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Benefit Of Insulin Pump

To Pump Or Not To Pump

To Pump Or Not To Pump

First fully described in 1983, intensive insulin therapy attempts to match the levels of insulin in the blood with the physiologic needs of the diabetic patient (1). The results of the Diabetes Control and Complications Trial solidified the importance of this approach to the prevention of microvascular complications of diabetes (2). There are two primary approaches to intensive insulin therapy: 1) multiple daily injections (MDI), and 2) continuous subcutaneous insulin infusion utilizing an external insulin infusion pump (CSII). For the last 10 years, a scientific (and often emotional) debate has existed concerning which approach is superior. The answer is important, as it affects the lifestyle, financial reserves, safety, and glucose control of the diabetic patient. Subcutaneous insulin does not reproduce the physiological delivery of insulin to the liver and systemic circulation. In humans, insulin is secreted directly into the hepatic portal vein such that the liver is exposed to higher concentrations of insulin compared with the systemic circulation. The liver subsequently removes ∼50% of this insulin, thereby lowering the exposure of the peripheral tissues to insulin. This differential insulin exposure has physiological ramifications, resulting in very fine control of intermediary metabolism. In contrast, both CSII and MDI deliver insulin subcutaneously, bypassing the liver and entering the systemic circulation. However, an insulin pump has one unique advantage over insulin injections: the ability to program changes in basal insulin dosage to meet an anticipated increase or decrease in need. This feature can be advantageous in controlling the normal rise in blood glucose concentration before breakfast (i.e., the dawn phenomenon) or preventing anticipated hypoglyce Continue reading >>

Benefits Of The Insulin Pump

Benefits Of The Insulin Pump

Insulin pump therapy, what the doctors call continuous subcutaneous infusion, offers a number of advantages over traditional (hypodermic injection) insulin therapy. Although the insulin pump is complex and expensive, it does a better job than the needle, and if you use insulin, it may do a better job for you. Where needle-injecting insulin users generally mix different insulin types to achieve optimal "coverage," pump users use only short-acting insulin, adjusting the machine rather than their insulin mix.� This produces results more resembling those of a healthy (non-diabetic) pancreas.� Once the new steps necessary to using the pump have been mastered, insulin pumpers report greater ease in diabetes self-management, less anxiety and depression, and significantly fewer problems with hypoglycemic events, compared with those on multiple insulin injection therapy.� One place where the pump offers marked improvement is in meal planning.� The diabetic who injects insulin several times a day must schedule meals to match his or her insulin's response curve.� You thus must eat when the medication you injected says so.� With the pump, that constraint is minimized.� The pumper merely adjusts the dosage for the desired amount of food, and goes about it. Remembering that exercise burns blood glucose, a diabetic using multiple injection therapy cannot engage in nonscheduled exercise (or miss scheduled exercise), without diet adjustment.� Everything must be scheduled around those injections.� With the pump, however, you can immediately take action to adjust the dose, and go have that off- schedule meal or exercise.� The pump user has far more freedom to vary his or her activities than does the syringe user.�� Today's pumps are not perfect robots, however.� Continue reading >>

Pros And Cons Of Insulin Pumps

Pros And Cons Of Insulin Pumps

Tweet Insulin pumps have become very sought after by people with diabetes, particularly people with type 1 diabetes as they have a number of key benefits over injections, including allowing greater control over diabetes. Insulin pumps are not for everyone though and there are a number of disadvantages which need to be taken into account when deciding whether a pump will be right for you. Advantages of insulin pumps Insulin pumps have a number of features which allow people to take firmer control over their diabetes as well as improving quality of life for those that have struggled on multiple daily injections. Less jabs Insulin pumps require a catheter to be implanted every 2 or 3 days, which can be more involved than single injections but the benefit is that you have to do this much less often than the number of times you’d need to inject. It also means you don’t need to associate every meal with a needle. Take insulin as and when you need it Because the cannula stays implanted, it is easier and painless to take additional insulin as and when it is needed. No need to go through the injection process, just press a few buttons and you’re done. Have different basal rates at different times of day A big advantage of an insulin pump is that you can set your pump to deliver different rates of background insulin at different times of day. So, if you’re having night time hypos, but are fine during the day, with a pump you can adjust your night time basal and keep your daytime basal dose the same. It may also give more control in beating dawn phenomenon. Flexibility with food Because delivering insulin is less hassle on a pump, you therefore have more flexibility around meal times. Say you decide you want to have a dessert after all, you can go ahead without having to d Continue reading >>

