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What have we learned about hybrid closed loop insulin pumps : top tips for hybrid closed loop insulin pump users
Jesson, A M R Sears, N L Kalaiah, Y Saraf, S
Jesson, A M R
Sears, N L
Kalaiah, Y
Saraf, S
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Affiliation
University Hospitals Birmingham
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Publication date
2024-04-24
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Abstract
Introduction
This abstract outlines some of the tips we have learned from almost 4 years of using hybrid closed loop insulin pumps.
Method
In November 2019 we started our first patient on an insulin pump with potential to use in a hybrid closed loop. Since then, we have worked with around 150 patients on 4 hybrid closed loop systems and have the following top tips for patients and professionals.
Top Tips for Hybrid Closed loop Insulin Pump users:
• Accurate carbohydrate counting improves HbA1c and time in target range
• When practical, give bolus doses 10-15 mins before having carbohydrates
• Leave the pump alone between meals – it will do its work
• Don’t treat alarms as hypoglycaemia, check blood glucose levels first and after 15 minutes, if necessary
• Reduce hypo treatment to four to eight grams of carbohydrate. The pump will reduce basal rate to treat hypoglycaemia
• Remember to re-attach your pump after a shower/bath/sport and give correction when reconnecting
• Don’t forget bolus doses
• Download your pump regularly and review the data
• Are you having hypos two to four hours after meals? Is your carbohydrate ratio too strong?
• Setting your basal rate to reflect the actual total basal daily dose given by the pump will help when out of loop/ in manual mode
• Try to use settings that avoid the pump pausing for hypos for more than 15 minutes
• If your blood glucose is above 18mmol/L, change your cannula and consumables, give correction via pen, test for ketones
• Check weight and total daily dose in pump settings are accurate every month
Exercise: set temp target/activity/exercise/ease off at least one hour before planned exercise. Avoid eating/bolus before exercise
Alcohol: use temp target/activity/exercise/ease off, only bolus with extreme caution.
Illness: activate basal rate with 50% more basal insulin or use boost function; Use lowest target available in pump; Consider turning automation off and using as standard pump
Summary
This is a summary of tips we have learned through patient experience, discussions, trial and error.
Please feel free to use these, and let us know any more top tips at: ghhpump.clinic@uhb.nhs.uk
Citation
Jesson, A.M.R., Sears, N.L., Kalaiah, Y. and Saraf, S. (2024) 'What have we learned about hybrid closed loop insulin pumps : top tips for hybrid closed loop insulin pump users'. Diabetes UK Annual Professional Conference. London: 17-19 April.
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Conference Output