Insulin Pump Therapy

• Basal rate – the basal rate is the background insulin your pump is giving you day and night. This may vary depending on the time of day and night, for example it may be lower at 2am and higher at 6am.  This differs from the bolus dose which you give to cover food and drink. For the best blood glucose control you have to have the right basal rate at all times

• Blood glucose within target throughout the day
• Flexibility – for example you can delay or skip meals without fear of hypo
• Better control – lower HbA1c levels
• Peace of mind

• You go low a lot, especially if you skip a meal
• You may gain weight as you are eating to deal with the lows

• You have lots of high blood glucose levels especially when you have a long gap between meals as in the middle of the night
• You have to give a lot of correction boluses to correct high blood glucose levels

• If any of the problems occur as listed above
• Routinely every 3-6 months when you are in the growth spurt
• If your HbA1c is rising

Basal rate testing tips

Here are a few tips to keep in mind before you do the testing: -

Don't test your basal rate during any circumstances that might affect the results, such as: -

• After strenuous exercise
• If you have an illness or infection
• After a serious low blood glucose
• During major emotional stress
• After eating food with high fat content

If blood glucose drops below 4.0mmol/L or rises above 14mmol/L, stop the test, get your blood glucose back in target range, and do the test again the next day or when it is convenient.  Discuss with your Diabetes Nurse Specialist .

Break up the day into 4 segments for convenience

• Overnight
• Between breakfast and lunch
• Between lunch and evening meal
• Between evening meal and bedtime

(see top tips leaflet on how to change your basal rate)

Contact the Diabetes Nurse if you are worried about what to do.

Record your results on a standardised form (see form no 5).  This is important in case your pump breaks down and you need to have a record of your new basal rate.