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Do People With Type 2 Diabetes Use Insulin Pumps?

People With Type 2 Diabetes Achieve Superior Outcomes With Insulin Pumps Vs. Multiple Daily Injections

People With Type 2 Diabetes Achieve Superior Outcomes With Insulin Pumps Vs. Multiple Daily Injections

This information is intended for media professionals and investors PEOPLE WITH TYPE 2 DIABETES ACHIEVE SUPERIOR OUTCOMES WITH INSULIN PUMPS VS. MULTIPLE DAILY INJECTIONS Comparative Efficacy Results from the OpT2mise trial Published in The Lancet Could Redefine Management of Insulin-Requiring Type 2 Diabetes BRAMPTON – June 3, 2014 – As an example of its commitment to improving clinical outcomes for all people with diabetes, Medtronic, Inc. (NYSE:MDT) today announced the results of the global OpT2mise trial, which included eight participating centres in Canada. The results showed that MiniMed insulin pumps safely achieve better glucose control for people with insulin-requiring type 2 diabetes than multiple daily injections. While the benefits of continuous subcutaneous insulin infusion (CSII) with an insulin pump for people with type 1 diabetes are well proven, this is the largest global study to evaluate the comparative efficacy of CSII with an insulin pump versus multiple daily insulin injections in people with type 2 diabetes with poor glycemic control. Study results were published online in The Lancet today. In the OpT2mise trial, those using insulin pumps achieved a mean A1C (average blood glucose) reduction of 1.1 percent compared to only a 0.4 percent reduction by those using multiple daily injections. This improvement in glucose control was achieved without any episodes of severe hypoglycemia. In addition, those in the insulin pump group lowered the total daily dose of insulin by more than 20 percent. There was no difference in weight gain between the two groups. Reducing A1C is critical for people with diabetes because even small percent drops aid significantly in preventing complications, such as eye disease, kidney disease, nerve damage and heart attacks[ 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 >>

Insulin Pumps

Insulin Pumps

Tweet Insulin pumps are portable devices attached to the body that continuously deliver amounts of rapid or short acting insulin via a catheter placed under the skin. They are seen as a better alternative to insulin injections as they reduce the need for multiple insulin jabs per day and give the user increased ability to control blood glucose levels. Around 1 in 1,000 people with diabetes wears an insulin pump. What is an insulin pump? An insulin pump is a small device (a little larger than a pack of cards) that delivers insulin into the layer of fat that sits just below the skin (subcutaneous tissue). Because the insulin pump stays connected to the body, it allows the wearer to modify the amount of insulin they take within the press of a few buttons at any time of the day or to program in a higher or lower rate of insulin delivery to occur at a chosen time, which can be when sleeping. An insulin pump consists of the main pump unit which holds an insulin reservoir which typically holds between 176 and 300 units of insulin. The reservoir is attached to a long, thin piece of tubing with a needle or cannula at one end. The tubing and the bit at the end are called the infusion set. Insulin pump therapy is also referred to as continuous subcutaneous insulin infusion therapy. How common are pumps? The UK Insulin pump audit of 2013 showed that: Around 6% of adults with type 1 diabetes use an insulin pump. Around 19% of children with type 1 diabetes use an insulin pump pump. Insulin pump therapy is offered to people with type 2 diabetes on a case-by-case basis, when a diabetes consultant with expertise in pump therapy believes strongly that it is the only appropriate treatment for a specific patient. Current research suggests that there is a small proportion of people with typ 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 >>

Suicide By Insulin A Risk In People With Diabetes

Suicide By Insulin A Risk In People With Diabetes

Insulin typically saves the lives of those with diabetes, but it can also be a way for some people to kill themselves, a new review warns. People with the blood sugar disease tend to suffer higher rates of depression, the researchers explained. And suicide or suicide attempts using insulin or other diabetes medications that lower blood sugar levels may not always be an easy-to-spot attempt at self-harm, they added. "Some suicides with insulin are likely missed in people with diabetes, just as [suicide may be missed] in people without diabetes using other medications or after a car accident. Could a suicide using insulin be missed? Absolutely," said Alicia McAuliffe-Fogarty, vice president of lifestyle management at the American Diabetes Association. Insulin is a natural hormone produced by the body. Its job is to help usher the sugar from foods into the body's cells to provide fuel for those cells. But insulin is also a complex medication. People with type 1 diabetes no longer make enough insulin and must give themselves insulin to stay alive. People with type 2 diabetes don't use insulin efficiently -- this is called insulin resistance -- and eventually don't make enough insulin to keep up with the body's demands. At this point, people with type 2 diabetes also need to take insulin. Insulin can be given by multiple injections every day or via an insulin pump. Insulin pumps deliver insulin through a small tube that's inserted under the skin. The site of the insulin pump must be changed every few days. But once the tube is in, someone who uses an insulin pump only needs to push a few buttons to deliver a dose of insulin. However, getting the right amount of insulin is no easy task. Many factors affect the body's need for insulin. Exercise decreases the need. Foods that a Continue reading >>