The Advantages And Disadvantages Of An Insulin Pump

The Advantages And Disadvantages Of An Insulin Pump

What is an insulin pump? An insulin pump is a small, computerized device that delivers insulin continuously throughout the day. It attempts to mimic the normal pancreas's release of insulin, but you must tell the pump how much insulin to inject. It delivers insulin in two ways: a basal rate which is a continuous, small trickle of insulin that keeps blood glucose stable between meals and overnight; and a bolus rate, which is a much higher rate of insulin taken before eating to "cover" the food you plan to eat. Effective, safe use of the pump requires: Commitment to checking blood glucose at least 4 times a day, every day. Adjusting insulin doses based on blood glucose levels, carbohydrate intake, and physical activity. The main advantages of pump therapy are: Increased flexibility in lifestyle. Predictable insulin delivery. Precise insulin delivery. Ability to accurately deliver 1/10th of a unit of insulin. Tighter blood glucose control, while reducing the risk of low blood glucose. Reducing episodes of severe hypoglycemia. Reducing wide fluctuations in blood glucose. Helping manage the "dawn phenomenon." The main disadvantages of pump therapy are: Risk of skin infections at the catheter site. Risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems. Cost: pumps are expensive, plus the continuing cost of supplies. Checking blood glucose at least 4 times per day. Letting others know that you have diabetes. Is pump therapy for you? Ask yourself these questions: Are you ready to be attached to a device that lets people know you have diabetes? Do you have realistic expectations? It is not the "magic bullet" that will solve all your blood glucose problems. Are you comfortable with the technology and mechanics of operating a pump? Are you committed to c Continue reading >>

Insulin Pump Risks And Benefits: A Clinical Appraisal Of Pump Safety Standards, Adverse Event Reporting, And Research Needs

Insulin Pump Risks And Benefits: A Clinical Appraisal Of Pump Safety Standards, Adverse Event Reporting, And Research Needs

Insulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII), is an important and evolving form of insulin delivery, which is mainly used for people with type 1 diabetes. 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. Users are therefore exposed to significant and potentially fatal hazards: interruption of insulin infusion can result in hyperglycemia and ketoacidosis; conversely, delivery of excessive insulin can cause severe hypoglycemia. Nevertheless, the available evidence on the safety and efficacy of CSII remains limited. The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have therefore joined forces to review the systems in place for evaluating the safety of pumps from a clinical perspective. We found that useful information held by the manufacturing companies is not currently shared in a sufficiently transparent manner. Public availability of adverse event (AE) reports on the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database is potentially a rich source of safety information but is insufficiently utilized due to the current configuration of the system; the comparable database in Europe (European Databank on Medical Devices [EUDAMED]) is not publicly accessible. Many AEs appear to be attributable to human factors and/or user error, but the extent to which manufacturing companies are required by regulators to consider the interactions of users with the technical features of their products is limited. The clinical studies required by regulators prior to marketing are Continue reading >>

Insulin Pump Overview

Insulin Pump Overview

As people with diabetes know, keeping blood sugar levels in a safe range is extremely important. Good blood sugar control not only makes you feel well, but also helps prevent long-term diabetes complications, such as blindness, kidney failure and heart disease. People with type 1 diabetes don’t produce insulin, a hormone that helps the body use sugar (glucose), a key source of energy that comes from carbohydrates. If you have type 1 diabetes you must make up for the lack of insulin with insulin therapy. Meanwhile, people with type 2 diabetes produce insulin, but their bodies don’t use insulin properly, or they don’t produce enough insulin. Diet, exercise and medication can often work to control glucose levels. However, in certain cases, these measures aren’t enough, and insulin therapy is needed to better control blood sugar levels. While insulin can be given by self-injection, people who take multiple daily injections of insulinmay also consider using an insulin pump. An insulin pump provides continuous delivery of short acting insulin all day long. The insulin pump substitutes the need for long acting insulin. A pump also replaces the need for multiple daily injections with a continuous insulin infusion, and also helps to improve your blood sugar levels. How Do Insulin Pumps Work? Insulin pumps are small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate). The device also is used to deliver variable amounts of insulin when a meal is eaten (bolus). The basal insulin rates are usually set up in your pump with your doctor, and you can have one or multiple basal settings programmed in your pump, based on your needs. You program the amount of insulin for your mealtime bolus di Continue reading >>

