Building Independence: Insulin Pumping

passing the T1D baton: Insulin Pumping

We all know that eventually our T1D child needs to be able to care for their diabetes for themselves. But how do we hand over that baton? The first step is identifying the concrete skills that we need to teach them. Here we will zoom in on the sub-skills needed for your child or teen to use their insulin pump safely, effectively and independently. Why not pick one now and work toward its mastery?

Background Info:

How to Pass the Diabetes Baton

Here is a list of sub-skills that are involved with using an insulin pump safely and effectively. Ask yourself if your child/teen can – and will – independently do all of the following tasks. If you answered “no” to a certain step, that could become a teaching target to move your child towards independence.

Steps for Using an Insulin Pump

  1. Delivers Insulin using the insulin pump

    (see Building Independence: Insulin for sub-skills)

  2. Inserts Infusion Sets:

    1. Gathers necessary supplies.
    2. (optional) Applies EMLA® cream or other topical anaesthetic, if desired.
      1. Applies appropriate amount of cream.
      2. Covers with Tegaderm®, IV3000®, or other barrier film.
      3. Waits the indicated time for product to “numb” area.
      4. After waiting period, removes the cover.
      5. Wipes away excess cream.
    3. Selects an infusion site (good absorption, not overused).
    4. Cleanses the intended site.
    5. Uses any skin preparatory products (SkinTac®, SkinPrep®, etc), as applicable.
    6. Inserts infusion set (according to manufacturer instructions).*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    7. Primes tubing just prior to connection.*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    8. Connects infusion set to the tubing/pump.*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    9. Fills cannula, if applicable. (i.e. For many FLEXIBLE cannula infusion sets, the cannula is filled after insertion – see manufacturer’s instructions.)
      (NOTE: FILL CANNULA STEP DOES NOT APPLY TO FIXED (metal) CANNULA INFUSION SETS.)
    10. Removes old infusion set.
    11. Safely disposes of old infusion set (in a sharps container), as well as other refuse.
    12. Effectively rotates sites.
    13. Recognizes the signs and symptoms of a possible site infection, and alerts caregiver.

  3. Replaces Pump Cartridges/Reservoirs and Batteries

    (Steps vary according to pump manufacturer and model – please consult manufacturer instructions.)

  4. Responds Appropriately to Insulin Pump Error Messages:

    1. Notices pump alarms and warnings sounds when they occur.
    2. Reads the alarm or warning from the pump screen.
    3. Takes appropriate steps to resolve the situation (restores prime, replaces battery, replaces low cartridge, etc).

Other Steps in Passing the T1D Baton:

Independence with Carbs & Exercise

Independence with Checking, Treating & Managing Blood Glucose

Independence with Delivering & Adjusting Insulin Doses

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The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.