insulin pumps

Insulin Pump Info for teachers and careguers

What is an insulin pump?

An insulin pump is a miniaturized machine. An insulin pump contains a large syringe filled with insulin, a computer which allows the user to time and adjust the administration of insulin to their bodies and a small motor to drive the syringe. Attached to the end of the syringe is a sterile tube (infusion line) fitted with a needle which is inserted into the soft tissue of the lower abdomen. The entire fluid system (needle, infusion line, and syringe), maintain a sterile environment and avoid infection at the infusion site on the abdomen.

Type 1 diabetes

Or juvenile diabetes. Is an autoinmune disease that destroys the hormone insulin which is required to metabolize glucose (blood sugar) and provide energy for cells in the body.

For years, most people with diabetes have taken two and sometimes three o four injections a day of insulin to control their blood sugar levels and manage their diabetes. With this level of control it is almost impossible to maintain near normal blood sugar levels and the onset of long term complications is inevitable. Since 1923 it has been recommended by diabetologists that blood sugar levels be maintained as close to normal as possible.

Insulin pump users test their blood sugar 3 to 4 times a day and program their insulin pump to provide continuous small drip of insulin that matches their body’s background (fasting) insulin requirements (this is called the «Basal Rate»). In addition, pumpers program their pumps as needed to provide the exact amount of insulin to match the food they eat at the time that it is consumed (this is called a «Bolus»). The management effect of an insulin pump can be approximated by using MDI (multiple daily injections) and frequent blood sugar testing, however, MDI to achieve intensive therapy is much more rigorous and difficult to maintain (especially for a kid).

High blood sugar - HYPERGLYCEMIA

Without insulin the body cannot use glucose and shifts from metabolizing carbohydrate (glucose) to metabolizing fat for energy. This shift is accompanied by elevated blood sugar levels (hyperglycemia) and normal, acidic by products of fat metabolism known as ketones. When fat is the main energy source, ketones accumulate and move the body’s electrolyte balance into the acidic range, causing excessive urination and dehydration as the body tries to reestablish its acid balance by excreting the ketones. This life threatening condition is known as diabetic ketoacidosis (DKA). Total interruption of insulin to a person with diabetes type 1 can result in DKA within 4 to 8 hours. Regular blood sugar testing can detect elevated blood sugar levels and the onset of DKA and timely action can be taken to prevent problems from occurring.

Low blood sugar - HYPOGLYCEMIA

Without an adequate supply of carbohydrate to support immediate metabolic requirements, a person with diabetes may experience low blood sugar (hypoglycemia). The symptoms of mild low blood sugar may include among other things; tremors, tingling, palpitations, sweating, anxiety, shivering, dizziness, confusion headache, speech impairment, drowsiness, weakness, hunger and blurred vision. Severe low blood sugar is associated with impaired cognitive function that results directly from brain glucose deprivation and may lead to unresponsiveness, coma, or seizure. The changes mentioned above may low blood sugar can usually recognize and treat the symptoms of low blood sugar can rapidly progress from moderate to severe if untreated, a person experiencing these symptoms should not be left above until action is taken to raise blood sugar levels.

What does this mean for you as a teacher or coach?

Now that you’ve read all about what happens on a day to day basis ? Usually everything works OK and (child’s name) takes care of problems that develop. The people with diabetes need the people around them to simply be aware that they may suffer from low blood sugar and need assistance to correct a severe low blood sugar or simply your patience and indulgence until they can correct a mild low blood sugar. On the average, a person with diabetes suffer a reaction which requires the assistance of others a couple of times a year or less.
A person with diabetes on intensive therapy on the average suffer 50% more low blood sugar reactions. (child’s name) suffers 2 to 5 mild reactions a week which she has always caught and corrected herself. Someday this will not be the case and that is why the people around her must constantly be vigilant in the event that she needs your assistance.

About your child

Name: Address: Parents:
Home phone: Work phone: Doctor name:
Educator-nurse name: Phone of the clinic: Emergency phone 24 h:

If (child’s name) is in need of medical treatment it is important that the medical team be aware that she is an «insulin dependent diabetic«. It is common practice for emergency rooms to give patients fluids and glucose which is not necessarily a good idea for a person with diabetes.

Physical exercise is not appropriate when (child’s name’s) blood sugar levels are below 70 or above 250. He/she can correct a low blood sugar in 10 to 20 minutes using glucose tablets but should have food containing carbohydrate for long term correction.

High blood sugar can be aggravated by exercise and may take several hours after an insulin infusion to return to acceptable levels.

Emergency treatment

In the event (child’s name) experiences a severe insulin reaction (low blood sugar), he/she carries in his/her pack the following items:

  • Glucose tablets: 3 tablets taken orally if awake and cognizant.
  • Glucagon emergency kit: In a small plastic box containing a syringe filled with sterile fluid and vial, shake vigorously, draw mixture into syringe, expel bubbles, then administer in muscle of butt or leg. Do not hesitate to administer if unconscious and you suspect an insulin reaction. No permanent harm will result if you are wrong.

Glucose and glucagon usually work within 10 to 15 minutes. Other forms of sugar are not suitable because they take much longer to enter the bloodstream since they must be broken down into glucose by the digestive system before the body can use them. A bread us the next best thing to bring blood sugar levels up if glucose is not available by the body within 30 minutes or less. Simple starch is converted to glucose.

Sports and exercise physical activity increases the body’s need for glucose and lowers blood glucose levels (as long as there is adequate insulin). Most ordinary exercise that is not strenuous or prolonged does not require any particular action on the part of the person with diabetes. Prolonged physical activity such as marathon runs, or other activities that extend more than an hour, and particularly swimming, require the intake of additional energy (glucose). (child’s name) burns an extra 15 grams of carbohydrate an hour while swimming. You may see (child’s name) munching on a cracker or other snack before or during exercise. This is normal. (child’s name) Sincerely.

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