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Insulin Pump Insulin Type

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 Pumps

Insulin Pumps

What is an insulin pump? An insulin pump is a small battery-operated electronic device that holds a reservoir of insulin. It is about the size of a mobile phone and is worn 24 hours a day. The pump is programmed to deliver insulin into the body through thin plastic tubing known as the infusion set or giving set. The pump is worn outside the body, in a pouch or on your belt. The infusion set has a fine needle or flexible cannula that is inserted just below the skin where it stays in place for two to three days. Only fast acting insulin is used in the pump. Whenever food is eaten the pump is programmed to deliver a surge of insulin into the body similar to the way the pancreas does in people without diabetes. Between meals a small and steady rate of insulin is delivered. The insulin pump is not suitable for everyone. If you’re considering using one, you must discuss it first with your doctor or Credentialled Diabetes Educator. How does it help me manage my diabetes? Research has shown that insulin pump therapy can reduce the frequency of severe hypoglycaemia as well as improve quality of life. Using a pump may also improve suboptimal blood glucose control. It is important that you have realistic expectations about pump therapy. It is not a cure for people who require insulin to manage their diabetes but a way of delivering insulin that may offer increased flexibility, improved glucose levels and improved quality of life. Pump therapy requires motivation, regular blood glucose checking, the ability to learn pump technology and the willingness to keep in regular contact with your diabetes educator or endocrinologist for review and adjustment of pump rates. Resources - Blog post- What I've Learned From 12 Years Pumping What insulin pumps are available to me? You can see av Continue reading >>

What Is An Insulin Pump

What Is An Insulin Pump

Insulin pumps are the size of a pager and fit in your pocket. Most pumps are "worn" on a belt, carried in a pocket, or attached by a holster and connected by thin plastic tubing to the infusion set. An insulin pump is a small, computerized device that is programmed to deliver insulin into the fatty tissue under the skin. The insulin pump is durable and lasts for years, but the insulin supply and certain pump components (insulin reservoir, tubing and infusion set) are changed every few days. What are the basic components of an insulin pump? The pump: Most insulin pumps are about the size of a pager, and contain a reservoir of insulin, the pumping mechanism, battery, computer chip and screen. They are outside of the body, so they are called external pumps. Most pumps are “worn” on a belt, carried in a pocket, or attached by a holster and connected by thin plastic tubing to the infusion set. Infusion set: The infusion set is the “connector” that allows insulin to flow from the pump into the skin. It is attached to the skin with a strong adhesive. On the under side of the infusion set, there is a short, fine cannula, or tube, that passes through the skin and rests in the subcutaneous fatty tissue. Tubing: The tubing brings insulin from the pump (insulin reservoir) to the infusion set. 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 t Continue reading >>

Point: Are Insulin Pumps Underutilized In Type 1 Diabetes? Yes

Point: Are Insulin Pumps Underutilized In Type 1 Diabetes? Yes

Continuous subcutaneous insulin infusion (CSII), popularly called insulin pump therapy, has evolved from its invention in the 1970s as an experimental treatment designed to test the relationship between glycemic control and diabetic tissue complications (1) to its present status as a routine therapy for selected type 1 diabetic patients (2). However, the use of insulin pump therapy varies markedly throughout the world; there are some notable high-use countries, e.g., the U.S. and Israel, where it is estimated that ∼20% of type 1 diabetic patients use CSII (manufacturers’ estimates), whereas in other countries, such as the U.K. and Denmark, ∼1% use pump therapy (3). The reasons for this variation include the availability of financial resources and health care professionals to supervise CSII and a lack of knowledge on the effectiveness of CSII (3), but there is also disagreement on which diabetic subjects should be treated with CSII, as evidenced by both the different intercountry usage and the large number of reasons for starting insulin pump therapy (4–6). As noted by Schade and Valentine (7), “the challenge for the health care provider is to select the diabetic patients who will really benefit from pump usage.” What proportion and what types of type 1 diabetic patients should then be offered a trial of CSII on clinical grounds alone, leaving aside the legitimate issues of supply on the basis of patient preference and restrictions due to availability of funding and staffing? I shall argue that the target proportion best treated by CSII, or offered a trial of CSII, can be derived from an estimate of the effectiveness of this therapy compared with the best insulin injection treatment for particular clinical problems in type 1 diabetes. Most current guidelines Continue reading >>

