It’s Time to Get Back to School!
It’s that time of the year again! Nationwide, kids are heading back to school in person. With that in mind, it’s important to ensure that students using diabetes technology while at school are prepared. For example, students using an insulin pump, such as the MiniMed™ 770G system, should have signed orders from their healthcare provider. These orders should include the name of the device they are using along with the programmed settings for both basal and bolus insulin, detailed instructions for a pump backup plan, as well as contact information for their healthcare provider (HCP) in case of emergency.
Sometimes the unexpected happens: running low on insulin, a kinked cannula, or a dead pump battery are all things that could impact a student while at school. For that reason, it’s a good idea for students to have extra pump supplies at school. These should at least include an extra infusion set, serter (if needed), a reservoir, and a rapid-acting insulin vial.
It is important to have a backup plan if the pump is not able to be used to deliver insulin. This should include rapid-acting insulin pens or syringes, and doses for food and for correcting high blood glucose values (BGs). Long-acting insulin pens or syringes, and a dose may also be necessary for longer stays at school.
General Guidelines:
It’s a good idea to encourage school staff to familiarize themselves with diabetes technology. The MiniMedTM 770G System School Nurse Guide for example, provides a comprehensive and yet simple overview of the MiniMed™ 770G system including its various modes of insulin delivery.
Below we share several best practices that can help students stay in SmartGuard™ Auto Mode while at school.
- Students should be checking their BGs are as indicated in the signed orders from their HCPs and calibrating their sensor at least 3-4 times per day. While at school, it’s reasonable students may need to calibrate once before lunch and/or if the device asks for a calibration.
- Students should also bolus for carbs before eating meals and snacks. Consider reviewing the signed orders from their HCP to ensure you’re familiar with the recommended length of time to bolus pre-meal.
- Lastly, students should respond to alarms and alerts as needed to help maximize their time spent in SmartGuard™ Auto Mode; this may also help with wide fluctuations in glucose values while at school.
Did you know? The MiniMed™ 770G System is a Bluetooth® -enabled device. This means students are able to view their sensor glucose values and receive optional alerts on a smartphone using the MiniMed™ Mobile App while parents or caregivers can also have access to this data remotely via the use of the CareLink™ Connect App (WiFi or mobile data required).
Gym class and SmartGuard™ Auto Mode:
When it comes to exercise while at school, students using Hybrid Closed Loop Technology like the MiniMed™ 770G system should be encouraged to continue with the same behaviors they were doing while on traditional pump therapy. Ideally, students should exercise with little or no insulin on board in order to help avoid lows. It’s wise to have carbs handy if needed and to replace carbs with long activity like what students without diabetes would do. Suspending the pump to prevent or react to lows can also be done if needed.
Keep in mind that if a student prefers to eat carbs before exercise, it’s important to remind them that carb loading too far in advance of exercise will cause Auto Basal delivery to increase in response to the increase in sensor glucose (SG) values; this may be counterproductive and may lead to lows during exercise.
Don’t forget about the Temp Target! A student may want to temporarily change the SmartGuard™ Auto Mode target from 120 mg/dL to 150mg/dL for exercise. School staff should be advised that the temp target duration may be set in 30-minute increments for up to 12 hours. While it’s active, the home screen will display a banner showing the remaining temp target time.
Safety Guidelines:
Safety first! Students and school staff should be well versed on DKA prevention guidelines. These include:
- Adhering to a routine BG monitoring schedule.
- If BG >250 mg/dL they should deliver a correction based on the recommendation calculated by the Bolus Wizard™ and recheck the BG 1 hour after to ensure it’s coming down to the target range.
- Students should never ignore an unexplained high blood glucose as this may indicate an infusion set or insulin pump problem.
- Students should be encouraged to test for ketones any time a BG is >250 mg/dL without explanation.
- Students and school staff should always follow the healthcare provider’s orders for guidelines to follow when there are positive urine ketones.
If you’d like to learn more about this topic ahead of the new school year, click here to access the MiniMed™ 770G System Webinar for School Nurses and here to access/download the MiniMed™ 770G System School Nurse Guide. For any other questions, please reach out to your local Medtronic Diabetes Representative