“Living with Your Insulin Pump” –a self management resource.

 Background:

Insulin pump therapy comprises the use of a small battery operated device that delivers rapid acting insulin via a subcutaneous cannula and line. Pump therapy is gaining popularity, with 14,990 insulin pump users in Australia, representing around 12% of people with type 1 diabetes. In 2015, Education Services at Baker IDI performed 83 pump starts, 51 were pump upgrades and 32 new starts.

Benefits of pump therapy include reduction in HbA1c and severe hypoglycaemia, with a consequent reduction in ambulance use, emergency department and hospital admissions.

Description of issue:

Comprehensive pre pump education is essential to ensure user safety and optimise clinical and lifestyle outcomes. Pump education guidelines exist to guide this process.

23% of pump users in Australia attend an emergency department or are admitted to hospital for diabetes management while using a pump. Most of these presentations are associated with pump cannula issues.

Outcome:

The diabetes educators at Baker IDI Education Services have produced a comprehensive 20 page booklet providing the user with information and skills to effectively and safely manage their pump and troubleshoot problems. It aims to empower users in the early identification and management of pump issues, thereby avoiding escalation of problems that can result in emergency department presentations or hospital admission. The booklet covers user friendly sections on testing and making changes to pump settings, hypoglycaemia management, hyperglycaemia and ketone management, troubleshooting, returning to injections and plane travel.

Conclusion and ongoing evaluation:

The booklet is undergoing evaluation this year. This will comprise a survey monkey questionnaire administered at 6 weeks and 12 months post pump initiation or upgrade. The survey aims to capture understanding of and compliance with, specific troubleshooting advice, as well as the incidence of ambulance call outs, emergency department presentations or hospital admission.