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Insulin Pump Therapy: Hospitalization Instructions

It is important to properly prepare for hospitalizations. Remember, not everyone is as familiar with insulin pump therapy as you are.  When you are hospitalized, consider the following:

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

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

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

  4. Remember to disconnect if you are having an MRI, CT scan or other radiology procedure.

  5. To continue using your pump in the hospital, you must sign a contract stating what your responsibilities are, and that you agree to let the provider review and adjust your settings as needed.
     
  6. Be prepared to show the hospital staff that you know how to use your pump: how to suspend; how to review basal rates; how to program a temporary basal rate; and how to give a bolus for food and to correct hyperglycemia. 

  7. Be aware that your pump settings will probably change while in the hospital.  During illness, insulin requirements typically increase.  You can set up a new basal pattern to use and save your current settings for use after discharge.

  8. While you can still use your own meter, the hospital will need to check your blood glucose (BG) with their meter prior to giving you any insulin.  This is a requirement that cannot be changed.

  9. If you are wearing a Continuous Glucose Monitor (CGM), you may keep it on, but be aware that 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. The nurse taking care of you will need to supervise your insulin boluses so they can be correctly documented: your BG levels; how many carbs you are eating; and how much insulin you are taking.  Remember, your insulin needs may change while you are in the hospital, and the doctors need this information readily available in your chart to help them make appropriate medical decisions.

  11. If you're using the Medtronic 670G insulin pump, you'll have to use manual mode.  You will not be able to go back to auto mode for several days post hospitalization.

  12. Typically, you will be put on a consistent carbohydrate diet, which means you will be limited to 180 grams of carbohydrate per day (aim for 60 grams per meal).  When filling out your daily menu, try to avoid concentrated sweets, and chose healthier carbohydrates whenever possible.

  13. If your judgement is affected (i.e. you are on pain medications, under sedation, etc.) you will not be able to stay on the pump.

  14. If you do not manage your own insulin pump, but instead have a family member or other caregiver who does it for you, that person will be required to stay with you at all times in order for you to stay on the pump.
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