Dear To Whom It May Concern

This patient uses an insulin Pump. The pump delivers rapid-acting insulin in a way that closely mimics insulin released by a normally functioning pancreas. Insulin delivery is intended to match the patient’s insulin needs in the fasting and fed state, as determined by history, blood glucose levels, food intake and expected exercise. Normally, the patient checks his or her blood glucose with a home blood glucose monitor at least 4-8 times a day and adjusts insulin to maintain as near-normal blood glucose levels as possible.

Insulin is delivered subcutaneously via the pump as a basal rate and bolus dose:

Basal Rate
A continuous insulin infusion. The amount of insulin the patient requires to maintain a normal metabolic state when not eating (fasting). Generally the rate is approximately 50% of the total daily insulin dosage divided over 24 hours.

Bolus Dose
The insulin infused for meals or hyperglycaemia. The patient programs this dose as needed and is taught to adjust this dose based on blood glucose reading, food intake and anticipated exercise.

Pump therapy during a hospitalisation or surgery provides the best means for normalising the patient’s blood glucose through these times of physiological stress. The best resource for pump management during the hospitalisation is the patient. Confidence in the patient's ability to make appropriate management decisions will greatly enhance the outcome of the hospitalisation and the interaction between the patient and staff.

SPECIAL WARNING FOR PATIENTS WITH TYPE 1 DIABETES MELLITUS:
DO NOT REMOVE THE INSULIN INFUSION PUMP UNLESS INSULIN THERAPY IS CONTINUED BY IV OR SUBCUTANEOUSLY. IF INSULIN DELIVERY IS DISCONTINUED, DIABETIC KETOACIDOSIS WILL RESULT. IF DKA IS NOT MEDICALLY TREATED IMMEDIATELY, DEATH MAY RESULT. IF THE PUMP IS DISCONTINUED, THE WEARER WILL NEED RAPID-ACTING INSULIN IMMEDIATELY!   INSULIN PUMP FUNCTION CAN BE AFFECTED BY SCANNERS E.G. CT SCANNERS, MRI SCANNERS AND AIRPORT SCANNERS.   IT MUST, THEREFORE, BE REMOVED PRIOR TO MEDICAL SCANNING FOR THE DURATION OF THE PROCEDURE AND THEN RECONNECTED. INSULIN PUMPS MUST NOT BE PASSED THROUGH AN AIRPORT BAGGAGE SCANNER AND SHOULD REMAIN CONNECTED TO THE PATIENT.

Leeds Children's Diabetes Team

Leeds General Infirmary - Tel: 0113 3927151/0113 3927152 (Dr Holland)

St James's Hospital - Tel: 0113 2065712 (Dr Campbell)