Knowing how to return to injection therapy is useful if you decide to take a "pump vacation", or need to interrupt your pumping routine for some other reason (you've totally run out of supplies, have been abducted by aliens, etc).
These procedures should have been written down for you by your health care team when you started pump therapy, and they should be reviewed from time to time, just in case.
- Short pump vacations of two or three days typically require you to take injections of Regular or Humalog every 3 - 5 hours until pump therapy is resumed.
- Typical formulas for this routine suggest injections of Regular or Humalog every 3 - 5 hours of the total amount of basal insulin you would normally require for this 3 - 5 hour time period.
(Estimate hourly basal rate times 4 hours if using Regular and times 3 hours if using Humalog. This will compute the amount of insulin needed per injection to replace your basal rate for this time period. Remember that these are estimates - actual rate of onset and duration of insulin activity will vary with each individual. The timing of injections and the amount of insulin required will need to be adjusted based on experience and the advice of your health care team).
- Bolus amounts will need to be taken by injection for meals and adjusting high BGs. This regimen will require that you wake during the night for an injection, since you will not have sufficient insulin in your system to carry you until morning.
- Pump vacations of longer than three days may require you to return to a combined regimen of long lasting insulin (NPH, Lente or UltraLente) and Regular or Humalog.
- It may have been a long time since you used NPH, Lente or UltraLente insulin. The dosages you need today are likely very different from the amount of Regular you are currently using in your pump. The timing of your injections and meals will likely need to be modified as well. If you write this plan down in advance, it will make the return to injections easier if necessary.
- Pump vacations should be discussed and planned with your health care team. As you become more experienced over time, these vacations can be easily fit into your overall management plan.