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How Much Is Insulin Pump

Guidelines For Temporary Removal Of The Insulin Pump

Guidelines For Temporary Removal Of The Insulin Pump

correction factor (insulin sensitivity factor) is 4.0 the basal rate is 0.60 units/hr until noon correction bolus: 14.8 – 6.0/4.0 = 2.2 units Total dose: 2.4 + 2.7 + 2.2 = 7.3 units, rounded off to 7.0 2- Long term off pump (24 hrs or more): There are 3 options Give long-acting insulin (Lantus or Levemir) as basal, and rapid insulin for boluses Give intermediate-acting insulin (NPH or N) ** call the doctor on-call for this dose Give rapid-acting insulin every 4 hours including overnight, as per the “short term” example Calculate the total daily basal amount of insulin and give as a single dose of Lantus or Levemir. It can be given as soon as convenient. Then continue every 24 hours thereafter. These insulins cannot be mixed with other insulins in a syringe Take rapid insulin for meal, snack and correction boluses The carb ratio’s and correction factors remain the same as for the pump Children who are too young to give their own insulin may need to have a parent go to school to give the lunchtime dose. The basal rate is 0.50 units from midnight to 6:00 a.m., and 0.40 units for the rest of the day until midnight. The total basal is 10.2 units. The dose of Lantus or Levemir will be rounded off to 10.0 units, given once every 24 hours until the insulin pump is resumed. Since Lantus and Levemir are basal insulins, you cannot have a basal rate running when you restart the pump or severe hypoglycemia may result! Restart your basal approximately 18 hours after the last Levemir dose; 22 hours after the last Lantus dose.    If you want to re-start the pump earlier, set the basal rate at 0.00 units/hr until all the Lantus or Levemir has worn off. Extra blood sugar checks will be needed to see how your adjustments are working, especially after the first inj 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 >>

Pump Faqs

Pump Faqs

Frequently Asked Questions about insulin pumps: In this section, you will find answers to these frequently asked questions: Which pump is the best? Most pumps have similar features, but they’re all a little different. No one pump is best. See What to consider when choosing an insulin pump? Does the pump know my sugar level and automatically deliver the right amount of insulin? No! At this time, insulin pumps cannot measure glucose levels and cannot automatically deliver the right amount of insulin. Do I have to be attached to the pump all the time? It is possible to temporarily disconnect yourself from the pump, but not for very long. If you are disconnected for more than an hour, you may need to replace your missed insulin. Once again, speak with your doctor about specific recommendations. It is important to assess the entire picture. What type of insulin is used in an insulin pump? Insulin pumps use rapid-acting insulins such as lispro, aspart and glulisine. Because the pump delivers tiny amounts of insulin every few minutes, longer-acting insulins are not necessary. Should I go on the pump? Insulin pumps can greatly benefit people with diabetes. However, not everyone with diabetes is a good pump candidate. Psychological readiness and physiological needs vary with individuals and need to be considered. How much time and effort commitment does pump therapy require? Starting pump therapy requires commitment. It is not unusual to check blood sugars 8-12 times per day in the beginning of pump therapy to assess basal and bolus insulin needs. This often means lots of interruptions during the workday and during family time. It also means disturbing your sleep in order to take blood sugar readings in the middle of the night. Think about your schedule and commitments. Talk t Continue reading >>

How Much Do Diabetes Supplies/medications Cost In The U.s.?

How Much Do Diabetes Supplies/medications Cost In The U.s.?

While everyone’s diabetes treatment plan, medications, and technology may be different, there is one thing we can all agree on: diabetes is expensive. In two previous posts at The Perfect D, I gave some sense of what the bare minimum of care for a U.S. adult with Type 1 diabetes would be and also financial resources and programs to help with the financial burden of living with diabetes. However, this post is about how much it could cost an adult with Type 1 diabetes if they used the technology and medications that are currently out on the market (and thought of as “the latest and greatest”) and paid out of pocket with no insurance. Research on this topic has shown me that: 1) prices can fluctuate wildly, so it pays to shop around and 2) there is a very big gap (financially, medically, and technologically) between the bare minimum and “surviving” and actually utilizing the tools and latest technology that is out there. So, the hypothetical person for this exercise is a Type 1 adult in the United States who weighs 60kg, just like the other calculation post I did. Ground Rules These prices are accurate on the websites I have referenced for December 1, 2014. They may change, they may add shipping, they may not offer the services, technology, or drugs on their website after this is posted. These prices are not a guarantee. They are to be used as a reference. The listing of prices/websites on this post does not mean that I endorse the company or product or service. I have not listed all the products available on the market for people with Type 1 diabetes. I have listed major ones to give you an idea of major manufacturers’ costs for the products that are available for general public viewing. I did not call any companies and ask for pricing. Why? Because I believe Continue reading >>