The Pros And Cons Of Insulin Pump Therapy

The Pros And Cons Of Insulin Pump Therapy

Certified diabetes educator Gary Scheiner lists all that can go wrong and all that can go right when you’re hooked up to an insulin pump. Editor’s Note: In his book, Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin, certified diabetes educator Gary Scheiner devotes a chapter on the basics of insulin pump therapy. While studies show that pump therapy, when done right, leads to better blood sugar control, it’s not for everyone. Scheiner gives a concise pro/con list of using an insulin pump. With his permission, we are sharing that list: The benefits of pump therapy include: 1. Better blood sugars. First and foremost. Pump users tend to have lower A1C scores and less glucose variability (fewer “high to low” and “low to high” swings) than those on injections. 2. Fewer lows. By using only rapid-acting insulin, there is no long-acting insulin peaking or working too hard at inappropriate times. This makes pump therapy a good choice for those who have frequent lows, a history of severe lows, or a hard time detecting low blood sugars. 3. A more flexible lifestyle. Raise your hand if you can eat, sleep and exercise at the same times every day. The pump lets you choose your own schedule. 4. Dose calculations. Modern pumps come equipped with a bolus calculator that helps the user determine mealtime doses based on carb intake, blood glucose levels, and the amount of insulin still active from previous boluses. Imagine that… no math! 5. Precise dosing. Pumps deliver insulin to the nearest .1, .05 or .025 units; ideal for those who are sensitive to very small doses, such as children and lean/active adults. 6. Convenience. There is no need to draw up syringes every time you need insulin; just reach to your pump and press a few buttons. 7. No Sho Continue reading >>

Insulin Pump Therapy Benefits

Insulin Pump Therapy Benefits

More Flexibility Since the insulin pump uses only more predictable rapid-acting insulin, you will not need to follow a strict schedule for eating, activity, and insulin injections. You can eat when you are hungry, delay a meal if you want, even broaden your food choices. If you do activities that lower your blood sugar such as riding your bike, playing with your kids, or gardening, you can reduce your basal rate so that your blood sugar does not drop too low. If you are sick or have an infection and tend to have an increase in your blood sugar, you can increase your basal rate so that your blood sugar does not go up too high. You can also change your meal bolus based on the foods you choose to eat. Fewer Injections With multiple daily injections, you can give yourself at least 120 injections per month. With insulin pump therapy, you can reduce this by 108 injections—you just change your infusion set 12 times per month.1 Tighter Control, Fewer Long-term Complications With more precise insulin delivery, you can also gain better control of your diabetes. With proper insulin pump use, you can be four times more likely to achieve your target A1C and potentially reduce your low blood sugars by 84%.2,3 Since insulin pump therapy can help you achieve better control, you can reduce your long-term complications of diabetes such as eye, heart, kidney, and nerve damage.4 Better Predictability Insulin pump therapy provides more predictability in the way your insulin works in your body than multiple daily injections (MDI). Traditional, long-acting insulin can “pool” under the skin, resulting in uneven absorption rates causing unpredictable lows and highs. Insulin pumps use only rapid-acting insulin, which is absorbed with more predictability so you can deliver smaller, more pre Continue reading >>

The Advantages Of Pumping

The Advantages Of Pumping

There are plenty of reasons. Here are our top 5. Lower A1c levels Studies show that people who use insulin pumps have lower A1c levels—a measure of blood sugar control over time—than those who take multiple daily injections.1 Fewer hypoglycemic episodes Pumpers have been shown to experience fewer episodes of severe hypoglycemia than those who take injections, including during the night.2 Overall, pump therapy is a great alternative for managing your diabetes. In fact, the majority of people who change to an insulin pump don't go back to injections.3 Read the real-life stories of people with Type 1 diabetes who have become Animas pumpers, and what life has been like for them. The information made available on the Animas website is not intended to be used or viewed as a substitute for consultation with a healthcare professional. The information provided on this site cannot be the basis for diagnosis or therapy. You are advised to obtain professional advice and should always discuss your treatment plan with your healthcare team. 1 Hoogma RPLM, Hammond PJ, Gomis R, Kerr D, Bruttomesso D, Bouter KP, et al. Comparison of the effects of continuous subcutaneous insulin infusion (CSII) and NPH-based multiple daily insulin injections (MDI) on glycaemic control and quality of life: results of the 5-nations trial. Diabet Med. 2005;23:141-147. 2 Bode BW, Sabbah HT, Gross TM, Fredrickson LP, Davidson PC. Diabetes management in the new millennium using insulin pump therapy. Diabetes Metab Res Rev. 2002;18(suppl 1):S14-S20. 3 Weisberg-Benchell J, Antisdel-Lomaglio J, Seshadri R. Insulin pump therapy. Diabetes Care. 2003;26(4):1079-1087.. Continue reading >>

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