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What Type Of Insulin Can Be Used In A Pump?

Insulin Analogs

Insulin Analogs

Insulin analogs mimic the body’s natural pattern of insulin release. Once absorbed, they act on cells like human insulin, but are absorbed from fatty tissue more predictably. An analog refers to something that is “analogous” or similar to something else. Therefore, “insulin” analogs are analogs that have been designed to mimic the body’s natural pattern of insulin release. These synthetic-made insulins are called analogs of human insulin. However, they have minor structural or amino acid changes that give them special desirable characteristics when injected under the skin. Once absorbed, they act on cells like human insulin, but are absorbed from fatty tissue more predictably. In this section, you will find information about: Rapid-acting injected insulin analog The fastest working insulins are referred to as rapid-acting insulin. They include: These insulin analogs enter the bloodstream within minutes, so it is important to inject them within 5 to 10 minutes of eating. They have a peak action period of 60-120 minutes, and fade completely after about four hours. Higher doses may last slightly longer, but will last no more than five or six hours. Rapid acting insulin analogs are ideal for bolus insulin replacement. They are given at mealtimes and for high blood sugar correction. Rapid-acting insulins are used in insulin pumps, also known as continuous subcutaneous insulin infusion (CSII) devices. When delivered through a CSII pump, the rapid-acting insulins provide the basal insulin replacement, as well as the mealtime and high blood sugar correction insulin replacement. The insulins that work for the longest period of time are referred to as long-acting insulin. They provide relatively constant insulin levels that plateau for many hours after injection. Some Continue reading >>

Insulin Pump Therapy

Insulin Pump Therapy

With increasing frequency, individuals with type 1 diabetes (and, to a lesser extent, type 2 diabetes) are being placed on insulin pump therapy (also called Continuous Subcutaneous Insulin Infusion or CSII for short). Unlike the usual form of intensified management which generally requires injections of insulin between 4 to 6 times per day and uses a combination of rapid or short-acting insulin as well as intermediate-acting insulin or long acting insulin, pump therapy uses only rapid-acting insulin and gives the insulin in tiny doses (called "basal insulin") around the clock. An insulin pump also allows you to give "boluses" (a few extra units of insulin) when you are about to eat. One advantage of insulin pump therapy (compared to giving yourself multiple daily injections of insulin) is that you will likely achieve better blood glucose control with fewer elevated readings and fewer episodes of hypoglycemia. A huge additional benefit is that the great majority of people with diabetes who go on pump therapy LOVE it and would NEVER go back to conventional injections. The most common comment I hear is: "It's so much more convenient. I wish I had done this sooner!" Note that I do not hear that it is less work (cuz it ain't less work; if anything it's more work). One potential turn off about being on a pump is that you have to wear it around the clock. Sure, that may sound unpleasant, BUT I must say that these words are seldom spoken by actual pump users; it's pretty well only people that haven't yet tried a pump who voice this concern. So, if you are considering pump therapy I'd suggest you mull over the following (I'll mention only major points): The Bad: Pumps have to be worn around the clock (with brief exceptions). Pumps are very expensive (as in thousands of dollars). Continue reading >>

Continuous Subcutaneous Insulin Infusion

Continuous Subcutaneous Insulin Infusion

As with any drug or medical device, professional staff and people with diabetes must be aware of the nature of insulin-pump ther-apy and its special requirements and be prepared to manage this therapy. Ideally, CSII therapy should be prescribed, implemented, and followed by a skilled professional team familiar with CSII therapy and capable of supporting the patient. PATIENT SELECTION Experi-ence with insulin-pump therapy indi-cates that candidates for CSII must be strongly motivated to improve glucose control and willing to work with their health care provider in assuming sub-stantial responsibility for their day-to-day care. They must also understand and demonstrate use of the insulin pump, self-monitoring of blood glucose, and use of the data so obtained. In many people, CSII or multiple insulin injections can provide equivalent improvements in control. Whereas some clinicians recommend CSII only when three or four daily injections fail to provide euglycemia, others consider CSII indicated for motivated patients whose daily schedule makes conventional therapy less effective. An insulin pump may provide great lifestyle flexibility, particularly with regard to meal schedules and travel but may be too demanding for some individuals. CSII can help improve metabolic control during pregnancy. The preferred meal planning approach used with patients on CSII is carbohydrate counting or carbohydrate equivalents. INSULIN PUMPS Factors to be considered in choosing an insulin pump should include safety features, durability, availability of service by the manufacturer, ability of the supplier to provide training, ease of use, clinically desirable features, and cosmetic attractiveness to the user. The nontechnical person may not be able to adequately evaluate the safety and dependab Continue reading >>

Insulin Pump Overview

Insulin Pump Overview

As people with diabetes know, keeping blood sugar levels in a safe range is extremely important. Good blood sugar control not only makes you feel well, but also helps prevent long-term diabetes complications, such as blindness, kidney failure and heart disease. People with type 1 diabetes don’t produce insulin, a hormone that helps the body use sugar (glucose), a key source of energy that comes from carbohydrates. If you have type 1 diabetes you must make up for the lack of insulin with insulin therapy. Meanwhile, people with type 2 diabetes produce insulin, but their bodies don’t use insulin properly, or they don’t produce enough insulin. Diet, exercise and medication can often work to control glucose levels. However, in certain cases, these measures aren’t enough, and insulin therapy is needed to better control blood sugar levels. While insulin can be given by self-injection, people who take multiple daily injections of insulinmay also consider using an insulin pump. An insulin pump provides continuous delivery of short acting insulin all day long. The insulin pump substitutes the need for long acting insulin. A pump also replaces the need for multiple daily injections with a continuous insulin infusion, and also helps to improve your blood sugar levels. How Do Insulin Pumps Work? Insulin pumps are small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate). The device also is used to deliver variable amounts of insulin when a meal is eaten (bolus). The basal insulin rates are usually set up in your pump with your doctor, and you can have one or multiple basal settings programmed in your pump, based on your needs. You program the amount of insulin for your mealtime bolus di Continue reading >>