2016 Insulin Pump Comparisons

2016 Insulin Pump Comparisons

Click to go to comparison page: Tandem t-Slim/t-Flex/t-slim G4Roche Accu-Chek Combo Insulet Insulet OmniPod Medtronic 530G With Enlite Animas Vibe Pump System Features in Common: 24-hour toll-free helpline Internal safety checks Child button lock-out Full Training Included Simplified programming Extended bolus options Temporary basal rate options Programmable reminders Downloadable Low battery warning Low insulin warning User-set active insulin time Tandem t:slim, t:slim G4 & t:flex Unique Advantages Potential Drawbacks Bright, full-color touch screen Modern, high-tech appearance Compact, thin dimensions Rapid numeric entry, fastest bolus entry Cartridges hold 300u (t:slim); 480u (t:flex) Can calculate boluses up to 50 units (60 on t:flex) Site-change reminder w/customizable day & time Graphic on-screen history display Carb counting calculator Temp basal up to 250%, 72 hrs Can set duration of insulin action in 1-minute increments IOB & time remaining displayed on home screen Missed bolus reminders customizable by day of week Alert for high temperatures which may spoil insulin Secondary basal programs linked with secondary bolus calculation parameters Web-based download software Compatible w/leur-lock infusion sets Minimal insulin movement with changes in altitude Small buttons can be difficult to activate; screen goes blank if buttons missed 3x Unlock procedure required to perform any programming No integrated clip (must put in a case that has a clip) Tubing connector looks “medical,” can snag on clothing Basal & bolus settings in same time slots; may take several steps to edit Extra confirmation steps with all programming Weak vibrate mechanism No meter link Manufacturer relatively new in pump industry Requires charging 1-2x/week No formal in-warranty upgrade polic 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 >>

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 >>

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 >>

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 >>

Convenient Diabetes Care: The Insulin Pump

Convenient Diabetes Care: The Insulin Pump

Insulin pumps are small, computerized devices that some people with diabetes use to help manage their blood sugar. They wear their pump on their belt or put it in their pocket. The pump releases rapid-acting insulin into your body through a small, flexible tube (called a catheter) which goes under your belly's skin and is taped in place. The insulin pump works nonstop, according to a programmed plan unique to each pump wearer. You can change the amount of insulin delivered. Between meals and overnights, the pump constantly delivers a small amount of insulin to keep your blood sugar in the target range. This is called the "basal rate." When you eat food, you can program extra insulin -- a "bolus dose" -- into the pump. You can calculate how much of a bolus you need based on the grams of carbohydrates you eat or drink. When you use an insulin pump, you must check your blood sugar level at least four times a day. You set the doses of your insulin and make adjustments to the dose depending on your food and exercise. Some doctors prefer the insulin pump because it releases insulin slowly, like how a normal pancreas works. Another advantage of the insulin pump is that you don't have to measure insulin into a syringe. Research is mixed on whether the pump provides better blood sugar control than more than one daily injection. An insulin pump is a small computerized device that delivers insulin into the body. This is different from injecting insulin throughout the day using insulin syringes and needles. Insulin pumps can be programmed to deliver very precise amounts of insulin in a continuous (basal) dose and in carefully planned extra (bolus) doses delivered at specific times throughout the day, usually when eating. Some pumps, like the one in this picture, connect to the body Continue reading >>

Insulin Pump For Type 2 Diabetes

Insulin Pump For Type 2 Diabetes

Progressive hyperglycemia in type 2 diabetes results from a progressive β-cell failure together with a state of insulin resistance (1). Insulin deficiency worsens with the natural progression of type 2 diabetes, explaining the escape from oral antihyperglycemic agents and the need for exogenous insulin therapy (2). The use of external pumps in patients with type 2 diabetes is a recent practice compared with that in type 1 diabetes, and its use is still debated. In only a few countries, such as in France and Israel, continuous subcutaneous insulin infusion (CSII) using an external pump is an alternative in type 2 diabetes that the health authorities have allowed for reimbursement. The rationale for using pump therapy was first suggested by its use in case reports of type 2 diabetes with extreme insulin resistance and poor glycemic control (3–6). In such patients, insulin was administered transiently by intravenous insulin infusion allowing lower mean glucose level despite a 40% reduction of insulin requirements. The sequential use of 4-week intravenous insulin infusion followed by 1-year CSII in a group of patients with type 2 diabetes patients poorly controlled despite very high insulin requirements allowed a dramatic reduction of HbA1c (−3%, −9 mmol/mol), while insulin requirements were reduced by one-third. Such beneficial effects of CSII were attributed to increased insulin sensitivity assessed by the hyperinsulinemic-euglycemic clamp study (7). These observations raised the question as to whether insulin continuous administration by a pump device gives an advantage compared with the conventional approach of insulin intensification by multiple daily injections (MDIs). The evidence base is still under debate and will be discussed in this review. Is CSII effecti Continue reading >>