Health Library Article

Health Library Article

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Get the facts Key points to remember An insulin pump can free you from a strict regimen of meals, sleep, and exercise, because you can program it to match your changing schedule. After you learn how to work with a pump, it can make living with diabetes easier. But it takes some time and effort to learn how to use the pump to keep it working properly and to control your diabetes. Using a pump includes checking your blood sugar many times a day and carefully counting the grams of carbohydrate that you eat. Using an insulin pump can keep your blood sugar at a more constant level so that you don't have as many big swings in your levels. People who use pumps have fewer problems with very low blood sugar. Many insurance companies cover the cost of insulin pumps, but they have strict guidelines that you will have to follow before they will pay. Continue reading >>

Long-acting Insulin Analogs Versus Insulin Pump Therapy For The Treatment Of Type 1 And Type 2 Diabetes

Long-acting Insulin Analogs Versus Insulin Pump Therapy For The Treatment Of Type 1 And Type 2 Diabetes

Insulin pump therapy (continuous subcutaneous insulin infusion [CSII]) is now an established form of intensive insulin treatment. It is pertinent to ask, however, if multiple daily injection (MDI) regimens based on new long-acting insulin analogs such as glargine and detemir have now replaced the need for CSII. In type 1 diabetes, CSII reduces the frequency of severe hypoglycemia compared with isophane-based MDIs, but the rate of severe hypoglycemia is usually similar on glargine- or detemir-based MDIs compared with isophane-based MDIs. CSII reduces A1C and glycemic variability compared with isophane-based MDIs; but glargine and detemir do not improve A1C or variability in many patients, particularly those who are prone to hypoglycemia. Head-to-head comparisons of CSII with MDI based on glargine indicate lower A1C, fructosamine, or glucose levels on CSII. It can be concluded that long-acting insulin analogs have not yet replaced the need for insulin pump therapy in type 1 diabetes, and CSII is the best current therapeutic option for some type 1 diabetic subjects. In type 2 diabetes, CSII and MDI produce similar glycemic control, although there is little study of MDI based on long-acting analogs compared with pumps. It is possible that CSII will be beneficial in selected patient groups with type 2 diabetes, but this requires further study. For many decades, it has been accepted that poor glycemic control in insulin injection–treated diabetes is mainly due to the inadequacies of insulin pharmacology (1,2). Regular (short-acting) insulin is absorbed too slowly from the subcutaneous site to control postprandial hyperglycemia, and the delayed absorption then results in late hypoglycemia. Both of these problems have now been much improved by the introduction of more quickly Continue reading >>

Soaring Insulin Prices Prompt Insurance Shift

Soaring Insulin Prices Prompt Insurance Shift

Since 2002, the cost of insulin has increased by almost 200 percent, according to a new study.Video provided by Newsy Newslook Corrections and clarifications:This story has been updated to reflect fact that Basaglar can’t be used in an insulin pump. Many parents of diabetic children and adults suffering with type 1 or type 2 diabetes are bracing for changes in insurance coverage of their insulin next year, as prices of the vital medication continue to soar. Higher insurance deductibles and changes in the prescription brands covered by some insurers are raising concerns among some people with diabetes. CVS Caremark, a pharmacy benefit manager (PBM), will no longer cover the insulin brand Lantus in favor of a new biosimilar version, Basaglar. Biosimilars are considered the generic versions of "biologic" drugs that are based on natural sources. The company also announced a program last week to further keep diabetes costs down, following a similar move in August by competitor Express Scripts. Diabetes is an epidemic in the United States, affecting nearly 10% of the population or about 29 million people, according to the Centers for Disease Control and Prevention. Of those, more than 8 million people are undiagnosed. Type 1 diabetes — often still called juvenile diabetes — can occur when people are children or adults. Type 2 diabetes is becoming more common with the increase in obesity and sedentary behavior. Prices for Humalog and many insulin brands have increased from about $300 to $500 between January 2013 to October 2016, according to drug discount search company GoodRx. Lantus increased about 60% — from $240 to $380 — in the same time period, GoodRx says. (Photo: T1D Exchange) "It’s definitely unfortunate prices are going up so much and impacting the people Continue reading >>