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

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

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

Thinking Twice About Using Apidra In Insulin Pumps

Thinking Twice About Using Apidra In Insulin Pumps

Anyone going on a brand spanking new insulin pump is probably filled with anticipation and excitement, but there's always a little bit of trepidation when it comes to a new piece of medical technology. Will it meet my needs? Will I like using it? Most importantly: will it work? The fear of potential problems like motor error, malfunctioning buttons, and occlusions can throw a wrench in anyone's pumping anticipation. Apparently, those wrenches have been flying around the Diabetes Community quite a bit lately, especially last summer when the newest insulin pump hit the market. We have discovered dozens of new Tandem t:slim users who've taken to the Internet, reporting on blogs and social networks that their pumping honeymoon swiftly came to an end with the onslaught of occlusions using Sanofi's Apidra insulin. Naturally we wondered what could be the cause, whether or not this was strictly a t:slim issue, and whether or not there is anything anyone can do about it. About Occlusions Occlusions are basically just blockages that prevent insulin from being delivered. If you have a blockage, pressure will build and usually your insulin pump with alarm, letting you know something has run afoul. "There are several reasons why they happen, " says Dr. Brian Levy, an endocrinologist and Senior Director of Clinical Affairs at Animas. "They include kinking of tubing that goes from the pump to the insertion side, or more importantly, the kinking of the catheter. Most cannulas are made of Teflon or plastic which can kink. It can also be due to problems at the insertion site, inflammation that can happen around the insertion catheter or the presence of scar tissue. If a patient uses the same place on their abdomen, there can be chronic build-up of scar tissue." Occlusions can and do happ 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 >>

What Is Insulin Pump Therapy?

What Is Insulin Pump Therapy?

Through the following simple questions and related answers, you can get an understanding of what an insulin pump is and how insulin pump therapy works, helping you keep your glucose levels under control whilst maintaining your lifestyle. What is a pump and how does it work? An insulin pump is a small electronic device, about the size of a mobile phone. It can be easily carried on a belt, inside a pocket, or even attached to a bra thus becoming virtually invisible to others and allowing a very discreet therapy. The pump can help you more closely mimic the way a healthy pancreas functions. The pump, through a Continuous Subcutaneous Insulin Infusion (CSII), replaces the need for frequent injections by delivering precise doses of rapid-acting insulin 24 hours a day to closely match your body's needs. Basal Rate: A programmed insulin rate made of small amounts of insulin delivered continuously mimics the basal insulin production by the pancreas for normal functions of the body (not including food). The programmed rate is determined by your healthcare professional based on your personal needs. This basal rate delivery can also be customised according to your specific daily needs. For example, it can be suspended or increased / decreased for a definite time frame: this is not possible with basal insulin injections. Bolus Dose: Additional insulin can be delivered "on demand" to match the food you are going to eat or to correct high blood sugar. Insulin pumps have bolus calculators that help you calculate your bolus amount based on settings that are pre-determined by your healthcare professional and again based on your special needs. What are the benefits of insulin pump therapy and how can it help you achieve better glucose control? Insulin pump therapy offers multiple clinica 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 >>

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 >>

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 >>

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

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 >>

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 >>

What Is Insulin?

What Is Insulin?

Insulin is a hormone that allows your body to regulate sugar in the blood. It helps to keep your blood sugar levels from getting too high (hyperglycemia) or too low (hypoglycemia). Insulin was discovered as a treatment for diabetes in the 1920s, and soon Eli Lily began producing the extract in great quantities. Prior to this discovery, diabetes was considered untreatable and likely to result in death. Special cells called beta cells in the pancreas make insulin. With each meal, the beta cells release insulin to help the body use sugar in the blood or store it. People with type 1 diabetes cannot make insulin because their beta cells are damaged or destroyed. Those with type 2 diabetes don't make enough insulin or the body can't use it properly. People with either type 1 or type 2 diabetes may need to receive injections of synthetic or animal insulin to help their bodies regulate their blood sugar. Types of Insulin Doctors prescribe different types of injectable insulin to treat diabetes. These are: Rapid-acting insulin: This insulin starts working about 15 minutes after you inject it into the tissue just beneath the skin. It peaks in about one hour but keeps working for two to four hours. It's typically taken before a meal along with a long-acting insulin. There's also a type of rapid-acting insulin, Afrezza, that can be inhaled through the mouth, which may be more convenient for some people. Short-acting insulin: This insulin starts working about 30 minutes after you inject it. It peaks in about two to three hours but keeps working for three to six hours. It's typically given before a meal along with a long-acting insulin. Intermediate-acting insulin: This insulin starts working about two to four hours after you inject it. It peaks in about four to 12 hours but keeps wo Continue reading >>

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