diabetestalk.net

Do People With Type 2 Diabetes Use Insulin Pumps?

Insulin Pumps

Insulin Pumps

Insulin pumps are an increasingly common treatment for type 1 diabetes. They can improve glucose control in people with type 1 diabetes but do not suit everyone. An insulin pump delivers insulin every few minutes in tiny amounts, 24 hours a day. It is usually about the size of a deck of cards, but can be much smaller. The insulin flows through a cannula which sits in the subcutaneous tissue (where you inject) and is changed by the pump user every few days. Basal (background) insulin is programmed to meet the pump user’s needs. The bolus insulin is delivered at the touch of a button to cover food or bring down a high blood glucose level. Only rapid-acting insulin is needed and provides all your insulin requirements. Insulin pumps reduce the need for multiple injections and give the user the ability to make smaller, more accurate adjustments to insulin delivery. Note: insulin pumps do not measure blood glucose levels, but some pumps can read the signal from a separate glucose sensor. What sort of insulin pumps are there? There are a number of different types of insulin pump and accessories. They vary in aspects such as weight; units of adjustment; whether they have tubing or not and battery life. A ‘tethered’ pump uses a fine tube to connect the pump to the cannula; the pump is worn in a pocket or clipped to a belt. A patch pump or micro pump has no tubing or a very short tube, and the pump is usually stuck on to the skin. The following suppliers currently offer pumps in the UK: Animas Advanced Therapeutics Cellnovo Medtronic Roche OmniPod A good document for comparison can be downloaded here. Type 1 Technology guide We have produced a family-friendly guide to type 1 diabetes technology, which highlights recommendations from NICE on treatments and technology for chi Continue reading >>

Insulin Pumps

Insulin Pumps

Not Just for Type 1 An estimated 350,000 people in the United States use insulin pumps today, and about 30,000 of those are believed to have Type 2 diabetes. Surprised? Type 2 diabetes is a progressive disease that causes many people who have it to eventually need to use insulin to control their blood glucose levels. Although many people still think insulin pumps are only for treatment of Type 1 diabetes, they can also be useful for some people with Type 2 diabetes. According to Charles H. Raine III, MD, a diabetologist in Orangeburg, South Carolina, who himself has Type 2 diabetes and uses an insulin pump, the criteria for a good pump candidate are the same, no matter what type of diabetes a person has. In general, a good pump candidate has uncontrolled blood glucose, but also has a desire to try for better control of his diabetes, is willing to measure and document food intake and blood glucose levels, and is physically, emotionally, and cognitively able to manage a pump (or has a caregiver who is). Another important characteristic is a willingness to keep appointments with members of his diabetes care team. Insulin pumps are cell-phone-size devices used to deliver preprogrammed and user-adjusted doses of insulin. Depending on the brand and model, they hold between 180 and 315 units of insulin. Most people use rapid-acting insulin — options include insulin lispro (brand name Humalog), insulin aspart (NovoLog), and insulin glulisine (Apidra) — in their pumps, with a few using Regular. Instead of using an intermediate- or long-acting insulin as a background — or basal — insulin, a user simulates the pancreas’s steady release of insulin by programming the pump to automatically give small amounts of the rapid-acting or Regular insulin around the clock, based on Continue reading >>

Misconceptions About Insulin Pump Therapy And Type 2 Diabetes

Misconceptions About Insulin Pump Therapy And Type 2 Diabetes

Many people think that if you live with type 2 diabetes and use insulin pump therapy, it means you’ve failed in managing your diabetes. Unfortunately, it’s a misconception that Medtronic Diabetes Clinical Manager, Beth Spencer Kline, MSN, RN, NP-C, CDE, hears too often from patients. Type 2 diabetes is a progressive disease, and exercise and eating right is always important, but over time, patients may need to change their insulin regimen to make sure their blood glucose is in a healthy range. Being passionate about type 2 diabetes weight management, co-morbid diabetes, and cardiovascular disease, Beth is here today to address common misconceptions many people have about type 2 diabetes and insulin pump therapy. Umbrellas Don’t Cause Rain: Lessons Learned as a New Healthcare Professional Despite studying how to manage disease in school, most of the learning is on the job. We walk into new jobs, ready to save the world one patient at a time, thinking we have all of the answers, and it’s easy to prescribe medication and make everything better. It doesn’t take long to realize medicine doesn’t work like that. It’s as much of an art as a science. Many seasoned healthcare professionals who work with patients who have diabetes would probably tell you they’ve learned the most about diabetes from their patients. Two of the most important things I’ve learned working with people with diabetes in the last 10 years is diabetes is a disease everyone seems to have an opinion about, and has a lot of misplaced judgment and surrounding myths. I’ll never forget, when I was a new nurse practitioner, I had a patient with type 2 diabetes who was afraid to start insulin due to his misguided fear that taking insulin would cause blindness and the need for dialysis. We had a Continue reading >>

