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Insulin Pump Therapy: Hospitalization Instructions

It's important to prepare for hospitalizations. Not everyone is as familiar with insulin pump therapy as you are. When you're hospitalized, consider the following:

  1. Ask for a diabetes consult (Blood Glucose Management Service).

  2. Bring insulin pump supplies including batteries, 2-3 reservoirs, 2-3 infusion sets, inserter device if used (the emergency kit you should always carry). Supplies are not available in most hospitals and you may be forced to come off the pump if you don't bring your own supplies. You'll need to change your infusion set a minimum of every 48-72 hours.

  3. Bring your insulin pump manual for reference, both for yourself as well as the hospital staff attending to you.

  4. Disconnect when getting an MRI, CT scan or other radiology procedure.

  5. To use an insulin pump while hospitalized, an agreement must be signed stating your responsibilities, and agreeing to allow the care team to review and adjust the settings as needed.
  6. Be prepared to demonstrate that you know how to suspend, review basal rates, program a temporary basal rate, and give a bolus for food and to correct hyperglycemia. 

  7. Pump settings will likely change during hospitalization. Insulin requirements typically increase during illness. Set up a new basal pattern but save your normal settings for use after discharge.

  8. You may use your own meter but the hospital is required to check your blood glucose (BG) with their meter prior to administering insulin.

  9. You may continue to wear a continuous glucose monitor (CGM) but treatment decisions will be based upon the hospital's BG meter. Your CGM can be helpful to let you know if your BG is dropping too low.

  10. A nurse must supervise insulin boluses and document your BG level, how many carbs you're eating, and the amount of insulin you're taking. Insulin needs may change during hospitalization and the care team needs this information readily available in your chart to make appropriate medical decisions.

  11. If using a Medtronic 670G insulin pump, you must be in manual mode. You will not be able to return to auto mode until several days after being discharged from the hospital.

  12. You should eat a consistent carbohydrate diet, limited to 180 grams of carbohydrates per day (about for 60 grams per meal). Avoid concentrated sweets and choose healthy carbohydrates. 

  13. Insulin pumps must be removed when  judgement is affected (i.e. pain medications, sedation, etc.). 

  14. If you don't manage your own insulin pump, the family member or caregiver who does it for you will be required to remain with you at all times in order to continue using the pump.