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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Diabetes, Endocrine

Problem Solving High Blood Sugars When Using an Insulin Pump (6979)

Problem Solving High Blood Sugars When Using an Insulin Pump (6979) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Diabetes, Endocrine

6979

Problem Solving High Blood Sugars
When Using an Insulin Pump

When using an insulin pump, it is important
to understand that when insulin flow stops,
the blood glucose (sugar) will rise quickly.
A sudden high blood glucose could be
related to an insulin pump problem.

When the blood glucose rises quickly,
diabetic ketoacidosis (DKA) can occur. This
is a serious problem that happens when the
body does not have enough insulin. Fat is
burned for energy. The breakdown of fat
produces ketones, which are an acid. When
ketones build up in the blood, this is called
DKA.

DKA can occur quickly and can be life
threatening. For this reason, an unexpected
blood glucose over 250 should never be
ignored.

Symptoms of DKA
• Nausea, vomiting
• Thirst
• Frequent urination
• Feeling drowsy and having difficulty
staying awake
• Weakness
• Stomach pain or cramps
• Shortness of breath
• Fruity taste or odor on the breath
• Dehydration




Common Causes of High Blood Glucose
• Problem with the infusion set or site.
The site may or may not appear red,
swollen or be painful.
• Insulin pump reservoir or pod is
empty.
• Leaking where tubing or pod
connects to the reservoir or the body.
• Infusion set or pod is dislodged or
kinked.

Other Causes
• Illness
• Changes in eating plan or exercise
• Physical stress: injury, pain,
infection
• Emotional stress
• Steroid pills or injection
• Missed bolus or under-counting
carbohydrates at a meal

If high BG is related to illness, follow sick
day guidelines.

If blood glucose is more than 250 mg/dL
two times in a row:
• Determine cause of the high blood
glucose.
• Check urine ketones
• Troubleshoot the pump, check your
infusion set and site.
• Follow action plan on the next page.





Action Plan

If Ketones are Negative If Ketones are Positive
1. Take a correction bolus using your
pump.
2. Increase fluid intake (8 ounces every
hour). Drink plenty of water or non-
carbohydrate fluids to prevent
dehydration.
3. Recheck blood glucose in 1-2 hours.
1. Take correction bolus by syringe or
insulin pen.
2. Change pump infusion set (pod) and site.
3. Increase fluid intake (8 ounces every
hour). Drink plenty of water or non-
carbohydrate fluids to prevent
dehydration.
4. Recheck blood glucose in 2 hours.
If next blood glucose is coming down: If next blood glucose is coming down:
• No further action is needed. Continue
to monitor blood glucose more closely
the rest of the day.
• Check blood glucose again in 2 hours
to be sure the new set (pod) is working.
• Continue to check urine ketones every
2 hours until negative.
• Resume giving correction bolus with
the pump.
• Continue to monitor blood glucose
more closely the rest of the day.
If next blood glucose is NOT coming
down:
If next blood glucose is NOT coming
down:
• If blood sugar is not coming down, then
take a correction bolus of your rapid
acting insulin (Humalog
®
, Novolog
®
or
Apidra
®
) using a syringe or insulin pen.
• Change insulin pump infusion set (pod)
and site.
• Test urine ketones again. If urine
ketones are positive, see next column.
Follow guidelines under “If next blood
glucose is NOT coming down.”


• Continue to take insulin using your
correction scale using a syringe or pen
every 2 hours (or as directed). Do this
until blood glucose levels start coming
down.
• Test urine ketones every 2 hours until
negative.
• If urine ketones are moderate to large
and / or you have symptoms of DKA,
call your doctor or go to urgent care or
the emergency room.







Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 12/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF# 6979