Insulin Pumps 'more Effective Than Injections' For Type 2 Diabetes

Insulin Pumps 'more Effective Than Injections' For Type 2 Diabetes

For patients with type 2 diabetes, managing the condition can involve multiple daily injections of insulin. But a new study published in The Lancet suggests that insulin pumps may be more effective for controlling blood sugar levels. This is not the first time a study has protested the benefits of insulin pumps. Last year, Medical News Today reported on a study suggesting that insulin pumps are better than insulin injections for type 1 diabetes. But the team involved in this latest study, led by Prof. Yves Reznik of the University of Caen Côte de Nacre Regional Hospital Center in France, claims theirs is the largest study to date that explores the effectiveness of insulin pumps for type 2 diabetes - the type that accounts for 90-95% of all diabetes cases. Type 2 diabetes is a condition whereby the body is unable to produce or use the hormone insulin effectively, resulting in high blood sugar levels. Over time, high blood sugar levels can cause nerve damage, stroke, and kidney, eye or heart diseases. In some cases, the condition can be managed through diet or blood sugar-lowering medication, such as metformin. But in many cases, a patient may require multiple daily doses of insulin delivered by injection into the abdomen, upper arms, thighs or buttocks. However, Prof. Reznik and colleagues note that around a third of patients that manage their condition with insulin injections have problems achieving the optimal level of blood sugar. With this in mind, the team decided to compare the effectiveness of insulin injections against insulin pumps - small portable, computerized devices that deliver continuous doses of insulin through a catheter places under the skin. Findings 'suggest insulin pumps are a valuable treatment option for type 2 diabetes' For their study, the resea Continue reading >>

5 Reasons People Ditch The Pump

5 Reasons People Ditch The Pump

We hear a lot about the pros of insulin pump therapy. A diabetes educator shares some of the cons. Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q – I see studies show that people with Type 1 do better on insulin pump therapy, but I sometimes hear of people stopping pump therapy to return to multiple daily injections. Can you tell me why it might be better for some people to stop using a pump? A – There are many more choices for insulin pumps than in the past, and many of these new pumps come with new and powerful technological options to help you with blood sugar management. Many clinicians promote pump use as the best way to achieve optimal control. But is it really the end-all-be-all of diabetes management? As with everything in life, it comes down to personal choice and what works for you. It’s best to do your homework to evaluate if a pump is best for your lifestyle and blood sugar management needs. There are plenty of articles discussing the pros of pump therapy, but few that discuss the cons. To offer some balance, here are some downsides to pump use that have caused people to switch back to multiple daily injections: 1) Mechanical Failure Insulin pens and syringes don’t have mechanical parts – they will not malfunction or have errors. The more technology that is used to deliver insulin, the higher the chance that something can go wrong in a mechanical sense. It doesn’t happen often, but it does happen. I have had several pump failures in 15 years of pump use; all were detected by the pump. Pump problems can include internal errors in Continue reading >>

