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Type 1 Diabetes Pumps

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 >>

Getting An Insulin Pump

Getting An Insulin Pump

Tweet There is a high level of demand for insulin pumps but currently the UK lags behind other European countries in its provision of insulin pumps. Insulin pumps allow greater opportunity to take control of diabetes but, because they are a more expensive option than injections, eligibility criteria exists to ensure the most suitable candidates have access to insulin pump therapy. Funding options There are two main options for getting an insulin pump: Self funding –whereby you buy the pump and consumables NHS funded –the pump is paid for by the NHS for those meeting eligibility criteria The most common option for getting an insulin pump in the UK is to have one funded by the NHS. Getting an insulin pump privately If you buy the pump privately, you will need to consider the total cost, including the consumables, and ensure you have a health team with a specialism in insulin pumps. You will need to arrange whether you will be able to receive care on the NHS or privately before going ahead with buying an insulin pump privately. Insulin pumps tend to cost between £2,000 and £3,000 and the consumables for an insulin pump, including infusion sets, reservoirs and batteries, can cost around £1,000 to £2,000 a year. The NHS does not operate a scheme in which it funds pumps which have been bought privately. Getting a pump on the NHS The process of getting an insulin pump can vary across different parts of the UK as budgets, the level of demand for pumps and the number of healthcare professionals with experience of insulin pumps can all play a part. The advantage of applying for an insulin pump through the NHS is that you have the chance of getting the pump for free. This for most people outweighs the disadvantages of not knowing whether or when they may qualify for a pump 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 >>

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 >>

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 >>

New Insulin Pump Spells More Freedom For Diabetics

New Insulin Pump Spells More Freedom For Diabetics

Sitting on the bleachers at Peninsula High School, a lacrosse helmet and stick beside him, Scott Phillips glances at fingers scarred from nearly six years of daily blood sugar tests. Phillips was diagnosed with Type 1 diabetes at 12 years old, and the day-to-day ordeal of managing Type 1 diabetes have been at the back of his mind ever since, he said. Now, he’s one of the first recipients of a new type of insulin pump that doctors say could be a huge step forward for diabetics managing disease. Peace of mind The pump, developed by medical technology company Medtronic, has been dubbed by some an “artificial pancreas” because of its ability to monitor a patient’s blood sugar and automatically adjust the amount of insulin it administers in response to an increase or decrease in glucose levels. The system doesn’t function exactly like a normal pancreas — users still have to monitor their blood sugar regularly and give additional insulin before meals. But for people with Type 1 diabetes, whose pancreases have stopped producing insulin that the body uses to process sugar from foods, it’s an improvement over other available options. “There’s not ever anything I thought, ‘Oh, I can’t do that because I have diabetes,’ ” Phillips said. “But (the system) definitely makes those things that I want to do that may be more challenging for someone who’s diabetic, it would probably make them a lot easier.” Phillips has never been one to let his diabetes slow him down, says his mother, Cheryl, but that doesn’t change the fact that it takes an enormous amount of thought to stay on top of a lengthy list of variables that can change blood sugar from one day to the next. “You can never just say, ‘Oh, I don’t want to deal with this,’ ever,” she said. Continue reading >>

The Use Of Insulin Pumps In Youth With Type 1 Diabetes

The Use Of Insulin Pumps In Youth With Type 1 Diabetes

Go to: Introduction Insulin pump (continuous subcutaneous insulin infusion [CSII]) therapy became more widely accepted for youth with type 1 diabetes (T1D) in the mid-1990s after the availability of the rapid-acting insulin, insulin lispro. Previously, pediatric diabetologists were cautious about pump use in children, particularly as a result of the threefold increase in severe hypoglycemia reported among intensively treated patients in the Diabetes Control and Complications Trial.1 Of these, two-thirds used an insulin pump at some time, and all used regular insulin. With advances in insulin development and in pump features, however, the fear of severe hypoglycemia associated with intensive diabetes management has diminished. It is impossible in this short article to describe all aspects of insulin pump care in youth (here defined as children 5–18 years of age) with diabetes. A more complete description, including our program for starting an insulin pump, is provided elsewhere.2 A consensus statement on insulin pump therapy in the pediatric age group may be helpful to healthcare providers.3 Table 1 lists some advantages and disadvantages of insulin pump use in children. Although insulin pump use is becoming more and more popular among families having a youth with T1D, it is not for everyone. In order for pump therapy to succeed, the youth as well as the parents must want the pump. Diabetes nurse-educators listed 12 other important factors to determine who should start pump therapy.4 They all agreed that doing adequate numbers of blood glucose (BG) tests per day was the most important criterion. Most pediatric centers require this for pump initiation, as this is not only a measure of compliance, but also a necessity for safety. Other criteria for initiation of insulin Continue reading >>

