Dealing with high glucose levels; ABCC (hybrid closed loop systems)

This information is for children and young people with type 1 diabetes, and their families, on how to manage high glucose levels when using their hybrid closed loop (HCL) systems (Medtronic 780G, T:Slim with Control IQ, Ypsopump with CamAPS).

If you are using an insulin pump without a HCL system please use ‘Dealing with high glucose levels ABCC (insulin pumps)’.

ASSESS

Is the pump running? Is there insulin in the pump?

Check the pump, infusion set and cannula for any issues, alerts or alarms.

Has the pump already taken action i.e. increased basal delivery or given an automatic correction.

BOLUS

Give a manual correction dose of insulin, via the pump, using the bolus calculator.

If no bolus advised - recheck in one hour and then give a correction if advised by the bolus calculator.

CHECK IN 1 HOUR

Check glucose level one hour after this bolus has been given.

If glucose level is lower than the previous value or the sensor arrow is showing that the glucose is decreasing, no further action required.

CHANGE

If after 1 hour, glucose level is the same as or higher than the previous value use the bolus calculator in your pump to calculate a correction dose of fast acting insulin and give by pen injection.

After a pen correction, ​​​​​​​exit the HCL system for the duration of your Active Insulin Time.

Change the infusion set.

Check blood ketones again. If blood ketones are 0.6mmol/L or above exit closed loop and follow the 'sick day rules'.