ADVANTAGES OF INSULIN PUMP THERAPY:
- Lifestyle flexibility – more spontaneity regarding food consumption and exercise
- More accurate insulin dosing
- More predictable insulin absorption
- Fewer injections
- Better control over insulin delivery during exercise, sleep, illness
- Less hypoglycemia
- More ease in achieving better metabolic control
- Dawn Phenomenon (elevation of blood glucose level in the early hours of the morning) more easily treated.
INSULIN PUMP THERAPY – WHAT IS IT?
Insulin pumps deliver rapid-acting insulin subcutaneously over 24-hour periods. This method of insulin therapy most closely imitates physiological insulin delivery in the healthy pancreas. An insulin pump is composed of a pump reservoir similar to that of an insulin cartridge, a battery–operated pump, and a computer chip that allows the user to control the exact amount of insulin being delivered. Approximately half of the total daily insulin requirement is preprogrammed and is administered at a constant rate (basal rate). Basal insulin represents the body’s insulin requirement without food. The insulin pump allows the user to program many different basal rates to allow for changing lifestyle variations. The pump will deliver additional insulin to cover meals containing carbohydrates or to correct an elevated blood glucose level (Bolus insulin). Bolus insulin is delivered by the user as needed and is not preprogrammed The total daily insulin requirement over the course of 24 hours varies and is dependent on factors such as exercise, activity level, and sleep.
Currently, pumps are about the size of a pager or beeper. The pump is attached to a thin plastic tube connected to an insulin cartridge on one end (the infusion set) that has a soft cannula at the other end through which the insulin passes. This cannula is inserted under the skin into the subcutaneous tissue. The cannula is changed every two to three days. The tubing can be disconnected from the pump while showering or swimming.
FOR WHOM IS IT RECOMMENDED?
Insulin pump therapy may be recommended for all age groups.
The best candidates for insulin pump therapy are those who actively practice diabetes self-management. They monitor and record their blood glucose levels frequently throughout the day, count carbohydrates, and visit their health care team on a regular basis. However, it has been found that many people who have managed their diabetes poorly with multiple daily injections may be very successful using pumps if they are motivated to achieve intensive treatment goals. Changing the insulin therapy method gives one the opportunity of starting with a “clean slate” – having another chance at changing from negative to positive behaviors regarding self-management of their diabetes.
SAFETY ISSUES
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Increased risk of Ketoacidosis (no depot of long-acting insulin)
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Unhealthy eating behaviors
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Infusion site problems (infections or sub-optimal absorption)