When used in manual mode the pump functions similarly to pumps that are commercially available with pre-set basal rates, correction factors and insulin sensitivity factors and requires that the user input all carbohydrates consumed and blood sugars into the pump.
- People who like the idea of a pump. ...
- Active people, who benefit from changes in basal rates or suspending the pump when exercising.
- People who have frequent low blood sugar reactions.
- Anyone who has delays in absorption of food from the stomach (gastroparesis).
- Women planning pregnancy.
Can insulin pumps be used to treat type 2 diabetes?
Although most of the earlier data on CSII was gained from use of insulin pumps in children and young adults with type 1 diabetes, this method of treatment has gained popularity in patients with type 2 diabetes as well.
When is an insulin pump not the answer?
An insulin pump is NOT the answer for patients who demonstrate limited diabetes education and/or poor self-management or for patients who expect the pump to “take over” diabetes care. How does an insulin pump work?
What follow-up is needed for patients on insulin pump therapy?
Upon initiation of insulin pump therapy, it is recommended that patients have face-to-face follow-up with their diabetes care providers within the first 3-14 days after starting. As with patients on MDI, insulin doses for patients on insulin pumps should be adjusted regularly.
Do primary care physicians need to know about insulin pumps and sensors?
Although endocrinologists and diabetes specialists will continue to maintain expertise in this field, it behooves the primary care physician to have a working knowledge of insulin pumps and sensors to ensure optimal clinical care and decision-making for their patients. Keywords: diabetes, insulin pump, pancreas, glucose sensor, monitoring 1.
What is the criteria for an insulin pump?
The one absolute requirement for using a pump is that you and/or your caregivers are ready and willing to do what it takes to use the pump safely. Most diabetes providers and insurance companies require that you check your blood glucose at least four times per day before you go on an insulin pump.
What are three factors that bring about changes in the diabetic patient's need for insulin?
Insulin needs often change over your lifetime. Changes in weight, diet (what you eat), health status (including pregnancy), activity level, and work can affect the amount of insulin needed to control your blood sugar.
What is the greatest risk associated with the use of an insulin pump?
The main disadvantages of pump therapy are: Risk of diabetic ketoacidosis (DKA) from pump or site malfunction.
Which factors determines insulin boluses given before meals via the insulin pump?
Bolus doses of insulin for corrections are calculated automatically by the insulin pump using the patient's finger-prick glucose (entered via a compatible blood glucose meter) and the pre-programmed insulin sensitivity factor. This factor is the amount that blood glucose (mmol/L) is lowered by one unit of insulin.
What factors are involved in the regulation of glucose and how do they specifically affect blood glucose concentration?
Insulin helps the cells absorb glucose, reducing blood sugar and providing the cells with glucose for energy. When blood sugar levels are too low, the pancreas releases glucagon. Glucagon instructs the liver to release stored glucose, which causes blood sugar to rise.
What factors may alter the results of a blood glucose measurement?
Food, alcohol, tiredness and stress can all impact blood glucose levels. Many people are surprised to know that protein can affect blood sugar levels, too.
Why would you need an insulin pump?
Why are insulin pumps used? People who have diabetes don't make enough insulin naturally. Instead, they have to use insulin injections to manage their blood sugar. Pumps offer a steady stream of insulin so that you can have fewer needle sticks.
What are the advantages and disadvantages of an insulin pump?
Pros and Cons of Insulin PumpsAdvantages of insulin pumps. ... Less jabs. ... Take insulin as and when you need it. ... Have different basal rates at different times of day. ... Flexibility with food. ... Flexibility with exercise. ... Increased blood glucose control. ... Reducing episodes of severe hypoglycaemia.More items...
What is the problem with insulin pumps?
However, even with modern insulin pumps, errors of insulin infusion can occur due to pump failure, insulin infusion set (IIS) blockage, infusion site problems, insulin stability issues, user error, or a combination of these.
What is the sensitivity factor on an insulin pump?
Insulin sensitivity factor, or ISF, refers to how much or how many points (mg/dl) the blood sugar will drop in response to one unit of insulin. It is also known as a high blood sugar correction, and is set as one unit of insulin to lower a specific amount of glucose (in mg/dl).
How is insulin correction factor determined?
The CIR is calculated by dividing the constant 450 by the Total Daily Dose (TDD). The CIR may be different for different meals of the day. If the premeal blood sugar is out of the targeted range , the meal related insulin dose may need to be adjusted accordingly.
What is insulin sensitivity factor?
The insulin sensitivity factor refers to the drop in blood sugar level. This measurement is done in milligrams per deciliter (mg/dl) and depends on the units of insulin taken. While insulin is meant to help your blood sugar levels fall, they should not fall too far as this can also be risky.