Why One Woman With Type 2 Diabetes Uses An Insulin Pump

Why One Woman With Type 2 Diabetes Uses An Insulin Pump

Pumps finely tune insulin to your body's needs, but can require a lot of tinkering.(ISTOCKPHOTO)Insulin pumps are used most often by people with type 1 diabetes, due to their more complicated insulin injection regimen. Only 5% of the more than 5,000 individuals who are members of insulin-pumpers.org, an online community for people interested in insulin-pump therapy, have type 2. So is the pump a good option for type 2 patients? Yes, if they require multiple daily insulin injections and don't mind programming and wearing the pump every day. 'I wanted my freedom' Jan Chait, a 59-year-old freelance writer in Terre Haute, Ind., used to take NPH (an intermediate-acting insulin) and regular insulin, but all the clock-watching was a drag. "I just wanted my freedom," she says. That's why nine years ago she switched to an insulin pump. She is one of a relatively small percentage of people with type 2 diabetes who use this insulin-delivery device. Chait finds the pump easy to use. "I was familiar with them because I had several friends who had pumps, and they always talked about how wonderful it was, the flexibility, I mean the ultimate flexibility. It's almost like not having diabetes anymore," she says. "Not quite, but almost, because you can set the basal rates to your body's natural cycles." For example, some people require less insulin at night; Chait, though, needs more. More about using insulin Consider the pros and cons Still, there are many pros and cons to consider. Advantages include eliminating many individual injections, improving hemoglobin A1C, and delivering insulin more accurately. On the other hand, some people may find it bothersome to be attached to a machine most of the time. And you may need quite a bit of training before you're ready to fly solo. In additio Continue reading >>

Clinical Recommendations In The Management Of The Patient With Type 1 Diabetes On Insulin Pump Therapy In The Perioperative Period: A Primer For The Anaesthetist

Clinical Recommendations In The Management Of The Patient With Type 1 Diabetes On Insulin Pump Therapy In The Perioperative Period: A Primer For The Anaesthetist

Since its introduction in the 1970s insulin pump therapy is being used increasingly in the management of type 1 diabetes, with current estimates of between 20 to 30% of people in North America with type 1 diabetes being pump users, 1,2 and this number is increasing rapidly in the UK. Current NICE guidance in the UK recommends 15–20% of the population with type 1 diabetes should be eligible for insulin pump therapy. However, uptake remains very dependent on individual diabetes centres having sufficient expertise in this technology, and it remains a postcode lottery. 3,4 Original studies of continuous subcutaneous insulin infusion (CSII), compared patient groups randomized to either multiple daily injections (MDI) or insulin pump therapy. The initial studies using older non-analogue based insulin regimens, demonstrated improvements in glycaemic control, with reductions in HbA1c and hypoglycaemia with insulin pump therapy. 5 These results were later confirmed using newer basal insulin analogues 6 and were demonstrated with an associated improved quality of life in both adults and children. 7 After publication of the results from the seminal Diabetes Control and Complications Trial (DCCT) in 1993, care for people with type 1 diabetes has focused on aiming to achieve intensive management of glucose control, hence reducing micro- and macrovascular risk. 8 Insulin pump therapy has been demonstrated to reduce HbA1c significantly over MDI in the first year of use in numerous studies 9,10 and we are now starting to see multicenter long-term outcome data, demonstrating similar results over 1–10 yr periods compared with prepump values 11,12 and in comparisons of matched cohorts continuing on MDI. 13 The primary goal of insulin pump therapy is to mimic physiological insulin repl Continue reading >>

Insulin Use - Type 2

Insulin Use - Type 2

Overview Most people with type 2 diabetes will eventually require insulin replacement therapy There are barriers to insulin treatment with multiple daily injections (MDI) Insulin pumps are effective in people with type 2 diabetes, but due to complexity use is limited To overcome insulin delivery barriers, new simple insulin infusion devices have been developed Type 2 diabetes is a progressive disease of insulin resistance and B-cell failure (cells that store and produce insulin) resulting in a continued and progressive need to intensify diabetes therapies to maintain glycemic (blood sugar) control. Eventually most people with type 2 diabetes require insulin replacement therapy. This is generally initiated with basal (background) insulin and, if needed, bolus (mealtime) insulin is introduced to address the high blood sugar after a meal.1 This "basal-bolus" insulin therapy is most frequently administered by multiple daily injections (MDI) with an insulin syringe or pen device. Unfortunately MDI therapy can be challenging and patient compliance and persistence with MDI therapy is frequently inadequate.2 Potential barriers to MDI, which can result in suboptimal glycemic control, include; having to take multiple injections, interference of injections with daily activities, injection pain and embarrassement.2 As a result many people using MDI therapy do not achieve target glycemic control.3 Continuous subcutaneous insulin infusion (CSII) therapy using an insulin pumps addresses many of the barriers associated with MDI therapy and could result in enhanced adherence. In type 1 diabetes, CSII therapy has shown benefits over MDI therapy including improved glycemic control, reduced glycemic variability, higher quality of life and has become standard of care.4,5,6 Several studies h Continue reading >>

Insulin? But I Have Type 2!

Insulin? But I Have Type 2!