Insulin Pumps

Insulin Pumps

How many children in the Western Isles have pumps?Currently 4 young people with diabetes are on pump therapy Should all children be on a pump? In short, no. Many children and families would not wish a pump even if one is offered and many would be unsuitable for a wide variety of reasons including not monitoring often enough or acting appropriately on the results. How are pump candidates chosen? Candidates for pump therapy are chosen on the basis of clinical need. In NHS Western Isles we have developed a system of bringing details of possible candidates to a regular multidisciplinary meeting where the whole team will discuss the pros and cons. How much does a pump cost? The average cost of an insulin pump is around £2500-2800 with annual supply costs (excluding insulin) of about £1500. Why can't we choose the pump make we prefer? There are two reasons for this; one financial and the other practical. The NHS in Scotland always wishes to get best value for money so ran a procurement for insulin pumps. This limits the range of technology available unless a strong clinical case is made for something else. From a practical perspective, it is important that the staff supporting patients on pumps are fully familiar with the buttons, nomenclature and detail of how the products work. Therefore, we have deliberately limited our use to very few pumps. Once you are started on a pump is that it for good? If a pump works well for a patient and family and diabetes control is good then pump therapy will continue but, especially in teenage years, some patients will decide that they no longer wish to be on a pump. Additionally, and where the pump has been supplied by the NHS, if the clinical outcome is unsatisfactory e.g. poor control, inadequate monitoring etc. the Team reserves the ri Continue reading >>

Insulin Pump For Diabetes

Insulin Pump For Diabetes

How does an insulin pump work? The typical insulin pump is attached to a thin plastic tube (an infusion set) that has a soft cannula (or plastic needle) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen. The cannula is changed every two days. The tubing can be disconnected from the pump while showering or swimming. The pump is used for continuous insulin delivery, 24 hours a day. The amount of insulin is programmed and is administered at a constant rate (basal rate). Often, the amount of insulin needed over the course of 24 hours varies depending on factors like exercise, activity level, and sleep. The insulin pump allows the user to program many different basal rates to allow for variation in lifestyle. In addition, the user can program the pump to deliver a bolus (large dose of insulin) during meals to cover the excess demands of carbohydrate ingestion. How common is an insulin pump? Hundreds of thousands of people with diabetes worldwide are using an insulin pump. Although insulin pumps were first used by people with type 1 diabetes, people with type 2 diabetes sometime use them as well. Many children successfully use insulin pumps. Insulin pumps allow for tight blood sugar control and lifestyle flexibility while minimizing the effects of low blood sugar (hypoglycemia). Newer models of the pump have been developed that do not require a tubing, in fact - the insulin delivery device is placed directly on the skin and any adjustments needed for insulin delivery are made through a PDA like device that must be kept within a 6 foot range of the insulin delivery device, and can be worn in a pocket, kept in a purse, or on a tabletop when working. Probably the most exciting innovation in pump technology is the ability to Continue reading >>

Insulin Pumps

Insulin Pumps

Thinking about getting an insulin pump to manage your Type 1 diabetes? As an alternative to injecting insulin with a pen, an insulin pump can help improve your diabetes control and give you more flexibility. What does an insulin pump do? An insulin pump is a battery-operated device that provides your body with regular insulin throughout the day. The insulin is provided via a tiny, flexible tube (cannula), inserted under the skin. The tube can be left in for two to three days before it needs to be replaced and moved to a different insulin injection site. When eating, you can release extra insulin using the pump. This is known as a 'bolus dose'. Your nurse and dietitian will help you to work out how much insulin you need. How can I get an insulin pump? The National Institute for Health and Care Excellence (NICE) haspublished criteria for suitability to use an insulin pump. Talk to your diabetes healthcare team about whether a pump is suitable for you. You're entitled to NHS-funded insulin pump therapy if you meet the following requirements: Your diabetes consultant recommends that you use an insulin pump. You'll need to show that you're committed to good diabetes control; for example, by having at least four insulin injections a day, checking your blood sugar levels at least four times a day, counting carbohydrates and adjusting insulin doses. You meet the NICE criteria (Technology Appraisal 151 (2008)) for NHS funding. You're having frequent hypos or hypos without warning that cause anxiety and have a negative impact on your quality of life, or your HbA1c is still 69mmol/mol (8.5%) or above, despite carefully trying to manage your diabetes. What pump types are available? Pumps vary in colour, battery life, screen size and extra features, such as a remote control. Your he Continue reading >>

