg/dl or 2. Glycated hemoglobin (A1C) >10% or 3. Random plasma glucose consistently >300 mg/dl
More information4/7/2015 CONFLICT OF INTEREST DISCLOSURE OBJECTIVES. Conflicts of Interest None Heather Rush. Heather M. Rush, APRN, CDE Louisville, KY
Heather M. Rush, APRN, CDE Louisville, KY CONFLICT OF INTEREST DISCLOSURE Conflicts of Interest None Heather Rush A conflict of interest exists when an individual is in a position to profit directly or
More informationI HAVE JUST BEEN DIAGNOSED WITH TYPE 1 DIABETES
Dominika In better control with her pump since 2012 I HAVE JUST BEEN DIAGNOSED WITH TYPE 1 DIABETES The diagnosis of Type 1 diabetes may come as a shock and may lead to many questions, such as: Why is
More informationAdvanced Carbohydrate Counting
Advanced Carbohydrate Counting Living Well with Your Health Conditions What is Carbohydrate Counting? Carbohydrate counting focuses on the amount of carbohydrate (carbs) in your diet. Carbohydrate is the
More informationBasal Rate Testing Blood sugar is affected at any time by 1) basal insulin 2) food (carbohydrate) intake 3) bolus insulin (meal time and correction)
Basal Rate Testing Blood sugar is affected at any time by 1) basal insulin 2) food (carbohydrate) intake 3) bolus insulin (meal time and correction) 4) activity and 5) other factors such as stress and
More informationStep-by-Step Patient Injection Guide
Step-by-Step Patient Injection Guide 1 Your step-by-step guide to injection. 3 Table of Contents How your insulin works... 1 o Definitions to review Insulin action curves... 2 o Rapid-acting insulin o
More informationFinally, the right fit for your insulin needs. www.tandemdiabetes.com
Finally, the right fit for your insulin needs. www.tandemdiabetes.com (Actual Size) For convenience and ease of use, the t:flex TM Insulin Pump just fits. It is designed to help make your day-to-day insulin
More informationCLASS OBJECTIVES. Describe the history of insulin discovery List types of insulin Define indications and dosages Review case studies
Insulins CLASS OBJECTIVES Describe the history of insulin discovery List types of insulin Define indications and dosages Review case studies INVENTION OF INSULIN 1921 The first stills used to make insulin
More informationDiabetes and Technology. Disclosures Certified Insulin Pump Trainer for: Animas Medtronic Diabetes Omnipod. Rebecca Ray, MSN, APRN, FNP-C
Diabetes and Technology Rebecca Ray, MSN, APRN, FNP-C Insulin Pump Therapy and Continuous Glucose Monitoring In Patients with Type 2 Diabetes Page 1 Disclosures Certified Insulin Pump Trainer for: Animas
More informationBASAL BOLUS INSULIN FOR MEDICAL- SURGICAL INPATIENTS
BASAL BOLUS INSULIN FOR MEDICAL- SURGICAL INPATIENTS C O N T A C T D I A B E T E S S E R V I C E S F O R M O R E I N F O R M A T I O N 8 4 7-9 1 7-6 9 0 7 THIS SLIDE PRESENTATION WAS PREPARED BY SUE DROGOS,
More informationcarb counting Participants will have a better understanding of:
carb counting Participants will have a better understanding of: The benefits of carbohydrate counting; What foods contain carbohydrate; How to count carbs using food labels, books and the LMC Carb Counting
More informationCalculating Insulin Dose
Calculating Insulin Dose First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This
More informationIs what you know about INSULIN PUMP THERAPY. This educational resource is provided by Medtronic MiniMed, Inc.
Is what you know about INSULIN PUMP THERAPY MYTH or? This educational resource is provided by Medtronic MiniMed, Inc. You have to know a lot about technology to learn to use a pump Interacting with your
More informationIntroduction. We hope this guide will aide you and your staff in creating a safe and supportive environment for your students challenged by diabetes.
