2. You Have Diabetes! New Diagnosis Scared 15 year old… What are your fears? Who are your stakeholders?

3. Insulin Pump Therapy

4. Objectives Explore the benefits of pump therapy Discuss Smart Pump features Experience pumping

5. Diabetes Treatment Evolution

6. Better simulates normal basal/bolus insulin delivery User may increase, decrease, or stop insulin Closest thing to working & thinking like a pancreas! The Pump Mimics Normal Insulin Action

7. Barriers Attached to device Loss of privacy Expense Risk of site infections DKA Benefits Customized basal rates Temp basal options Bolus options IOB feature ezBG and ezCarb does the math for you Sickday management Decreased TDD Stop insulin delivery

8. Ways to determine starting insulin dose 1.Current TDD on injections 2.Current TDD – 25 to 50% 3.Weight ÷ 4 X 0.9 Wolpert H, ed. Smart Pumping: A Practical Approach to Mastering the Insulin Pump. Alexandria, VA: American Diabetes Association; 2002. Walsh, J. Pumping Insulin Torrey Pines San Diego 2000 Your Total Daily Dose Your Wt ÷ 4 = ___ X 0.9 = _____units Example: 150 ÷ 4 = 38 X 0.9 = 34 units

9. Determining Your Basal Rate 50% of TDD is Basal Need Basal Rate is divided over 24 hrs Wolpert H, ed. Smart Pumping: A Practical Approach to Mastering the Insulin Pump. Alexandria, VA: American Diabetes Association; 2002. Walsh, J. Pumping Insulin Torrey Pines San Diego 2000 TDD ÷ 2 = ____ ÷ 24hrs = __.___

10. Tools to Glucose Control Value of 1 unit of insulin  Sensitivity Factor (SF) Lowering of glucose per unit of insulin  Insulin to Carb Ratio (I:CHO) Grams of carbohydrates per unit of insulin

11. Easy Math - 1800/500 Rules 1. 1800 ÷ by TDD = SF 2. 500 ÷ by TDD = I : CHO 3. SF = I:CHO = 1 :

12. Starting your pump 1.Set up a Basal Rate, an Insulin to Carbohydrate Ratio, & Insulin Sensitivity Factor. 2.Review ezCarbs & ezBG features 3.Insert infusion set