Insulin Pump Smackdown: Revel Vs 522

Insulin Pump Smackdown: Revel Vs 522

I’ve been wearing the newest pump available from Minimed in the U.S., the Revel, for almost four months now. Minimed made it available to me through their temporary loaner pump program, and have kindly allowed me to hang on to it while I decide whether the Revel, an upgrade from the Minimed 522 I currently own, is worth the $400 that it costs to upgrade via their Paradigm Pathway Program. So I’ve been putting off sitting down and detailing how I like or don’t like the Revel for far too long now, knowing that as soon as I finally put my thoughts on paper, I will be forced to either pay for the upgrade or send the pump back. But the time has come, my friends. And that brings me to the big questions: is the Minimed Revel, full of the promise of its new features, worth $400 more to me than the Minimed 522? Is the new pump an improvement, and, if so, what is the dollar value of the incremental improvement for me? In thinking about this, there are several important angles to consider. Notably, I am coming from the position of having a Minimed pump already, and one that is jut one generation older to boot. However, there are several scenarios under which you might be considering the Revel*: 1. Having no insulin pump vs. getting the Minimed Revel Get it. Get it get it get it. I know there are those who insist on staying away from pumps, appreciating the freedom of injections in that there is no machine tethered to their bodies, but I for one am a pump advocate. A pump devotee. The freedom of motion lost because of the machinery is far outweighed by the flexibility of schedule and insulin delivery gained. Plus, the ability to have a constant basal rate of insulin is hugely beneficial, both in terms of daily control and long-term mimicry of the natural pancreas. But this is Continue reading >>

Insulet's Second-generation Omnipod

Insulet's Second-generation Omnipod

by Adam Brown and Kelly Close The next-generation OmniPod was recently approved in the US – after receiving approval in the EU in 2011 – and we finally got to try it! The next-generation pod has about 2,000 users in the EU and just a few users in the US, as it just began shipping to brand new pumpers last week and will start going to current OmniPod wearers over the next month. (That may not seem fair, but it’s because existing patients will be upgraded when they reorder supplies, meaning they need to use up their old pods first.) This new technology took quite a while to be approved by the FDA – it was originally submitted in May 2011. What’s new about the second-generation OmniPod? It is MUCH smaller. Specifically, the new OmniPod is an impressive 34% smaller, 25% lighter, and 16% slimmer than its predecessor. Insulet made three key changes to enable this: one less battery, a new reservoir shape, and a refined insertion system. There’s no question that the new OmniPod immediately looked and felt much smaller when we first put it on! The second-generation OmniPod’s handheld controller (“PDM”) has some new “human factor screens” that we were really excited to see (see below). The FDA has placed increasing concern on human factors, and though the regulatory delays are lamentable, they do ensure a safer pumping experience for patients. Insulin-on-board (IOB) now appears on the home screen of the PDM – it’s great to see this front and center, since we both tend to use it so often and it’s annoying to press buttons and track this down in menus. Furthermore, Insulet has added a new feature that breaks insulin-on-board into components: meal and correction. No other pump on the market does this, and we found it useful for getting a much better sense Continue reading >>

