Pumps in practice

Practical Diabetes Vol.31 No.2 - Insulin pump therapy: a practical guide to optimising glycaemic control click HERE

A Practical Diabetes International publication which provides some practical guidance on the approach to the patient on CSII therapy.

East Lancashire Hospitals NHS Trust Referal Form - Criteria for use of continuous subcutaneous insulin infusion (CSII) for adult patients - Click HERE 

East Lancashire Hospitals NHS Trust have developed a referral form and criteria for the use of Continuous Subcutaneous Insulin Infusion (CSII) for adult patients.

Northumbria Diabetes Service CSII Pathway - Click HERE

Northumbria Diabetes Service have developed a care pathway to ensure that all patients considered for pump therapy receive a standardised and documented approach with their multi-disciplinary team through decision making, initiation and follow-up. 

Key to this pathway is their selection process and pre-enrolment discussion and preparation of patients which must fulfill the trust’s referral criteria (including having undertaken a self management course) and be documented in their referral form. 

In-patients

Joint British Diabetes Societies for Inpatient Care Group - Self-management of diabetes in hospital Click HERE

The aim of the document is to improve the safety of the in hospital management of diabetes. Diabetes care is very individualised, especially if that person is using insulin. It follows that the person with the greatest expertise in managing diabetes is commonly the individual themselves. 

Chapter 5 and Appendices 5 and 6 provide guidance on the self- management of insulin pumps during hospital admission. 

Paediatrics:

Norfolk and Norwich University Hospitals Trust Guideline for the Management of: Insulin Pump Therapy in Children with Type 1 Diabetes - click HERE

Norfolk and Norwich University Hospitals NHS Foundation Trust have produced a guideline for the management of insulin pump therapy for children with Type 1 diabetes that covers the following: the process by which suitability for CSII will be determined; the responsibilities of the diabetes team and families, to facilitate effective management of CSII; criteria for discontinuing CSII where its use has not been effective in improving diabetes control and/or quality of life; guidance on management of sick day rules for patients on CSII; insulin pump failure 

Trusts wanting to use or adapt any part of the guideline are welcome to do so but the source  should be acknowledged. 

East of England Paediatric Diabetes Network - Management of Children and Adolescents with Diabetes Requiring Elective or Emergency Surgery and Other Procedures  Click HERE

During surgery or other procedures under sedation or anaesthesia, the aim is to maintain normal glycaemic control with optimal hydration while preventing hypoglycaemia. These guidelines are based on the International Society of Paediatric and Adolescent Diabetes (ISPAD) clinical practice consensus guidelines. Modifications have been made in the light of recently published adult guidelines and from the guidelines published in the anaesthetic literature. They aim to ensure quality of patient care is standardised but individual units may make adjustments to fit with local practice.