With type 2 diabetes, many people think, "take a pill, watch your diet and all will be well." Right? Then, out of the blue, your doctor mentioned insulin. Insulin is secreted from a healthy-functioning pancreas in response to food or stress—whenever your body needs to get glucose into your muscle cells. In doing so, it helps keep a healthy level of glucose in your blood. Without a doubt, insulin is the most natural, easiest way to keep your blood sugar in an optimal range. Still, some physicians don't recommend insulin because they think that their patients might be too scared. Diabetes is a progressive disease. Over time, your pancreas will make more mistakes, even when you take care of yourself. Actually, 6 years after being diagnosed with diabetes, over 50% of people with type 2 need insulin.1 The better you care for yourself, the healthier you'll be, but your diabetes still wants to win the blood sugar battle. There comes a time when you and your doctor need to fight back with insulin. Even though insulin is good news for your health, there may be some things you're wondering about: Why do I have to take it in a shot? Insulin is a protein chain. If it were swallowed in a pill, stomach acid would digest it like a piece of cheese. Instead, it's injected through a syringe directly into fatty tissue—anyplace you can pinch an inch—such as your stomach, back of an arm, buttocks, thigh or hip. Today's needles are thin and coated with silicone, so they're barely noticeable and definitely not painful. Are there other ways to get insulin? Some people prefer to use an insulin pen, insulin pump or inhaled insulin. Ask your doctor if one of these might be right for you. Can someone with type 2 diabetes wear an insulin pump? Definitely! Today's insulin pumps are easy to use Continue reading >>

Type 2 Pump Rx

Type 2 Pump Rx

Insulin pump therapy can improve your blood sugar control. Insulin pumps more closely mimic what your body does naturally, so you can enjoy a more flexible lifestyle. Insulin pump therapy is increasingly popular. Because insulin pumps more closely mimic what your body does naturally, you can improve your blood sugar control. With that control comes a more flexible lifestyle. Remember, though, that the pumps still require a lot of input from users. If you are wondering whether you should use a pump or are already on a pump, this section explains: Advanced programming features: How to get the most out of the pump and use all the options Infusion sets: All about the different sets and how to place them Ketones and insulin pumps: Why to watch for ketones and what to do if you have them Travel: Special considerations when using a pump while traveling Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Insulin Pumps, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information. Continue reading >>

Insulin Pumps 'better Than Injections' For Type 2 Diabetes

Insulin Pumps 'better Than Injections' For Type 2 Diabetes

The research, published in The Lancet, has discovered that the pump results in better blood sugar control and should help the one-third of diabetes patients who struggle with injections. Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. In the UK, approximately 2.9million people are affected by the condition. There are also thought to be around 850,000 people with undiagnosed diabetes. Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body’s cells don't react to insulin. This is known as insulin resistance. Type 2 diabetes is far more common than type 1 diabetes, which occurs when the body doesn't produce any insulin at all. Previous studies had returned mixed results on the efficiency of insulin pumps but the OpT2mise trial showed a clear benefit. The study involved 495 adults aged 30-75 with poorly controlled type 2 diabetes, who were helped to optimise daily insulin injections for two months prior to the study. After this period, researchers randomly assigned 331 adults with HbA1c levels still above 16.5mmol/L to continue multiple daily insulin injections or use an insulin pump. Patients using an insulin pump saw HbA1c levels fall by 1.1mmol/L more than those using injections. Of patients using pump therapy, 55% reached the target HbA1c level of 10.1mmol/L compared with just 28% of injecting patients. Those on pump therapy also spent three hours fewer each day in hyperglycemia (an excess of glucose in the bloodstream). By the end of the study, insulin doses were 20% lower in patients using pumps. Lead professor, Yves Reznik, said: "Pumps enhance effective insulin absorption and increase insulin sensitivity thanks to the continuous daily subcutaneous insulin delivery. "Our fin Continue reading >>

