Thanks for our wonderful support group, GNO, and Sharon Roberson, here is a great guide for converting back to insulin shots from being on an insulin pump. This comes from a British site called Salford Diabetes Care (www.salforddiabetescare.co.uk)
Why would you want to switch from a pump to injections?
- In an emergency situation, such as a pump failure, it may be necessary for you to convert back onto insulin injections.
- In case you are unable to recall information from your pump it is recommended that you should always keep a written record of your current basal rate and average total daily insulin usage.
- You are going on vacation and don’t want to be sporting an insulin pump at the beach or while scuba diving.
- You are just plain TIRED of managing the insulin pump.
- Your skin is sore, needs a break or you are simply running out of skin geography.
How to Calculate Your Starting Dose
- Calculate using your average total daily dose (TTD) of insulin. TTD is all the insulin you have i.e. the basal and every bolus.
Obtain this information by:
- Accessing the history of daily insulin totals in the memory of the pump or:
- From your records add together the daily set basal rate and the bolus doses together.
- Add 20% onto your average daily total of insulin then divide this in two equal parts.
- 50% is now your background insulin eg Lantus or Levemir.
- You should continue with your usual insulin to CHO ratio at mealtimes and give your usual correction dose.
- This formula provide a starting dose, further adjustments may be necessary depending on your blood sugar results
- Daily average insulin total via the insulin pump = 36 units
- Add on 20% (36 x 20% extra insulin = 7 units)
- 36 units + 7 units= 43 units
- Divide into two equal parts = 43 units/2 = 22 units
You would administer:
- 22 units of Lantus or Levemir as soon as you came off the pump.
- Continue with your usual insulin to CHO ratio
- Continue with your usual correction dose.
Converting back to CSII:
If your main reason for converting to injections is that something has happened to the pump. You should have a new pump within 24- 48 hours and can re-start pump therapy.
It is important that you keep a record of your basal rates etc so that you can re-set the your carb ratios.
Remember that both Lantus, Levemir and Tresiba have a long term effect on your blood glucose and you will need to consider when you last gave an injection.
You will need to consider putting on a temporary basal rate and check your blood glucose regularly till you are re-established on the pump.