Introduction Diabetes is a chronic disease that affects the body s ability to metabolize food. The body converts much of the food we eat into glucose, the body s main source of energy. Glucose is carried
More informationInsulin Pens & Improving Patient Adherence
Insulin Pens & Improving Patient Adherence Bonnie Pepon, RN, BSN, CDE Certified Diabetes Educator Conemaugh Diabetes Institute Kip Benko, MD FACEP Asst Clinical Professor University of Pittsburgh School
More informationGETTING THE MOST OUT OF YOUR CLINIC APPOINTMENT
GETTING THE MOST OUT OF YOUR CLINIC APPOINTMENT In preparation for your visit to the Diabetes Clinic, we have created this checklist which will help you get the most out of your clinic appointment. Have
More informationCarbohydrate Counting and Insulin. Diabetes Care Group www.diabetescaregrp.com
Carbohydrate Counting and Insulin Diabetes Care Group www.diabetescaregrp.com 1 Objectives State carbohydrate grams in commonly eaten foods Determine total carbohydrate grams using a nutrition label or
More informationBlood Sugar Log. Breakfast (daily) Before Lunch Before Dinner Bedtime
Blood Sugar Log Date Before Breakfast (daily) Before Lunch Before Dinner Bedtime DIABETES MANAGEMENT (HEMOGLOBIN A1c) Your Hemoglobin A1c is the blood test that tells your doctor how well you are managing
More informationResident s Guide to Inpatient Diabetes
Resident s Guide to Inpatient Diabetes 1. All patients with diabetes of ANY TYPE, regardless of reason for admission, must have a Hemoglobin A1C documented in the medical record within 24 hours of admission
More informationType 1 Diabetes Management Based on Glucose Intake www.utmem.edu/endocrinology click Patients (Revised 7/13/2007)
Type 1 Diabetes Management Based on Glucose Intake www.utmem.edu/endocrinology click Patients (Revised 7/13/2007) The following is a system of insulin therapy, diet management, and blood glucose monitoring
More informationYour Insulin Adjustment Workbook Yes, You Can Do It!
S T AY I N G O N T A R G E T TARGET THERAPY Staying on Target TM Your Insulin Adjustment Workbook Yes, You Can Do It! YES, YOU CAN DO IT! Your How-To Guide for Adjusting Basal and Bolus Insulin This workbook
More informationEquipment and Supplies Checklist for Parents Student: DOB: School: Grade: Equipment and Supplies to be Provided by Parent. Parent Signature Date
Equipment and Supplies Checklist for Parents Student: DOB: School: Grade: Equipment and Supplies to be Provided by Parent Parent Signature Date Daily Snacks (for AM/PM snack times): Specify: Extra Snacks
More informationOptimizing Insulin Therapy. Calculating Insulin to Carbohydrate Ratios and Correction/Sensitivity Factors
Optimizing Insulin Therapy Calculating Insulin to Carbohydrate Ratios and Correction/Sensitivity Factors Introduction Diabetes management, and particularly self-management, has come a long way. Unfortunately,
More informationOneTouch Reveal Web Application. User Manual for Patients Instructions for Use
OneTouch Reveal Web Application User Manual for Patients Instructions for Use Contents 2 Contents Chapter 1: Introduction...3 Product Overview...3 Intended Use...3 System Requirements... 3 Technical Support...3
More informationINPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco
INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco CLINICAL RECOGNITION Background: Appropriate inpatient glycemic
More informationAre you thinking about an insulin pump!
Are you thinking about an insulin pump! Information Session Montreal Children s Hospital Pediatric Insulin Pump Centre Anne Bossy, BSc(N), CDE Evelyne Pytka, PDt, CDE ARE YOU A GOOD CANDIDATE FOR AN INSULIN
More informationHealth Professional s. Guide to INSULIN PUMP THERAPY
Health Professional s Guide to INSULIN PUMP THERAPY Table of Contents Introduction Presenting Insulin Pump Therapy to Your Patients When Your Patient Chooses the Pump Estimates for Starting Insulin Pump
More informationUniversity Hospitals of Leicester NHS Trust. Carbohydrates. A guide to carbohydrate containing foods for people with diabetes
University Hospitals of Leicester NHS Trust Carbohydrates A guide to carbohydrate containing foods for people with diabetes This information is designed to help you to understand how carbohydrates affect
More informationIntensifying Insulin Therapy
Intensifying Insulin Therapy Rick Hess, PharmD, CDE, BC-ADM Associate Professor Gatton College of Pharmacy, Department of Pharmacy Practice East Tennessee State University Johnson City, Tennessee Learning
More informationTypes of insulin and How to Use Them
Diabetes and Insulin Pumps Amy S. Pullen Pharm.D ISHP Spring Meeting April 2012 Objectives Describe the different types of insulin used in diabetes Identify the types of insulin that are compatible with
More informationChapter 21 Adjusting the Insulin Dosage and Thinking Scales
Chapter 21 Adjusting the Insulin Dosage and Thinking Scales BLOOD SUGAR GOALS (suggested ranges) It is our general goal to have blood sugar levels in the ranges listed below (also see Chapter 7). These
More informationSick Day Management for People with Type 2 Diabetes Using Insulin
