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SMBG (Self-monitoring of BG)
Insufficient BG testing Check more often when BG is elevated.
Rebound high BG after low BG
(Somogyi Effect)
Check 3 am BG. May need to adjust basal rate during night.
Consult healthcare team.
Elevated fasting BG May need to adjust basal rate. Consult healthcare team.
Insulin sensitivity factor not
correct or not used
Consult healthcare team for possible recalculation of sensitivity
factor.
OTHER
Medications (steroids,
terbutaline, other hormone
treatments)
Inform physician of all medication changes or additions.
Infection, illness, virus Refer to Sick Day Management Guidelines.
Pre-menstrual cycle
Consult healthcare team. May need to use Temp Basal or set
additional Basal Program.
Pregnancy
Insulin requirements may increase in later trimesters. Consult
healthcare team.
Weight changes
May need recalculation of basal or bolus doses. Consult
healthcare team.
Consult your healthcare team before making any changes in your basal rates, bolus
ratios or correction factor.
When in doubt, change it out!
1. Follow guidelines provided by your healthcare team.
2. Change infusion set.
3. Check for ketones.
4. Take rapid-acting insulin by injection.
Problems with Infusion Sets and Sites
A number of problems can occur with infusion sets and sites, the most common of which are
listed in the following table, along with some suggested solutions.
Infusion Sets and Sites Suggested Solution
Air bubbles in tubing
Always fill your pump cartridge with room temperature insulin.
Check Luer lock connection and tubing; change infusion set if
needed. If using a disconnect set, remove the set from your
infusion site and prime the bubbles out. Check that cartridge
plunger is straight and the cartridge is not filled with more than
2.0 mL of insulin.
Kinked tubing Straighten tubing if needed; replace infusion set if needed.
Dislodged needle or cannula
Change infusion set and site. Consider using different tape,
dressing or infusion set. A cannula cannot be pushed back into
skin successfully.
Blood in tubing (insulin looks
pink or red)
Change infusion set and site. Check needle/cannula angle at new
infusion site.
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