What To Know Before Using An Insulin Pump

What To Know Before Using An Insulin Pump

There is no right or wrong way to manage your diabetes. With that being said, there are a variety of options and devices that can be used for proper diabetes management. Many of my patients choose to use an insulin pump because they find that it provides better control over their blood glucose levels. While a pump can be effective in alleviating some of the challenges associated with diabetes, it is important to know the basics before you decide whether or not an insulin pump is the right fit for you and your diabetes. The Basics of How an Insulin Pump Works At its core, an insulin pump is a fancy syringe. Imagine a syringe with a very fine motor that pushes the plunger with great precision. In order for the pump to be effective, the motor pushing the plunger of the syringe has to be extremely reliable and accurate. In recent years, there have been several developments in pump technology, offering users better control of their pump both directly and remotely. Throughout the day, the pump delivers insulin continuously. By doing this, the pump is attempting to mimic the normal pancreas’ release of insulin, but you must tell the pump how much insulin to inject. The pump 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. One factor to consider before choosing to use a pump is the differences between a pump and insulin injections. When using a pump, typically a needle is inserted under the skin in the abdomen, and the needle is connected to the syringe in the pump. The needle then stays in place for two to three days, and you simply program the pump to deli 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 Pump Therapy For Diabetes

Insulin Pump Therapy For Diabetes

Information about NICE technology appraisal guidance 151 Issue date: July 2008 This leaflet is about when continuous subcutaneous insulin infusion or ‘insulin pump’ therapy should be used to treat people with diabetes mellitus in the NHS in England and Wales. It explains guidance (advice) from NICE (the National Institute for Health and Clinical Excellence). It is written for people with diabetes but it may also be useful for their families or carers or anyone with an interest in the condition. It does not describe diabetes or the treatments in detail – a member of your healthcare team should discuss these with you. Some sources of further information and support are on the back page. NICE ‘technology appraisal guidance’ advises on when and how drugs and other treatments should be used in the NHS. Understanding NICE guidance Information for people who use NHS services 2 Information about NICE technology appraisal guidance xxInformation about NICE technology appraisal guidance 151 This may not be the only possible treatment for diabetes. Your healthcare team should talk to you about whether it is suitable for you and about other treatment options available. What has NICE said? Continuous subcutaneous insulin infusion or ‘insulin pump’ therapy is recommended as a possible treatment for adults and children 12 years and over with type 1 diabetes mellitus if: • attempts to reach target haemoglobin A1c (HbA1c) levels with multiple daily injections result in the person having ‘disabling hypoglycaemia’, or • HbA1c levels have remained high (8.5% or above) with multiple daily injections (including using long-acting insulin analogues if appropriate) despite the person and/or their carer carefully trying to man Continue reading >>

Insulin Pump Use In Type 2 Diabetes

Insulin Pump Use In Type 2 Diabetes

Go to: Introduction People with type 2 diabetes mellitus (T2DM) often require insulin therapy, especially as beta-cell function declines with the progression of the disease. The current American Diabetes Association (ADA)/European Society for the Study of Diabetes consensus treatment algorithm1 for T2DM includes basal insulin therapy at Step 2 (Tier 1) and intensive insulin at Step 3 (Tiers 1 and 2). Given the increasing amounts of insulin required by people with T2DM and the failure of any single insulin regimen to obtain glycemic control over the long term,2 continuous subcutaneous insulin infusion (CSII) or insulin pump therapy has been explored as an alternative to conventional or intensive insulin therapy using one or more daily injections. In addition, over one-third of people with T2DM on multiple daily injections (MDI) still do not achieve the ADA hemoglobin A1c (HbA1c) goal of <7%.2 The advantage of CSII is the ability to infuse precise amounts of insulin at a continuous basal rate to control glucose when not eating and prandial and correction boluses to cover food intake and out of range glucose values, respectively. When used appropriately, CSII can closely mimic the insulin provided by a normally functioning pancreas.3 There are challenges to widespread adoption of CSII among people with T2DM (Table 1). Most people with T2DM are cared for by primary care healthcare providers who have minimal knowledge and exposure to CSII; most people with type 1 diabetes mellitus (T1DM) are cared by specialists in diabetes and endocrinology who have significant training and exposure to CSII. In addition, CSII technology may be complex and may be difficult for people with T2DM, who usually receive their diabetes diagnosis at a later stage in life than people with T1DM. Peopl 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 Pumps In Type 1 And Type 2 Diabetes