Sick Day Management for People with Type 2 Diabetes Using Insulin When you are sick, controlling your blood sugar (glucose) can be a challenge. Nausea, vomiting, illness and changes in eating will affect
More informationDiabetes and Your Kidneys
American Kidney Fund reaching out giving hope improving lives Diabetes and Your Kidneys reaching out giving hope improving lives Diabetes: The #1 Cause of Kidney Failure Your doctor told you that you have
More informationDiabetes: When To Treat With Insulin and Treatment Goals
Diabetes: When To Treat With Insulin and Treatment Goals Lanita. S. White, Pharm.D. Director, UAMS 12 th Street Health and Wellness Center Assistant Professor of Pharmacy Practice, UAMS College of Pharmacy
More informationMy Sick Day Plan for Type 1 Diabetes on an Insulin Pump
My Sick Day Plan for Type 1 Diabetes on an Insulin Pump When you are sick, your blood sugar levels may be harder to keep under control. Your blood sugar may go too high or too low. Use this guide to help
More informationOnset Peak Duration Comments
Rapid- Acting 5-15 minutes 0.5-3 hours 3-5 hours Meal should be available before administering, ideally taking within 10 minutes of eating). Good in refrigerator (36-46 F) until expiration date. Protect
More informationDiabetes and Exercise:
Diabetes and Exercise: The Great Blood Sugar Balancing Act By Gary Scheiner MS, CDE Last month, I saw two very different clients with two very similar problems. One was a 62 year-old man named Anthony
More informationPump Therapy Indications:
Insulin Pumping Getting Started March 7, 2008 Clinical Pearls To understand the rational behind pump therapy To explore patient preferences for and against insulin pump therapy Realistic expectations for
More informationJDRF Type One Nation Research Summit Diabetes Technology: A Bridge to a Cure
JDRF Type One Nation Research Summit Diabetes Technology: A Bridge to a Cure Kelly L. Close, president, Close Concerns editor-in-chief, diatribe March 1, 2014 closeconcerns.com diatribe.org @diatribenews
More informationInsulin Infusion Pumps
Medical Coverage Policy Insulin Infusion Pumps EFFECTIVE DATE: 09/01/2004 POLICY LAST UPDATED: 08/06/2013 OVERVIEW The policy addresses insulin infusion pumps that are worn externally and those that are
More informationWelcome to Diabetes Education! Why Should I Take Control of My Diabetes?
Welcome to Diabetes Education! Why Should I Take Control of My Diabetes? NEEDS and BENEFITS of SELF-MANAGEMENT You make choices about your life and health Controlling diabetes needs every day decisions
More informationStrategies for Managing the Patient on Insulin. Judy Davis RN, BA, CDE, FAADE May 3, 2013
Strategies for Managing the Patient on Insulin Judy Davis RN, BA, CDE, FAADE May 3, 2013 1 Objectives To identify the need for all health providers to play an active role in the education of the individual
More informationDiabetes How to manage illness
York Teaching Hospital NHS Foundation Trust Diabetes How to manage illness For adults with Type 1 diabetes on a basal bolus insulin regime For more information, please contact: Diabetes and Endocrinology
More informationHow to adjust your insulin if taken two or three times daily. To change the insulin dose, you will need to know:
What to do if your results are too high or too low The target range for your blood glucose results is from to 8 mmol/l - aim to have four out of every five blood glucose results in this range. If three
More informationImagine a world... Believe in better control. MiniMed Veo Paradigm System Questions and Answers About Insulin Pumping
Imagine a world... Believe in better control MiniMed Veo Paradigm System Questions and Answers About Insulin Pumping 1 Imagine a world... Where you can exercise whenever you want and not have to carb load
More informationBlood Sugar Testing. Bayer Health Facts
Blood Sugar Testing Bayer Health Facts What is Blood Sugar Testing? A blood sugar test tells you how much sugar is in your blood at the moment it is tested. Blood sugar is also called blood glucose. One
More informationInsulin Pump Therapy and Continuous Glucose Sensor Use in the Management of Diabetes Mellitus
Insulin Pump Therapy and Continuous Glucose Sensor Use in the Management of Diabetes Mellitus Louis Haenel, IV, DO, FACOI, FACE Endocrinology Roper Hospital Charleston, SC Dr. Louis Haenel IV has disclosed
More informationBlood Glucose Monitoring Basics
Blood glucose (BG) monitoring is a critical aspect of diabetes management and, for patients using insulin, the purpose is robust. A patient s insulin dose design and adjustment are based on glycemic patterns
More informationMedical Policy Insulin Pumps
Medical Policy Insulin Pumps Document Number: 027 Authorization required Insulin Pumps & supplies Notification within 24 hours of service or next business day No Prior Authorization Not covered Pulsatile
More informationDiabetesMeter User Manual
DiabetesMeter User Manual 1. THE GENERAL OUTLINE DiabeticMeter is an application for people suffering from insulin-dependent diabetes. It provides support in taking day-to-day decisions regarding products
More informationEmma Jenkins BSc, RD, CEDT Diabetes Specialist Dietitian Royal Bournemouth Hospital Dorset, UK. Pens & calculators at the ready?!...
