Insulin pump overview
Insulin pump mimic pancreas
A pump is constantly dribbling insulin. This is called basal delivery since it forms the “base” of the insulin need. Wear the pump all the time. You can take off for about an hour for things like swimming or taking a bath, but otherwise it is always on. With the help of the health care team, programs the pump, so it knows how much insulin to dribble and how much to squirt at meal or snack time (This is called a bolus - it is like an insulin booster). It is important to check the blood-glucose level (by glucose monitor) several times a day to make sure the insulin pump and the catheter are working okay.
Of course, a need to make adjustments for hypoglycemia (low blood-sugar) or hyperglycemia (high blood-sugar) happens accidentally.
If you are interested in an insulin pump, discuss with your health care team and see if they think it would work for you. Some people get the benefit of an insulin pump without an insulin pump. They do this by using both short acting and long-lasting insulin. You may want to ask your doctor about doing this if you decide against a pump.
Insulin pump training
Training for the pump usually involves a one-hour training session with a diabetes educator, and a return visit several days later to set up the pump, set basal rates and administer a bolus, and learn when and how to change the infusion set.
One who going to use the pump, should achieve technical competence with the following tasks of the insulin pump therapy:
- inserting the diabetes pump cannula
- delivering a dose of insulin through the pump (bolus)
- checking the diabetes pump memory (time of the last bolus dose)
- troubleshooting (determine a problem with the diabetes pump)
- Replacing batteries
Advantage of the insulin pump
All with type 1 diabetes requires insulin from an outside source. To live with diabetes, they must control their blood-glucose by balancing food, insulin, and exercise. You can take Insulin by traditional injection, insulin pen, or pump. The pump acts somewhat like (mimic) the pancreas by delivering insulin continuously. The insulin pump has several advantages over other forms of insulin delivery:
- Precise infusion — Diabetes Pump delivers insulin as little as one-tenth of a unit – that can be closely matched to the needs.
- Easy predictable — absorption of short-acting insulin, which is used in diabetes pump, is more predictable than that of long-acting insulin.
- Continuous infusion —diabetes pump delivers basal insulin 24 hours a day and allows the user to change the amount infused on an hourly basis, if necessary.
- Painless —diabetes pump holds a supply of insulin for several days, and it eliminates the need for scheduled injections since it delivers insulin continuously.
- Individualized —you can program the diabetes pump to meet your personal needs, and it is easy to adjust and to keep blood-glucose levels in the target range during illness or physical activity.
- Smart Intelligence — most diabetes pump calculates insulin doses needed based on carbohydrate intake, user’s personal insulin-to-carbohydrate ratio and insulin sensitivity factor, and insulin still active in the body from the previous dose.
- Convenient control —diabetes pump can be lifesaving for children who have a history of widely fluctuating blood-glucose levels. People who use the pump are better able to keep their glucose level in the target range.
- Freedom —diabetes pump gives children more freedom to vary when, what and how much they eat, through the continuous infusion of short-acting insulin and the ability to “cover” with additional doses as needed.
Disadvantages of Insulin pump
- Uncomfortable - insulin pump warns most of the time, so the diabetes pump users need to be careful to avoid any damage to diabetes pump. Some users may find that wearing diabetes pump all the time (together with the infusion set tubing) is uneasy.
- Unexpected incidents - an episode of diabetic ketoacidosis(Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA.) may occur if a diabetes pump user does not receive sufficient fast acting insulin for many hours. This can happen if insulin pump battery is discharged, if the insulin reservoir runs empty, the tubing becomes loose or insulin leaks rather than being injected, or if the cannula becomes bent or kinked in the body, preventing delivery. Therefore, pump users typically monitor their blood sugars more frequently to evaluate the effectiveness of insulin delivery.
- Infection - there is also a risk that the insertion site might become irritated or infected. Insulin pump user will have to change the insertion site every two or three days in order to avoid infection.
- Costly - since insulin pumps can cost more, compare to other insulin delivery systems.