Case Presentation
S.P., is a 10-year-old boy with a 3-year history of type 1 diabetes. In May 2000, while on three insulin injections per day, he requested insulin pump therapy in order to increase lifestyle flexibility. His height was at the 90–95th percentile, and his weight was at greater than the 75th percentile. His hemoglobin A 1c (A1C) concentration was 6.9%.
Discussion
Insulin pump therapy provides a more physiologically precise manner of delivering insulin compared to self-injections with less variable insulin absorption and a better match between insulin and food intake.
Article Information
We would like to thank our colleagues in the Department of Endocrinology and Metabolism for their assistance with this article and their contributions to our program. We also appreciate the efforts of Natalie Bellini, RN, CDE, CPT, for her invaluable contributions.
What happens when you use a pump for insulin?
When you use the pump for insulin administration, the pattern is almost like the one where insulin is produced in the body of a healthy So, this process leads to better insulin absorption
What is insulin pump?
An insulin pump is a device which is used by the diabetes patients to administer insulin into the body externally. It is a computerized device which is used for this purpose. There are two different ways in which the device can be used to administer insulin: Basal rate: This refers to the continuous administration of the hormone into your body in ...
What to do if blood glucose is low at night?
For example, if you feel that your blood glucose is going too low during the night, you can adjust the base of the insulin and administer the hormone accordingly . The same helps to fight the reasons for high blood glucose such as the dawn phenomenon, amongst others.
What are the disadvantages of insulin pumps?
The Insulin pump offers the following disadvantages to all the users: 1 The major disadvantage of using insulin pumps is that the malfunction of these pumps can lead to Diabetic Ketoacidosis. 2 Besides, inefficient use of these pumps can also cause a lot of infections 3 You have to check your glucose levels at least four times a day 4 You need to inform others that you have diabetes when you are using diabetes pump. 5 These insulin pumps are very expensive and may not be available at affordable rates 6 You should not use this pump if you do not have the self-discipline to be consistent
Why do you take bolus before meals?
It is usually taken just before the meals in order to ensure that the blood glucose is within the normal range when you eat food.
Can you adjust insulin dosage?
You should be able to adjust the total dosage of the insulin you take according to the food you eat, the total carbohydrate intake, the amount of physical activity that you do, as well as the total level of blood glucose in your body. You need to let other people know that you have diabetes.
Can insulin be used for exercise?
Besides, this method of taking in insulin helps you with flexible timing when it comes to exercise or other physical activities. if you decide to do some form of physical exercise, you can always lower your dose so that you have little to no chances of experiencing hypoglycemia.
RESEARCH DESIGN AND METHODS
Literature searches were conducted on MEDLINE and PubMed using the keywords “insulin,” “pump,” “insulin infusion,” and “continuous subcutaneous insulin infusion (CSII)” to identify relevant studies. Studies were also obtained from review articles and from references contained within individual articles.
CONCLUSIONS
Research on CSII therapy began in the late 1970s, with a strong resurgence in the 1990s after technological advances in blood glucose monitoring devices and insulin delivery systems.
How does a pump deliver insulin?
All pumps deliver insulin in 2 ways: basal and bolus delivery. The majority of pumps are NOT fully automatic; basal insulin will be delivered automatically, but bolus insulin (approximately 50% of daily needs) MUST be programmed by wearer.
How does an insulin pump work?
Current models of insulin pumps are the size of small cell phones or pagers, are powered by AA or AAA batteries or can be recharged through a micro-USB (T-slim pump). Pumps use only rapid-acting insulin (aspart, lispro, or glulisine) or U-500 regular insulin. For most rapid-acting insulin, most insulin activity occurs within the first 3 hours after injection.
Why does the body need insulin when you are sick?
Sick Days. In the event that someone is ill and not eating, the body still requires insulin to counteract increases in glucose and ketone production by the liver due to increased secretion of stress hormones (cortisol, glucagon, growth hormone, epinephrine/norepinephrine).
What is the A1C level for adults?
Based on a large body of evidence that supports the reduction in the number of microvascular, macrovascular and neuropathic complications with successful intensive diabetes management, the American Diabetes Association (ADA) recommends target A1c levels of <7.0% in adults. The International Society of Pediatric and Adolescent Diabetes (ISPAD) recommends target A1c levels of <7.5% in children.
How long does an insulin reservoir hold?
Most models use a large syringe- like cartridge or reservoir to hold several days’ worth of insulin. The cartridge/reservoir is attached to a length of tubing (18-42 inches) that then attaches to a small (6-17 mm) Teflon or steel needle catheter (entire unit is called the infusion set)
Why is retrieving data from a pump important?
Retrieving data from a pump can be a helpful and time-saving tool for the clinician and patient.
Where is the insulin pump shipped?
The insulin pump is typically shipped to the patient’s home, unless otherwise specified.