I have a child in my school with an insulin pump, and during the school day her blood sugar is checked when she arrives, before snack, before lunch, after lunch with recess, (if it’s a gym day, before she goes to gym and after gym class) and before departing for home. She receives coverage for each blood sugar taken as indicated for by her levels, at times getting one-half a correction bolus as directed. It seems that this is an awful lot to be checking her blood sugars.

I thought that when someone was on an insulin pump, it was supposed to be less invasive of their normal routine. How often should her blood sugars be checked?

There is no absolute number of times that blood sugar levels must be checked. In general, as a school nurse, you should check the number of times requested by the parents and/or health care team. If you think this may be excessive, and it sounds like a possibility from your question details, then you would be wise to have a conference with the parents and find out their rationale. Try not to get them angry or defensive but ask the questions in a non-threatening fashion to gather information. It also would be reasonable to discuss directly with their health care team — nurse and/or physician. In labile diabetes, often the case with kids on pumps and kids no matter how they are treated, more frequent testing is one of the strategies for making frequent corrections. The general goal of insulin pump therapy is not automatically to make life simpler but rather to control the blood glucose and hemoglobin A1c levels better than what was possible with multiple injections.

SB