The Benefits Of An Insulin Pump For Type 2 Diabetes

The Benefits Of An Insulin Pump For Type 2 Diabetes

The continuation of OpT2mise–a randomized and controlled study sponsored by Medtronic showed that insulin pumps provided much more consistent and reliable blood sugar improvements in comparison with multiple daily injections. The OpT2mise study is the largest randomized controlled trial to compare multiple daily injections (MDI) and insulin pump therapy in patients with poorly managed type 2 diabetes. It followed 331 patients between 30 and 75 years of age. The study utilized MiniMed brand insulin pumps and the data showed that the group of patients who began using the pump after six months of MDI doubled their A1c reduction from .4% to .8% while also using 19% less insulin. Dr. Ronnie Aronson, FRCPC, FACE, was the lead author of this continuation phase of the study and the executive director at LMC Diabetes and Endocrinology in Toronto, Ontario, Canada and said in the press release: “The continuation phase of OpT2mise builds on the findings of the initial study period, which showed that insulin pumps helped participants with insulin-requiring type 2 diabetes safely achieve better glucose control, with lower insulin doses, than MDI,” and “We found that participants who switched from MDI to insulin pumps were able to achieve these same results by the 12-month mark. Given that many patients with type 2 diabetes have difficulty achieving glycemic control, these additional data demonstrate that insulin pumps provide a significant advantage over MDI with a safe and consistent effect.” For people with type 2 diabetes, blood sugar management is crucial to avoid complications. The press release mentioned that “A 1% reduction in A1C is associated with a reduction in the risk of long-term complications like stroke, heart disease, eye damage, and kidney disease reduces Continue reading >>

Insulin Pump

Insulin Pump

An insulin pump is a medical device used for the administration of insulin in the treatment of diabetes mellitus, also known as continuous subcutaneous insulin infusion therapy. The device configuration may vary depending on design. A traditional pump includes: the pump (including controls, processing module, and batteries) a disposable reservoir for insulin (inside the pump) a disposable infusion set, including a cannula for subcutaneous insertion (under the skin) and a tubing system to interface the insulin reservoir to the cannula. Other configurations are possible. For instance, more recent models may include disposable or semi-disposable designs for the pumping mechanism and may eliminate tubing from the infusion set. An insulin pump is an alternative to multiple daily injections of insulin by insulin syringes or an insulin pen and allows for intensive insulin therapy when used in conjunction with blood glucose monitoring and carb counting. Medical uses[edit] Advantages[edit] Users report better quality of life (QOL) compared to using other devices for administering insulin. The improvement in QOL is reported in type 1 and insulin-requiring type 2 diabetes subjects on pumps.[1] The use of rapid-acting insulin for basal needs offers relative freedom from a structured meal and exercise regime previously needed to control blood sugar with slow-acting insulin.[citation needed] Programmable basal rates allow for scheduled insulin deliveries of varying amounts at different times of the day. This is especially useful in controlling events such as the dawn phenomenon resulting in less low blood sugar during the night.[2] Many users feel that bolusing insulin from a pump is more convenient and discreet than injection.[2][3] Insulin pumps make it possible to deliver more pre 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 >>

Insulin Pumps May Control Blood Sugar Better For Some With Type 2 Diabetes

Insulin Pumps May Control Blood Sugar Better For Some With Type 2 Diabetes

TORONTO -- Insulin pumps appear to be significantly better at controlling blood-sugar levels in some people with hard-to-treat Type 2 diabetes compared to the standard therapy of multiple daily insulin injections, an international study has found. Type 2 diabetes, in which the pancreas doesn't make enough insulin or the body doesn't use the hormone effectively, is typically controlled by diet and medication, but most people also end up needing insulin therapy to manage their blood sugar as the disease advances. However, about a third of these patients have difficulty achieving optimal blood-sugar control with insulin injections, which they must administer several times a day. Poor blood-glucose management can lead to such complications as vision damage, cardiovascular disease and kidney failure. Insulin pumps deliver continuous amounts of rapid- or short-acting insulin through a catheter placed under the skin, without the need for self-injection. The 2010-2013 study involved 331 people, aged 30 to 75, with Type 2 diabetes in Canada, Europe, Israel, South Africa and the United States. Researchers randomly assigned roughly half the patients to receive treatment with insulin pumps, while the rest continued with multiple daily injections. Each therapy delivers both basal insulin to cover daily needs and bolus insulin taken near mealtimes. Diabetics on injections take long-acting insulin to cover their basal needs, and rapid-action insulin to cover carbohydrate intake. Insulin pumps deliver small amounts of rapid-action insulin throughout the day and night to cover basal needs, and users can program additional "boluses" to cover food intake. Before being split into the two groups, all patients had gone through a two-month "run-in" period to optimize their blood-sugar control Continue reading >>

More in insulin