High blood glucose can occur while using the pump for the same reasons it did when you were not on the pump, including some situations that are unique to insulin pump therapy:
- Too Much Food
- Not Enough Insulin
- Loss of Insulin Potency
- Not Receiving Insulin From The Pump
The goal of treating hyperglycemia is to prevent Diabetic Ketoacidosis (DKA) and delay or prevent diabetes complications due to high blood glucose over an extended period of time.
If for any reason you are not receiving insulin or are not absorbing the proper amount of insulin, your blood glucose will rise quickly. This can occur with insulin pump therapy from the interruption of insulin delivery due to the infusion set becoming dislodged, infusion set clogs, leaks, or from the insulin no longer being absorbed properly.
Since the pump only delivers fast-acting insulin, hyperglycemia can occur rapidly. It is important that you understand these guidelines:
Hyperglycemia Protocol
If one blood glucose reading is above 250 mg/dl (13.9 mmol/l), immediate steps must be taken:
- Immediately take a correction bolus with the pump
- Recheck your blood glucose in 60-90 minutes.
If the reading is not coming down, do the following:
- Take a correction insulin injection by syringe. (Not through the pump).
- Change infusion set.
- Drink liquids with no calories every 30 minutes. (For example: Diet Ginger Ale, Broth, Water)
- Test blood glucose every 2 hours and continue to take correction insulin injections until blood glucose reaches target.
- Check urine for ketones and call physician if ketones are present.
- Call physician if your blood glucose and urine ketones remain elevated or you are unable to drink.
NOTE:
You should always have a meter, glucose strips and ketone strips available to you at all times to test your blood glucose and ketones. Without them, diabetes management becomes a guessing game and the threat of serious problems from hyperglycemia or DKA increase.
