Pumper Tip #146 (in a series)
OK, it's not really the 146th tip that I've posted, but it is one of many that I hope to post in my future as a blogger.I recently bought the 4th edition of the excellent Pumping Insulin book, and I've been reading it. It's a great book, and the few pages on Symlin are much more informative than all the literature I've read.
So I was surprised when I read Text Box 5.7 on page 53, which says:
BOB Will Not Work After An Injection
Even when wearing a pump, injections may still be needed. When a blood sugar is unexpectedly high due to an infusion site problem or when only enough insulin remains in your reservoir to cover the basal rates, an injection can be used for a correction or a carb bolus.
However, when an injection is used in these situations, your pump will not know it and cannot determine the true BOB (Bolus on Board). After an injection this insulin remains active for about 5 hours. The BOB from an injection can be tracked the old-fashioned way by estimating that 20% to 25% of this injected dose will be used each hour.
However, in the situation where you have enough insulin in the reservoir but you think there are site problems, you can have your cake and eat it too (metaphorically speaking).
What I do is to detach the infusion set and, before putting a new reservoir into the pump, bolused the amount of insulin that I inject using a syringe. Then I replace the reservoir, infusion set, etc. So the pump still thinks that it gave me the bolus that I injected manually, and it continues to track my bolus on board.
I hope this helps you if you've had site problems and then had to deal with tracking the manual bolus while also doing the whole infusion set replacement dance.
posted by Bernard @ 6:46 PM
4 Comments:
I do the same thing you do when I inject. Then it's included in my tdd dose too.
I think that's a great way to keep the pump "in the loop" on your boluses!
I don't know about you, but having to manually think through the whole 20% to 25% per hour left working thing would confuse the crap out of me. Something I never used to do before pumping.
I mean, conceptually I "get it", but enough with the math already - know what I mean?!
Scott
I can't imagine going back to calculating the bolus on board the old way. First of all, anytime I have to replace the infusion set unexpectedly it's generally because my blood glucose readings are sky high - which makes me feel lousy.
So I'm not exactly feeling that all is well with the world, so adding the calculation work to this just adds insult to injury.
I hope it's helpful to some, and I'll try to contact the Pumping Insulin authors to see if they can add this to a future version of the book.
I do it a little different if I suspect Im having pump problems, or not enough insulin in the pump for bolus & basal. If I take five units of insulin, I program a .5u bolus on the pump. I know Ive been taking injections, so I can glimpse at the history and I know .5=5u and .2=2u etc....It sounds like your way works pretty well though, I may have to try that out.....
Post a Comment
Links to this post:
Create a Link
<< Home