Diabetes 911. Larry A. Fox

you to download pump setup information to your home computer. Having this information readily available will make the transition between injections and pump therapy seamless and easy.

ARE YOU AT RISK FOR SEVERE LOWS?

      You are at risk of severe hypoglycemia if any of the following apply to you:

      

you are taking insulin or taking a pill that causes your pancreas to make insulin

      

you have neuropathy

      

you have frequent lows

      

you cannot recognize the warning signs of hypoglycemia

      

you have had a prior severe low blood glucose reaction This is discussed in greater detail in chapter 2.

      Knowing your bolus calculations may also be necessary if you use injections until the pump is replaced. It is also useful to have a vial, cartridge, or pen of long-acting insulin available. The kind and amount of insulin you use should be discussed with your diabetes team, written down, and placed in your diabetes supply kit. For more details about switching to injections while waiting to restart pump therapy, see chapter 4.

       SICK DAY SUPPLIES

      If you become ill, you’ll need extra supplies to ensure that you have a safe and speedy recovery. Make sure that the items for sick day management are at home all the time. If you are vomiting, stay hydrated by taking frequent sips of clear fluids, such as ginger ale, sports drinks, or water (plain or flavored). Popsicles or other frozen fluids are sometimes easier to take in if you are nauseated. Keep both regular and sugar-free fluids on hand: regular for when blood glucose levels are low or in your target range and sugar-free for when you have high blood glucose levels. Be sure your refrigerator or pantry is stocked with these items. You do not want to have to run to the grocery store at the last minute.

      Your diabetes team may want you to keep limited amounts of medicines on hand to treat vomiting. Being prepared can help minimize your risks of dehydration and avoid a visit to the emergency room. If your team suggests this, be sure of a few things: 1) the supply is kept up to date (not expired), 2) you know how to use the medicine correctly, and 3) contact your diabetes team before taking the medicine. Also, call or go to the emergency room if, despite the medicine, you are still not able to keep fluids down or your condition worsens.

      SUMMARY:

      PREPARATION AND PREVENTION

       YOUR DIABETES SUPPLY KIT INVENTORY

      

Diabetes medicines (such as unopened insulin vials and diabetes pills)

      

Blood glucose test strips

      

Lancets

      

Alcohol wipes

      

Urine and/or ketone strips

      

Items to treat mild or moderate low blood glucose levels (hypoglycemia)

      

Glucagon emergency kits (2), if you are at high risk for severe hypoglycemia

      

Insulin syringes and/or pen needles

      

Extra blood glucose meter and batteries

      

Insulin pump supplies—infusion sets, reservoirs, batteries, transparent medical dressings (if used)

      

Written instructions from your diabetes team regarding an insulin regimen to follow when off pump therapy (be sure to include the right kind of insulin)

      

A list of emergency contact phone numbers for your diabetes team (weekday and evening/weekend numbers), primary care physician, and pharmacy.

       YOUR RISK OF SEVERE HYPOGLYCEMIA IS HIGHIF ANY OF THE FOLLOWING APPLY TO YOU

      

you are taking insulin or taking a pill that causes your pancreas to make insulin

      

you have neuropathy

      

you have frequent lows

      

you cannot recognize the early warning signs of hypoglycemia

      

you have had a prior severe low blood glucose reaction

       RECOMMENDATIONS FOR HOW YOU CAN LESSEN THE RISK OF SOME COMMON DIABETES PROBLEMS

      

Put together a diabetes supply kit and review it monthly. Such a kit should be available at home and in other places where you spend a lot of time (work, school, daycare, and relatives’ houses).

      

Keep at least one extra bottle or cartridge of insulin available, not only at home but also in other frequented places.

      

Give at least one week’s notice to your diabetes team or pharmacy when asking for medicine and/or supply refills. For mail-order prescriptions, you may need three weeks.

      

Make a backup copy of all insulin pump settings and alarms.

      

Keep sick day supplies on hand.