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.
I think the author is making this overly complicated to calculate moving from pump to shots and it seems odd to include both daily total basal and bolus, followed by dividing it in half.
Doesn’t it make more sense to just get your total daily basal insulin off your pump, multiple by 1.2 and use that for your long acting shot given 1x every 24 hrs of (Lantus, Levemir or Toujeo). If you are going off the pump for a very active vacation, you might lower the amount for the long acting insulin shot to equal your total basal dose instead of bumping it up by 20%
Then use shots of short acting (novolg, humalog or Apidra) every time you eat carbs or need to correct for activity or hormones or insulin resistance. This method gives one more flexibility.
You are absolutely right, Marianne. Someone had shared the other method and it had worked too. Whatever works! Many thanks … j
That sounds better..I justNgot off the pump cause I am behind on supply payments for medtronic and I have a financial hold..I’ve been using and paying this pump for 3yrs now. I got my basal rate from the pump which was 39.5 so I am just injecting 40 units, of tresiba daily. I am still using my for bolus wizard..hope this helps thanks for yours too..pump basal is a good place to start..according to my nurse
Help! Are you doing one or two Lantus doses per day?
Hi Julie … this is shows how to switch to injections, if needed. Are you ok?