Clinical Protocol Using Insulin Pump Easy Guideline for
- Slides: 21
Clinical Protocol Using Insulin Pump Easy Guideline for Initiating Insulin Pumps on Type 2 Diabetes Patients
The Big Picture 1. 2. 3. 4. Choose Initial Dose Check Blood Glucose Frequently Make Adjustments After Stabilization, Follow-up Check at Regular Schedule 5. Successful Treatment – remission of diabetes, less complications
1. Choose Initial Dose 1) Based on patient weight 2) Based on previous insulin treatment dose 3) After a accumulated experiences: Make your own strategy
1. Choose Initial Dose Start with low dose and make adjustments step by step 1) Based on patient weight - Initial total daily insulin dose : Weight x 0. 22 Ex> If the patient’s weight is 70 kg 0. 22 x 70 = 15. 4 U 15 U
1. Choose Initial Dose 2) Based on previous insulin treatment dose - 75% of previous dose 3) After a accumulated experiences: Make your own strategy Depending on diet, culture and obesity etc.
1. Choose Initial Dose • Dose Distributions – Basal : Bolus = 5: 5 ~ 3: 7 – Distribution of bolus : • Breakfast, Lunch and Dinner • Even Distribution vs 40 : 30 • For small size breakfast, decrease breakfast bolus dose.
100% 64% 36%
21. 9% 28. 7% 14. 2% 19. 6% 16. 1% Bolus Basal Koreans with moderate amount of breakfast meal For small size breakfast, decrease breakfast bolus dose
2. Check Blood Glucose Frequently • For initial 10~14 days • 7 -8 times a day – Before and after meals – Before sleep – Any unusual symptoms • Hypoglycemia • Hyperglycemia • For dose adjustments
3. Make Adjustments • For Bolus – Blood Glucose before and after meals – Increase or decrease 2 units (1~4) • For Basal – Blood Glucose results : • Day Basal: Before Lunch and before Dinner • Night Basal: Before Breakfast and Sleep – Increase or decrease 0. 1 units/hr (0. 1~0. 2)
Daily Insulin Dose Variation During First 14 days • Usually the total daily insulin dosage given to normalize blood glucose levels reaches a maximum dosage at 6~8 days and gradually decreases. • And after 14 days, daily insulin dose variations generally become stabilized. Insulin 1 6 8 14 28 Day
4. After Stabilization • Follow-up Check at Regular Schedule • First visit – after 1 month • Regular 3 month follow-up visit • If unexpected event like hypo or hyperglycemia occurs, patient should make a telephone contact to the supporting health care service.
Examples
Patient 1 Unit/meal Unit/24 hr Blood Glucose Insulin Dose Bolus Breakfast Basal Breakfast Lunch Dinner Bed Time Lunch. Dinner Day Night before after before
Patient 1
Patient 2 Unit/meal Unit/24 hr Blood Glucose Insulin Dose Bolus Breakfast Basal Breakfast Lunch Dinner Bed Time Lunch. Dinner Day Night before after before
Patient 2
Patient 3 Unit/meal Unit/24 hr Blood Glucose Insulin Dose Bolus Breakfast Basal Breakfast Lunch Dinner Bed Time Lunch. Dinner Day Night before after before
Patient 3
Thank you • Initiating a insulin pump to a type 2 diabetes patient is not that difficult once you know these protocols • Don’t hesitate • Start now, and save precious lives.
- Insulin pump protocol
- Guideline clinical nutrition in patients with stroke
- Aki kdigo
- Hrayr shahinian
- Mechanism of action of insulin
- Insulin and insulin receptor
- Insulin pump hardware architecture
- Mentcare system
- Insulin pump case study in software engineering
- Insulin pump hardware architecture
- Insulin stacking
- Vibe insulin pump
- Portland protocol insulin
- Hstix
- Reciprocating pump classification
- Difference between external and internal gear pump
- Screw pump vs gear pump
- Inductive reasoning definition
- Deductive method
- Inductive vs deductive reasoning math
- Answer this easy kitchen math problems using this table
- Sales force mobility