Insulin Pump Therapy

• You need to be more accurate at carbohydrate counting on a pump than with injections.  Pumps are more sensitive and you can deliver more accurate doses.

• Weigh homemade food wherever possible - pasta, rice & potatoes are difficult to estimate so this will give you the most accurate figures.

• Are you using the correct insulin: to CHO ratio?  This may change from your initial start dose (usually 1 unit per 10g of CHO).

• Do some blood glucoses 2 hours after a meal to check whether your ratio is enough.  If 2 hours after a meal the blood glucoses are high, you may need to adjust your meal ratio - speak to the nurses or dietitian about this.

• Large protein portions (meat, cheese, fish, chicken) require a unit of insulin even if there is no carbohydrate in a meal.

• Don't forget that drinks like milk or fruit juice need some insulin.  Any snack with more than 5g CHO (most things) needs some insulin.

• For large amounts of insulin (more than 6 units per meal) split the dose giving some units before and some after, but don't forget the second dose!

• For some meals it is better to use the extended or square wave bolus.  This is particularly for long acting carbohydrates or fatty meals e.g.

Takeaway pizza

Indian/Thai curries eaten with basmati rice

Takeaway burger/chicken and fries

Pasta with creamy/cheesy sauce and/or garlic bread

Pub meals with lots of meat

Vegetarian meals with lots of pulses/nuts/cheese

Pub meal with chocolate/cheesecake/puddings