1 / 21

Clinical Protocol Using Insulin Pump

Clinical Protocol Using Insulin Pump. Easy Guideline for Initiating Insulin Pumps on Type 2 Diabetes Patients. The Big Picture. Choose Initial Dose Check Blood Glucose Frequently Make Adjustments After Stabilization, Follow-up Check at Regular Schedule

anevay
Download Presentation

Clinical Protocol Using Insulin Pump

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clinical ProtocolUsing Insulin Pump Easy Guideline for Initiating Insulin Pumps on Type 2 Diabetes Patients

  2. The Big Picture • Choose Initial Dose • Check Blood Glucose Frequently • Make Adjustments • After Stabilization, Follow-up Check at Regular Schedule • Successful Treatment – remission of diabetes, less complications

  3. 1. Choose Initial Dose • Based on patient weight • Based on previous insulin treatment dose • After a accumulated experiences: Make your own strategy

  4. 1. Choose Initial Dose Start with low dose and make adjustments step by step • Based on patient weight • Initial total daily insulin dose : Weight x 0.22 Ex> If the patient’s weight is 70 kg 0.22 x 70 = 15.4 U  15 U

  5. 1. Choose Initial Dose 2) Based on previous insulin treatment dose - 75% of previous dose 3) After a accumulated experiences: Make your own strategy Depending on diet, culture and obesity etc.

  6. 1. Choose Initial Dose • Dose Distributions • Basal : Bolus = 5:5 ~ 3:7 • Distribution of bolus : • Breakfast, Lunch and Dinner • Even Distribution vs 40 : 30 : 30 • For small size breakfast, decrease breakfast bolus dose.

  7. 100% 64% 36%

  8. 21.9% 28.7% 14.2% 19.6% 16.1% Basal Bolus Koreans with moderate amount of breakfast meal For small size breakfast, decrease breakfast bolus dose

  9. 2. Check Blood Glucose Frequently • For initial 10~14 days • 7-8 times a day • Before and after meals • Before sleep • Any unusual symptoms • Hypoglycemia • Hyperglycemia • For dose adjustments

  10. 3. Make Adjustments • For Bolus • Blood Glucose before and after meals • Increase or decrease 2 units (1~4) • For Basal • Blood Glucose results : • Day Basal: Before Lunch and before Dinner • Night Basal: Before Breakfast and Sleep • Increase or decrease 0.1 units/hr (0.1~0.2)

  11. Daily Insulin Dose VariationDuring First 14 days • Usually the total daily insulin dosage given to normalize blood glucose levels reaches a maximum dosage at 6~8 days and gradually decreases. • And after 14 days, daily insulin dose variations generally become stabilized. Insulin 1 6 8 14 28 Day

  12. 4. After Stabilization • Follow-up Check at Regular Schedule • First visit – after 1 month • Regular 3 month follow-up visit • If unexpected event like hypo or hyperglycemia occurs, patient should make a telephone contact to the supporting health care service.

  13. Examples

  14. Patient 1 Unit/meal Unit/24hr Blood Glucose Insulin Dose Breakfast Lunch Dinner Bed Time Basal Bolus before before before after before Lunch Dinner after Break- fast after Day Night

  15. Patient 1

  16. Unit/meal Unit/24hr Patient 2 Blood Glucose Insulin Dose Breakfast Lunch Dinner Bed Time Basal Bolus before before before after before Lunch Dinner after Break- fast after Day Night

  17. Patient 2

  18. Patient 3 Unit/meal Unit/24hr Blood Glucose Insulin Dose Breakfast Lunch Dinner Bed Time Basal Bolus before before before after before Lunch Dinner after Break- fast after Day Night

  19. Patient 3

  20. Thank you • Initiating a insulin pump to a type 2 diabetes patient is not that difficult once you know these protocols • Don’t hesitate • Start now, and save precious lives.

More Related