Cgm Benefits Type 1 Diabetes With Insulin Pumps Or Shots

Cgm Benefits Type 1 Diabetes With Insulin Pumps Or Shots

CGM Benefits Type 1 Diabetes With Insulin Pumps or Shots LISBON, PORTUGAL Use of real-time continuous glucose monitoring (CGM) produces significant long-term improvement in HbA1c among adult patients with type 1 diabetes, regardless of whether they use insulin pumps or multiple daily insulin injections (MDI), new research shows. Two-year data from the Comparison of Different Treatment Modalities for Type 1 Diabetes Including Sensor-Augmented Insulin Regimens (COMISAIR) study were presented September 11, 2017 here at the European Association for the Study of Diabetes (EASD) 2017 Annual Meeting by Jan oupal, of the Charles University, Prague, Czech Republic. The real-world, nonrandomized study compared changes in HbA1c among 65 patients using one of four treatment regimens: insulin pumps with or without real-time CGM (n=15 and 20, respectively) and MDI with or without real-time CGM (12 and 18, respectively), with all patients using self blood glucose (finger-stick) monitoring. At 2 years, use of CGM, with or without the pump and with MDI provided "significant, comparable, and stable improvement of HbA1c." In fact, the combination of CGM and MDI was actually more effective than insulin-pump therapy alone in reducing HbA1c, Dr oupal said. "In this trial, we're showing it's not so important how insulin is injected. What's more important is how patients monitor their glucose," he told Medscape Medical News, adding that the 2-year data are the longest-ever for a trial of real-time CGM. [Real-time CGMs are the systems that patients use, allowing them to view their data continuously, as opposed to the blinded CGM systems that physicians download data from in their office, thereby reviewing the data in retrospect]. Although the findings were presented in a Dexcom-sponsored satel 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 >>

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 >>

To Pump, Or Not To Pump?

To Pump, Or Not To Pump?

Your 10-year-old daughter just returned from diabetes camp. She said that everyone was using an insulin pump, and she wants one too. You are worried about having a tiny computer deliver insulin into her body. Should you ask your daughter’s health-care team about pumps? Your three-year-old son is a very picky eater and you are having a very hard time controlling his blood glucose levels, even with multiple injections every day. You have heard about insulin pumps, but is he too young for one? Your teenager has been using a pump for about three years. She is now on the cheerleading team and she does not like being connected to the pump because of how it looks on her clothes. Should she switch back to injections? These are all common scenarios for parents of children or teens with diabetes. If you’re facing a decision about whether your child should use a pump, this article may help by explaining some of the advantages and challenges of insulin pump therapy for children and teens. Pump basics An insulin pump is a small, computerized device that is programmed to continuously deliver basal, or background, insulin and that also allows bolus doses of insulin to be delivered to cover meals and snacks. The pumps currently on the market are about the size of a cell phone. An insulin pump is worn outside the body; no surgery is necessary for insulin pump therapy. Instead, an infusion set is used to connect the pump to the body. An infusion set consists of a small plastic cannula, or catheter, that is connected to a length of plastic tubing, which transports insulin from the pump reservoir to the body. The cannula is inserted into the fatty tissue just under the skin with a small needle, either manually or with an insertion device. The needle is removed after the cannula is inse 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 >>