Emma Jenkins BSc, RD, CEDT Diabetes Specialist Dietitian Royal Bournemouth Hospital Dorset, UK Pens & calculators at the ready?!... Robert, age 42. Type 1 diabetes for 26yrs. HbA1c 76mmols/mol 2 recent
More informationHypoglycemia and Diabetes
My Doctor Says I Should Avoid Low Blood Glucose Reactions... How Can I Prevent Them? BD Getting Started Hypoglycemia and Diabetes What You Should Know About Low Blood Glucose Reactions If you are taking
More information2010 Partners & Peers for Diabetes Care, Inc. www.partnersandpeers.org
Without a working knowledge of the way insulin works in your body it is very difficult to effectively manage diabetes... Kind of like driving a car without knowing how to use the gas pedal and brakes...
More informationCauses, incidence, and risk factors
Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,
More informationInsulin: Breaking Barriers Enhancing Therapies. Jerry Meece, RPh, FACA, CDE jmeece12@cooke.net
Insulin: Breaking Barriers Enhancing Therapies Jerry Meece, RPh, FACA, CDE jmeece12@cooke.net Questions To Address Who are candidates for insulin? When do we start insulin? How do the different types of
More informationInsulin Pump Therapy Education Protocol
Insulin Pump Therapy Education Protocol Considerations for Developing Your Own Best Practices 9402474-011 1 Objective Provide an overview of the importance of developing an insulin pump therapy education
More informationAnchor Bay School District Diabetic Medical Care Plan. Student Name Date Grade Teacher
Rev: 4/2009 Anchor Bay School District Diabetic Medical Care Plan Place Child s Picture Here Student Name Date Grade Teacher Emergency Contact information (Please list in order to be called) #1 Parent
More information[ ] POCT glucose Routine, As needed, If long acting insulin is given and patient NPO, do POCT glucose every 2 hours until patient eats.
Glycemic Control - Insulin Infusion NOTE: For treatment of Diabetic Ketoacidosis or Hyperglycemic Hyperosmolar Syndrome please go to order set named Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar
More informationInnovations in Diabetes. Angela Blair Channel Manager RN Credentialled Diabetes Educator
Innovations in Diabetes Angela Blair Channel Manager RN Credentialled Diabetes Educator Innovations Time - $$$ Innovations & Technology Blood Testing Insulin delivery devices Insulin pumps Pills & Potions
More informationReport reference guide. mmol/l. One. solution EMR. No fuss
Report reference guide mmol/l One solution No fuss 0000000000 00 0 0000 00 0 0 0 0 0 0 000000000 0 0 00 0 0 0 00 00 0 0 0 0 0 0 00 00000000000000000000 00 EMR About. Plug Transmitter into your outlet is
More informationTHE INS AND OUTS OF INSULIN. Mary Beth Wald, RN,BSN,CDE
THE INS AND OUTS OF INSULIN Mary Beth Wald, RN,BSN,CDE WHAT HAPPENS IN MY BODY? When we eat, the food gets changed into glucose, a type of sugar. Glucose travels in the blood to all the cells in your body
More informationIntroduction to Insulin Pump Therapy
Introduction to Insulin Pump Therapy What is an insulin pump and how does it work? An insulin pump is a small electronic device which provides a continuous infusion of very fast acting insulin (Novorapid
More informationWhat is Gestational Diabetes?
What is Gestational Diabetes? Gestational (jes-tay-shun-ul) diabetes is a type of diabetes that can happen during pregnancy. It means you have never had diabetes before. Having gestational diabetes means
More informationManaging the Diabetes Patient. Dan Kremer, RN, BSN Diabetes Nurse Educator
Managing the Diabetes Patient Dan Kremer, RN, BSN Diabetes Nurse Educator Objectives Referring & assessing the inpatient Address the needed diabetes education for the patients survival skills Problem solving
More informationWHAT CAN I DO TO REDUCE MY RISK OF DEVELOPING THE COMPLICATIONS OF TYPE 1 DIABETES?
