Before starting insulin pump therapy, the following are checked and reviewed:
Carbohydrate counting and insulin-to-carbohydrate ratios (ICR) at different times of the day
Insulin sensitivity factor (ISF) at different times of the day
The need and amount of basal insulin in relation to mealtime insulin
The impact of exercise and physical stress on insulin requirements
Injection sites
Utilizing the results from the glucose sensor and self-monitoring of blood glucose
If you are not being treated at a healthcare unit specialized in type 1 diabetes, your attending physician will refer you for an assessment of pump therapy to the nearest specialized care provider. During the consultation, the status of your diabetes, current treatment issues, and the aspects you wish to improve or alleviate with pump therapy are determined. Goals for pump therapy are set together, and an appropriate pump model is chosen.
Prior to the start of pump therapy, a monitoring period with a glucose sensor is often conducted. Insulin doses, carbohydrates, exercise, and other treatment-affecting factors are recorded over several days. This provides sufficient information about previous insulin dosing to set the adjustments for the pump.
With a nurse or a representative of the pump manufacturer, you will learn the basics of using the pump. This includes setting and adjusting the planned basal insulin program, administering meal boluses, setting and changing dose calculator settings. Additionally, you will learn how to fill the pump with insulin, prepare the infusion set, and insert the cannula.