Intra op use of home insulin pumps, yea or nay?

[caligas]

Navigating Perioperative Insulin Pump Use

Dear Q&A Over the last decade, patients with insulin-requiring diabetes are increasingly using continuous subcutaneous insulin infusion (CSII) pumps.

www.apsf.org

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[GassYous]

yea or nay

 

[coffeebythelake]

Navigating Perioperative Insulin Pump Use

Dear Q&A Over the last decade, patients with insulin-requiring diabetes are increasingly using continuous subcutaneous insulin infusion (CSII) pumps.

www.apsf.org

Depends on the surgery particulars. Subq insulin absorption can be less reliable in certain situations, body temp, hypotension etc. If this is a case where you otherwise feel comfortable giving subq insulin rather than IV insulin then I would set the pump to basal rate. There are recommendations out there by some of the different anesthesia societies about dosing and preferred route of administration for insulin.

 

[DocVapor]

Yea. Unless of course the SHTF then I turn it off and/or pull the whole thing out so I personally have more control.

 

[caligas]

yea or nay

Corrected!

 

[Volatile]

Tell them to hold bolus dosing morning of surgery, keep basal rate running 👍

 

[Arch Guillotti]

Basal or half every now and then

 

[GravelRider]

The vast majority of the time, I keep it going. My thinking is that the device is probably a lot better at managing their insulin requirements than I am. I just have the patient give me a quick rundown on how to use the thing if I need to. Most of those devices are pretty straightforward since they are designed for patient use. The technology is actually pretty cool. The patients can get real time readings of their blood glucose levels via an app on their phone or smartwatch.

 

[Hoya11]

The vast majority of the time, I keep it going. My thinking is that the device is probably a lot better at managing their insulin requirements than I am. I just have the patient give me a quick rundown on how to use the thing if I need to. Most of those devices are pretty straightforward since they are designed for patient use. The technology is actually pretty cool. The patients can get real time readings of their blood glucose levels via an app on their phone or smartwatch.

agree. i often borrow their phone

 

[GassYous]

agree. i often borrow their phone

Same, but I usually wait until they're asleep as those international calls can get expensive

 

[coffeebythelake]

I think the functionality with such devices that is most appreciated is the continuous blood glucose monitoring aspect. These insulin pumps come jn some many different ways, some with out CGM, some with CGM built in, and some with advanced algorithms to actually make automatic corrections based on CGM results.