Christian In better control with his pump since 2012 WHAT CAN I DO TO REDUCE MY RISK OF DEVELOPING THE COMPLICATIONS OF TYPE 1 DIABETES? Many people with Type 1 diabetes worry about potential long-term
More informationLead Clinician(S) (DATE) Approved by Diabetes Directorate on: Approved by Medicines Safety Group on: This guideline should not be used after end of:
Guideline for members of the diabetes team and dietetic department for advising on insulin dose adjustment and teaching the skills of insulin dose adjustment to adults with type 1 or type 2 diabetes mellitus
More informationUniversity College Hospital. Sick day rules insulin pump therapy
University College Hospital Sick day rules insulin pump therapy Children and Young People s Diabetes Service Children whose diabetes is well controlled should not experience more illness or infections
More informationThe What, Why, Who & How of Insulin Pumps. Bridget Lydon May 2014
The What, Why, Who & How of Insulin Pumps Bridget Lydon May 2014 Topics WHAT is an insulin pump HOW a pump works WHY use a pump WHO should use a pump Pharmac criteria for funded pumps All began back in
More informationInsulin Delivery Devices
My Doctor Says I Need Insulin to Control My Diabetes... How Should I Take It? BD Getting Started Insulin Delivery Devices Why is Insulin So Important? Insulin is a life-saving drug for people with diabetes.
More informationDIABETES AND INSULIN PUMP THERAPY TOP TIPS FOR TRAVELLING
DIABETES AND INSULIN PUMP THERAPY TOP TIPS FOR TRAVELLING Information Leaflet Your Health. Our Priority. Page 2 of 6 People with diabetes who use an insulin pump can still enjoy foreign travel. However
More informationIntroducing DEXCOM STUDIO INTUITIVE. FOCUSED. SIMPLIFIED. HELP TAKE the GUESSWORK OUT of GLUCOSE PATTERN MANAGEMENT
Introducing DEXCOM STUDIO Continuous Glucose Monitoring Software INTUITIVE. FOCUSED. SIMPLIFIED. HELP TAKE the GUESSWORK OUT of GLUCOSE PATTERN MANAGEMENT Glucose Pattern Management A Guide to Interpreting
More informationWritten and illustrated by Sandra J. Hollenberg (Malcolm s Grandma Sandy)
Written and illustrated by Sandra J. Hollenberg (Malcolm s Grandma Sandy) 2008 Edition Sandra J. Hollenberg Additional copies available for free downloading at www.grandmasandy.com To the adult reader
More informationBlood Glucose Management
Blood Glucose Management What Influences Blood Sugar Levels? There are three main things that influence your blood sugar: Nutrition Exercise Medication What Influences Blood Sugar Levels? NUTRITION 4 Meal
More informationSelf-Monitoring of Blood Glucose
My Doctor Says I Should Monitor My Blood Glucose... What Does This Mean? BD Getting Started Self-Monitoring of Blood Glucose Daily Blood Sugar Monitoring When you have diabetes, managing your blood glucose
More informationMedical Coverage Policy Glucose Monitoring Systems sad
Medical Coverage Policy Glucose Monitoring Systems sad EFFECTIVE DATE: 03 03 2009 POLICY LAST UPDATED: 01 17 2012 OVERVIEW This policy addresses several methods of monitoring blood glucose: the glucometer,
More informationDiabetes. Rochester Recreation Club for the Deaf January 21, 2010
Diabetes Rochester Recreation Club for the Deaf January 21, 2010 Supporters Deaf Health Community Committee Members Cathie Armstrong Michael McKee Mistie Cramer Matt Starr Patrick Sullivan University of
More information10 to 30 minutes ½ to 3 hours 3 to 5 hours. 30 60 minutes 1 to 5 hours 8 hours. 1 to 4 hours
Insulin Action There are several types of insulin. They are classified by how long they act: very fast, fast, slow and very slow acting. Each type of insulin has a certain time period in which it works.
More informationEducational Objectives. Type 2 Diabetes: a progressive condition. Insulin Delivery Devices. Insulin we may wait too long
Educational Objectives Insulin Delivery Devices James Bennett RPh, FACA, CDE Director of Clinical Services at James Bennett Apothecary Corinth Mississippi After viewing this program, participants should
More informationBLOOD GLUCOSE MONITORING MEDICATION
DIABETES CARE FOR SCHOOL MEDICAL MANAGEMENT PLAN Most Recent A1C and Date: BLOOD GLUCOSE MONITORING Meter Type: Testing Independently: yes no Testing times: Before meals Two hours after insulin dosing
More information