Using An Insulin Pump

Using An Insulin Pump

NovoLog® has been proven safe and effective for use in insulin pumps in children ages 2 and older with type 1 diabetes and adults with type 1 and type 2 diabetes. Many people with type 1 diabetes use an insulin pump. What is an insulin pump? An insulin pump is a small, programmable, battery-operated device that delivers a steady, measured amount of insulin under your skin. You and your diabetes care team can program your insulin pump to deliver NovoLog® in constant “basal” doses throughout the day and “bolus” doses at mealtime. Insulin pumps may be helpful for people with diabetes who have more than one insulin injection per day, including some people with type 2 diabetes. Pumps provide continuous insulin delivery in small doses, similar to the way the pancreas naturally releases basal insulin. You push a button to release mealtime doses of insulin to cover food. They allow people with diabetes to take their insulin automatically, wherever they happen to be. Benefits of NovoLog® in an insulin pump NovoLog® is a fast-acting insulin that can be used for up to 6 days in a pump before it needs to be changed. The table below shows how often to change NovoLog® in a pump. Please be sure to check the instructions that came with your pump. Pump component Time frame before changing NovoLog® in reservoir Up to 6 days Infusion set and infusion set insertion site Up to 3 days NovoLog® in the pump should be discarded after exposure to temperatures that exceed 98.6ºF. Low rate of clogs in an insulin pump In a clinical study, NovoLog® was found to have a low rate of clogs when used in pumps. That's good news if you are already using, or thinking about using, an insulin pump. NovoLog® remains heat stable in pumps at normal body temperature (up to 98.6°F). This makes N Continue reading >>

Counterpoint: Are Insulin Pumps Underutilized In Type 1 Diabetes? No

Counterpoint: Are Insulin Pumps Underutilized In Type 1 Diabetes? No

One of the major goals in the treatment of diabetes is to achieve an HbA1c (A1C) <6.5 or 7.0% (depending on which organization’s guidelines are used) without an unacceptable incidence of hypoglycemia. This goal has not been achieved in many patients with diabetes. The reasons are diverse and often complex. It is appropriate to ask whether placing more patients with type 1 diabetes on insulin pumps (continuous subcutaneous insulin infusion [CSII]) would achieve this goal and be the best use of limited medical resources. Alternatively, resources could be utilized to purchase insulin analogs, to train additional diabetes educators, to transport patients to diabetes centers, or to purchase improved insulin-delivery devices. Some clinicians believe that increasing the number of type 1 diabetic patients on pumps is the best solution (1,2). It has been estimated that at least 160,000 patients in the U.S. were already utilizing insulin pumps in 2001 and >200,000 worldwide (3). This article will address one specific question, i.e., whether a major effort should be made to increase the number of patients on insulin pumps in order to achieve the above-stated A1C goal. Determinants of plasma glucose concentration There are several factors that determine plasma glucose concentration. These include 1) the carbohydrate composition of food, 2) the rate of gastric emptying, 3) the rate of glucose absorption, 4) the concurrent magnitude of endogenous glucose production, 5) the concurrent rate of glucose disposal, 6) the diurnal change in insulin sensitivity, 7) the activity of counterregulatory hormones, 8) the change in the magnitude and type of exercise, and 9) the ambient insulin concentration. It is important to note that most of these factors are not directly under the patient’s 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 >>

Type 1 Insulin Pump Therapy

Type 1 Insulin Pump Therapy

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 an increasingly popular method of insulin replacement therapy. Because the insulin delivery from insulin pumps can 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 Ketones and insulin pumps: Why to watch for ketones and what to do if you have them 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 >>

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