Insulin Pumps In Type 1 And Type 2 Diabetes

Continuous Subcutaneous Insulin Infusion (CSII) uses a small battery powered syringe driver or insulin pump and a short acting insulin (or insulin analogue). The pump is worn 24 hours a day and insulin delivered via a subcutaneous needle sited in the abdominal wall or thigh. The pump holds sufficient insulin for 2 to 3 days after which the pump is refilled and the subcutaneous needle resited. The pump can be programmed to infuse insulin continuously - the so called 'basal rate'. In addition the patient is able, by means of a button on the pump, to administer boluses of insulin whenever he or she takes a meal - 'boosting'. More expensive pumps can be programmed to change their basal rate automatically and are of use in brittle diabetics who are not controlled on a fixed basal rate. CSII pumps have a number of advantages and disadvantages: advantages include: flexibility with timing and composition of meals. with CSII insulin delivery is more physiological than other regimens and in a few difficult to control diabetics CSII produces good glycaemic control evidence that insulin pumps can reduce hypoglycaemias, insulin doses required, weight gain and improve metabolic control (1,2) disadvantages include: regular blood glucose measurement is an essential part of CSII therapy and patients using it must be well motivated an insulin pump can be an inconvenient. It must be removed for most sports and when bathing or showering A review stated (3) that CSII improves glycaemic control compared to other intensified insulin regimens, with a small decrease in HbA1C and mean blood glucose, and a larger reduction in glucose fluctuation improved control is not associated with an increased risk of hypoglycaemia; also CSII probably results in significantly lower rates of severe hypoglycaem Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Professor John Pickup, Professor of Diabetes & Metabolism at Guy’s Hospital, London, writes: “Many patients with type 2 diabetes eventually need insulin injections to achieve good blood glucose control. Whilst this switch from tablets to insulin produces improved long-term control in most people with type 2 diabetes, a proportion of those on insulin injections still struggle to obtain satisfactory HbA1c levels. It is logical, then, to ask if insulin pump therapy has a role in the treatment of type 2 diabetes, particularly in those with sub-optimal control on injections. The latest NICE Guidelines on the use of insulin pumps, issued in 2008, state that ‘CSII therapy is not recommended for the treatment of people with type 2 diabetes mellitus’. The Appraisal Committee came to this view because the relatively few clinical trials that have been done to date of pumps in type 2 diabetes have shown no consistent difference in blood glucose control between insulin pump and intensive insulin injection treatment (multiple daily injections). Most countries have followed this view that the clinical benefit of insulin pumps is not established in type 2 diabetes, and consequently CSII is used in few patients with this type of diabetes. In the UK, NHS funding for CSII in people with type 2 diabetes will therefore be very difficult to obtain at present. However, from a research and from the pump manufacturers’ point of view there has been a recent resurgence of interest in pumps in type 2 diabetes, which may change our (and maybe NICE’s) notion of pumps for type 2 diabetes. This is partly because special groups of people with type 2 diabetes have been identified who seem to do particularly well on CSII, namely those with a very high HbA1c on multiple injections, those with 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 >>

Everything You Need To Know About Insulin Pumps

Everything You Need To Know About Insulin Pumps

Everyone needs insulin to live. Insulin is a hormone that helps our bodies use and store the food we eat. People with Type 1 Diabetes no longer make insulin and have to give insulin in order to sustain life. People with Type 2 Diabetes don’t use their own insulin well, and over time can have trouble making enough. So, all people with Type 1 diabetes and some people with Type 2 diabetes need insulin. When people give insulin injections, they may take 1-2 injections of a long acting insulin every day and 3+ injections of rapid acting insulin for meals and snacks. The typical person with Type 1 Diabetes could take anywhere from 4-7+ injections a day. Many people currently give insulin through an insulin pen or a syringe. But, there is another option, an insulin pump. An insulin pump delivers rapid acting insulin in two ways. First, the pump is programmed to give you insulin every hour throughout the hour referred to basal insulin. Basal, think “base,” is the insulin your body needs even in the absence of food, it is also referred to as background insulin. This basal rate replaces the long acting injection that you take. Second, is bolus, this is the insulin you take for food or to correct a high blood sugar. If you get basal and bolus confused, think “bowl”, as in you eat out of a bowl, to help you remember bolus is for food. Once you are on a pump, all insulin is delivered through the pump and shots are no longer necessary. Components There are a few things necessary to make a pump work. When a pump is shipped to someone: they will also need to send infusion sets, reservoirs, and possibly batteries, depending on your pump. Let’s talk about each component. Infusion Sets An infusion set is the part that is actually inserted into the body and has tubing that conn Continue reading >>

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