Starting Pump Therapy
You will meet your pump care team a few weeks before pump start, and they will work with you
to decide what basals and boluses you should start with. Usually, you need less insulin than you are taking by
injection, perhaps 80 percent as much.
For example, if you were on 20 units of insulin glargine, 80 percent of this would be 16
units. Dividing this by 24 hours gives you 0.67 units per hour. You would probably start at even a lower dose,
and the initial basals might be
• Midnight—0.45 units per hour
•
3 A . M .—0.5 units
per hour
•
9 A . M .—0.45 units
per hour
Usually, as illustrated in this example, more insulin is needed very early in the morning
because of the normal hormonal changes in the body that occur at that time (referred to as the
dawn phenomenon). The bolus insulin
ratios are usually the same as with the injections—for example 1 unit per 15 grams carbohydrate and 1 unit for
50 mg/dl over target.
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