Why I Don’t Need An Insulin Pump To Live Well With Type 1 Diabetes

Why I Don’t Need An Insulin Pump To Live Well With Type 1 Diabetes

I am often asked why I don’t use an insulin pump. With the variety of choices in insulin pumps and the impressive programming abilities they each offer, it’s assumed that if you can get your hands on a pump, then you should, and you should want to. It’s also assumed that pumps are the answer for improved blood sugar management and improved A1C levels. Here are 3 reasons why I don’t use an insulin pump: 1. Fewer malfunctions with syringes and pens… While an insulin pump can provide the most specified basal rates for every hour of your body’s personal needs, it can also malfunction a lot. The more complex a method of delivering insulin, the more things that can go wrong. When I’ve been on both an insulin pump (for 7-ish years) and an insulin pod (for 30 days), I had more super-high blood sugar levels in one month from infusion site inflammation, blood occlusions, and mechanical errors breakdowns than I have over the course of an entire year while taking insulin via syringe and pen. (As a senior in high school, I landed in the ER due to overnight pump malfunctions which led to diabetic ketoacidosis, DKA.) There’s a trade-off: if you love your pump and the benefits it provides in helping you maintain healthier blood sugar levels most of the time, then perhaps those malfunctions and skin issues and cannula issues don’t bother you enough. For me, I can absolutely achieve A1Cs in the 5s and low 6s without a pump. And it’s nearly impossible to end up in DKA on injections unless you completely forget to take your long-acting insulin, which I’ve never forgotten in the 16 years I’ve lived with type 1 diabetes. But there’s a trade-off to achieving great blood sugar levels without a pump. For me, it means I have to take at least 6 injections a day, making t Continue reading >>

Diabetes Type 1

Diabetes Type 1

An insulin pump is made up of a battery operated pump, a pump reservoir holding two to three days of insulin and a computer chip that allows the user to control how much insulin the pump delivers. It is all contained in a plastic case about the size of a small mobile phone How does it work? The pump is attached to a thin plastic tube (an infusion set) that has a soft cannula (plastic needle) at the end through which the insulin passes. This cannula is inserted under the skin, usually on the abdomen (belly). The cannula is changed every two to three days. The pump delivers insulin in two ways: 1) Releasing a low dose (of rapid acting insulin) every few minutes, 24-hours a day, to maintain the basal level. This insulin keeps blood glucose in the desired range between meals and over-night. This does the same job as basal insulin, but is more flexible, and the rate can be changed during the day if need be – for example, if your body releases more stored sugar in the mornings, or if you know you will be doing a lot of exercise which means less insulin is required. 2) Larger bolus doses are activated by the user before meals, just as with a bolus injection. The tube or infusion set can be disconnected from the pump when showering, swimming, doing sport or having sex. Reasons for using an insulin pump Some of the young people we talked to are using, or are thinking about using, an insulin pump. The main reason is related to difficulty in controlling their blood glucose level. They talked of being unable to assess how much insulin to take; of going constantly high and low for no apparent reason and of getting bad HbA1c's. (See also 'Managing diabetes as a teenager', 'Hypos' and 'Highs'). One young woman was 12 when she started using the pump because at that point she'd had to Continue reading >>

Insulin Pump Therapy For Kids

Insulin Pump Therapy For Kids

There’s no doubt that interest in insulin pumps is up among people with diabetes. In fact, the most commonly asked question of the staff at the Yale Children’s Diabetes Program in New Haven, Connecticut, is, “Am I a candidate for the pump?” or “Is my child a candidate for the pump?” In many cases, the answer is yes. Let’s have a look at what makes a child a good candidate for a pump and what’s involved in getting started using one. As you read, keep in mind that this article describes primarily how the Yale Children’s Diabetes Program operates. As in all aspects of diabetes care, there are many “right” ways of doing things, and the diabetes center in your area may do things differently. If you are interested in any of the methods or products mentioned in this article, please check with your health-care team before making changes in your child’s diabetes-care routine. Who’s a pump candidate? The children who are most likely to be offered a pump at Yale are those who are working very hard to maintain normal blood glucose levels, those who are not meeting goals, those who ask about pump treatment and how it might help them, and those whose episodes of hypoglycemia or high blood glucose are affecting their school work, sports performance, and normal, day-to-day living. However, pump treatment will succeed only if both child and parents are motivated and have reasonable expectations of what a pump can and can’t achieve. They must understand that a pump is only as good as the person operating it. In addition, parents need to be reliable, and a child must be willing to check his blood glucose level at least four times a day. In fact, a child or teen wouldn’t be considered for pump treatment at the Yale Program if this minimum requirement were not Continue reading >>

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