How Pumping Works

How Pumping Works

An insulin pump is a device about the size of a cell phone that contains a cartridge of rapid-acting insulin. A pump has a screen and buttons for programming the pump’s internal computer, and a precise motor that pushes the insulin from the cartridge into your body through a thin plastic tube called an infusion set. How is insulin delivered? Like your pancreas, an insulin pump releases small amounts of rapid-acting insulin to keep blood glucose levels steady between meals and during sleep. This is called the basal rate. Basal insulin takes the place of long-acting insulin. Then, at meal or snack time, you can tell the pump to deliver the amount of insulin needed to match the grams of carbohydrate in the food that is eaten, just like a healthy pancreas. This is called a bolus. A bolus can also be given to correct a high blood glucose. How is an insulin pump connected to my body? Every 2-3 days, a thin plastic tube called a cannula is inserted just underneath the skin using an infusion set. The infusion set is typically an all-in-one set that uses a thin introducer needle to insert the soft, thin cannula, which is then removed once the cannula is under the skin. A tube connects the infusion set to the pump using a Luer connector, a standard locking mechanism that securely attaches the tube to the pump.. Your healthcare professional will help you determine the best insulin infusion site for you. Typical infusion sites include the abdomen, hips, buttocks, upper back arm, and thighs. How is an insulin pump worn? Most pumps are so small and discreet, no one has to know you're wearing one unless you want them to. Plus, there are so many accessories available, you have many options to choose from. And for pumps that share information and communicate wirelessly using a meter-r Continue reading >>

Desperate Families Driven To Black Market Insulin

Desperate Families Driven To Black Market Insulin

Fourth grader Gabriella Corley is trapped. She has type-1 diabetes and is allergic to the kind of insulin her insurer makes affordable — and her family can't pay for the kind she needs every day to stay alive. Glancing at the cheerleader from Elkins, West Virginia, at a recent football game, held up on her teammates' shoulders, her grin as wide as her two fists in the air, you might not think anything was wrong. Then you might notice the insulin pump about the size of a pager tucked into her black compression shorts, clear tubes going under her shirt. It infuses insulin directly into her body through a tube connected to a site on her abdomen. "She's a beautiful, intelligent, amazing little 10-year-old girl who stands up in the face of adversity every single day without blinking an eye and does it with a smile," said her mother, 32-year-old Andrea Corley. Soaring insulin prices and inflexible insurance policies have forced this working-class mom to take desperate measures outside the system to keep her child alive. Gabriella is allergic to the kind of insulin her insurer covers at a $25 out-of-pocket cost. She can only take Apidra, but her insurance only covers 25 percent of the price, leaving the family to pay hundreds of dollars a month they can't afford. So her mom has turned to the black market, trading for the medication with other families with diabetes she meets online, a tactic that regulators and health experts warn is a health risk. And she cut a back-end deal with a sympathetic drug rep: If she bought one vial he would give her 10 vials from his sample kit, nearly a one year's supply. Gabriella's grandmother covered the cost. None of the Federal regulators NBC News contacted said that online trading of insulin is illegal, as it's not a controlled substance. Continue reading >>

Health Insurer’s Limit On Insulin Pumps Worries Patients

Health Insurer’s Limit On Insulin Pumps Worries Patients

Stephanie Rodenberg-Lewis wasn’t happy with her insulin pump and finally switched two years ago to another brand. Now her health insurer is pushing her to go back. UnitedHealth Group Inc. has made a deal with device maker Medtronic that will slash options for diabetics who use the portable pumps, which cost thousands of dollars. The move has angered Rodenberg-Lewis and others who will be limited to three pump choices instead of nine. Health insurers, big employers, and other bill payers have been trying for years to rein in costs and improve care by steering clients to certain doctors and hospitals. They’ve also restricted options for some prescriptions and lined up deals for smaller-ticket items like diabetes test strips or items patients don’t chose, like heart stents. Limiting choice for medical equipment that a patient usually selects is uncharted territory. UnitedHealth rivals Aetna and the Blue Cross-Blue Shield insurer Anthem say they haven’t done this. But experts say it could become more common. “It’s unfair,” said Rodenberg-Lewis, 41, a Katy, Texas, elementary school teacher who also has a teenage son with type 1 diabetes. “I have this disease that I did not ask for, did not cause, and now you’re telling me you’re going to make the decision for me (about) the device that keeps me alive?” Insulin pumps are pager-size devices used mainly by people with type 1 diabetes, the kind often found in childhood. These patients can’t make their own insulin, the hormone that turns food into energy. The external pumps make up for that by delivering a steady dose through a tube into the skin or a patch and extra doses at mealtimes Starting July 1, customers on many of UnitedHealth’s plans will only be able to choose between two Medtronic pumps or an Continue reading >>

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