Information about converting from insulin pump therapy back to Multiple Daily Injections (MDI/Insulin pens)

Children and Young People’s Diabetes Service

Information for patients, parents and carers

Download leaflet

Diabetes Converting from Insulin Pump Back to MDI, Insulin Pens PIAG114 (204kB pdf)

Introduction

Sometimes you may need to go back onto insulin injections. This may be due to a pump failure or for going on holiday. To go back onto insulin injections you will need to calculate a background insulin dose to replace the pump basal rate and use your insulin to carbohydrate ratios and insulin sensitivity factor to calculate bolus insulin injections.

It is very important that:

• You download your meter and/or pump regularly
  OR keep written records of your pump doses, including your average total daily dose
  and the total daily basal insulin dose.
• You know your insulin sensitivity factors, i.e. how much insulin is required to correct
  high blood glucose levels
• You know your insulin carbohydrate ratios, i.e. how much insulin is required for
  carbohydrate foods
• Keep a record of total insulin doses, each time any changes are made, update your
  records.
• You keep a supply of rapid acting and long acting insulin and insulin pens in date

How to calculate your long acting insulin dose:

1. Find the total daily basal dose of insulin from the memory of the pump or your written
   records.
2. If basal/background insulin is Levemir or Lantus add 10% to this amount, and this will be the dose in units.
3. If basal/background insulin is Tresiba, deduct 10% from this amount and this will be the dose in units.

Example: 1

Changing from pump to Levemir® or Lantus®

Current total daily basal insulin dose = 15 units
Find 10% of this dose – 15 x 0.1 = 1.5 units
Add the 10% on to the total daily basal 15 + 1.5 = 16.5 units
to calculate the dose required

Example: 2

Changing from pump to Tresiba®

Current total daily basal insulin dose = 15 units
Find 10% of this dose – 15 x 0.1 = 1.5 units
Deduct 10% from the total daily basal 15 – 1.5 = 13.5 units
to calculate the dose required.

This formula will provide you with a starting background insulin dose, you will need to check blood glucose levels and adjust insulin doses as needed.

For all food and correction doses give rapid acting insulin ( Humalog® , Novorapid®, or Apidra ®)
using your insulin to carbohydrate ratio (ICR) and insulin sensitivity factor (ISF).

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 114