What Happens While Using An Insulin Pump
An insulin pump delivers insulin in one of two ways:
- Small, continuous insulin doses .
- Surges of insulin near mealtimes .
While using an insulin pump, you still need to check your blood sugar levels. Most people check blood sugar at least four times a day. Or you may use a continuous glucose monitor.
The pump uses information you enter about your food intake and blood sugar levels to calculate how much bolus insulin you need. The pump then recommends a bolus dose to you and waits for your approval before delivering. In addition, some pumps automatically adjust basal doses based on glucose levels from a continuous glucose monitor.
What Should Be Considered When Choosing An Insulin Pump
The following list may seem formidable and long, but keep in mind that not all of it may apply to you. Discuss which features and elements are most relevant to your care with your doctor.
- Weight, size and color of pump
- Lowest basal rate delivery
- Amount of insulin a cartridge can hold
- Number of different background, or basal, insulin patterns available
- Insulin-to-carbohydrate ratio program feature
- Insulin-sensitivity factor and target glucose features
- Number of different customized bolus programs available for example: breakfast, lunch, dinner, pizza, use of pramlintide, etc.
- Nutritional information
- Types of alarms and alerts
- Waterproof, watertight, or water-resistant
- Ease of use programming, delivering a bolus, navigating program menus
- Infusion set compatibility brand-specific or universal
- Customer service technical support, clinical support, warranty, trial period, upgrades, cost of upgrade
- Future features of upgrades
II. Starting on the pump:
You will attend an insulin pump start class on two consecutive mornings taught by certified diabetes educators. This is when you will start pumping insulin.
III. Follow up:
Make appointments with pump team
- MD 2 to 5 visits or more
- RN 2 to 4 visits or more
- RD 0 to 2 visits or more
Once you are given the dates for your pump class be sure to schedule your pump team follow up appointments.
What Other Technology Can An Insulin Pump Work With
Some pumps can interact with continuous glucose monitors and adjust insulin delivery based on your glucose readings. Medtronics Minimed 780G works with Guardian 4 CGM, the Tandem t:slim x2 works with Dexcom G6 and Ypsopump works with Dexcom G6 using the CamDiab algorithm. Find out more about hybrid closed loop technology
Insulin pumps are not compatible with flash glucose monitoring.
Content last reviewed and updated: 20 October 2022
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Advantages Of The Freestyle Libre 2
Newer models are worn outside the body and integrate data recording so its no longer necessary to download data for analysis.
With the FreeStyle Libre 2, patients can scan the sensor with a handheld reader to see their current glucose levels and trends over the previous eight hours. This system also uses Bluetooth technology to alert users when blood sugar gets too high or too low without needing to scan the sensor.
Patients who get readings that dont match their symptoms or expectations may still need to use a finger stick blood test to help inform treatment decisions, according to Abbott.
Newer-generation products that win FDA approval to be marketed this way need to do a lot more than just communicate with a hand held scanner or with devices that can pump insulin into the body, Breton says.
It also ensures minimum levels of accuracy, the capacity to stream data in real-time to other applications, and a regulatory framework of a class 2 medical device with special control that should allow much faster iterations of the product in the future, Breton says. So-called class 2 medical devices dont require the most stringent FDA regulation or approval processes, and can include products like blood pressure cuffs, condoms, pregnancy tests, and power wheelchairs.
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How Does An Insulin Pump Work
Insulin pumps are connected to the body and are able to deliver insulin subcutaneously for someone in need of insulin therapy.
Some insulin pumps have an infusion set that connects the pump to the body through a tubing system. Others adhere directly to the body, but also have a small cannula that gets inserted through the skin.
An insulin pump holds a set amount of insulin in a cartridge or reservoir and then delivers it to the body through the skin, where it then enters the bloodstream. From there, the insulin allows cells of the body to absorb glucose and metabolize it as energy.
An insulin pump can closely mimic the body’s physiological needs by slowly releasing insulin into the body throughout the day and providing a larger dose at meals.
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What Are The Parts Of An Insulin Pump
Traditional insulin pumps contain three main parts:
-
Pump. Traditional insulin pumps are battery powered and contain an insulin reservoir , pumping mechanism, and buttons or touch screen to program insulin delivery. Pumps send insulin through tubing into an infusion set that delivers the insulin to your body.
-
Tubing. A thin plastic tube is connected to the insulin reservoir and insulin flows into the subcutaneous tissue through the infusion set. There are several length sizes of tubing length. They are chosen based on how you wear the insulin pump. For example, longer tubing may be good for people who wear their pump far from the infusion set.
-
Infusion set. Infusions sets are made of Teflon or steel and attach to your skin with an adhesive patch. On the underside of the infusion set is a short thin tube that is inserted in your skin with a small needle that is housed within the cannula to deliver insulin into a layer of fatty tissue. The needle is necessary to puncture the skin and insert the set. After insertion, the needle is removed and the thin cannula stays under the skin. The set is usually implanted around your stomach area, but can be placed on the thigh, hips, upper arms, or buttocks.
There are a variety of infusion sets to choose from, and your diabetes care team can help you choose what is best for you based on your body type, lifestyle, and a variety of other factors. Infusion sets fall into two categories:
Patch pumps contain three main parts:
What Kind Of Insulin Do Pumps Use
Insulin pumps only use fast-acting insulin. If you inject insulin with a pen, you need to inject slow-acting insulin once a day, which usually lasts for about 24 hours . However, because insulin pumps deliver fast-acting insulin in tiny amounts all the time, there is no need for a separate slow-acting insulin to work in the background, because your pump is doing that job already.
This constant delivery is still known as basal even though its delivering fast-acting insulin. This is because its doing the same job as the slow-acting background insulin you use when youre managing type 1 with multiple daily injections. You can also adjust how much is being delivered per hour, which gives you more flexibility.
There are two types of insulin pump:
- 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.
To find out what insulin pumps are currently available in the UK, visit Pumps and Infusion Sets Available in the UK.
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What Does An Insulin Pump Look Like
If you have been diagnosed with diabetes, you may feel overwhelmed by all the new information you have learned and will continue to learn about managing your diabetes.
You already know your main goal should be to get your blood glucose levels under control in order to increase your chances of a complication-free life. Many people know this, but need to know how to achieve good diabetes management, while balancing the day-to-day demands of diabetes with other life demands.
An insulin pump can help you manage your diabetes. By using an insulin pump, you can match your insulin to your lifestyle, rather than getting an insulin injection and matching your life to how the insulin is working.
When you work closely with your diabetes care team, insulin pumps can help you keep your blood glucose levels within your target ranges.
People of all ages with type 1 diabetes use insulin pumps and people with type 2 diabetes have started to use them as well.
Figure 1. Insulin pump
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How Much Does An Insulin Pump Cost
Insulin pumps arent always covered by insurance companies. In many cases, to get insurance coverage for an insulin pump, your doctor will need to approve it as medically necessary.
If they arent covered by insurance, insulin pumps can be costly you can expect to pay about $6,000 for the device itself. Thats not counting the cost of batteries, sensors, and other supplies, which can run you another $3,000 to $6,000 annually. Finally, youll need to pay separately for insulin delivered by a pump!
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How Do Pumps Work And What Makes Them Different
- Insulin pumps are about the size of a pager. They are worn all the time.
- The pump is set to deliver an infusion of basal insulin all the time, over 24 hours. Different basal rates are set for different times of day depending on your needs.
- You give a certain amount of insulin for each meal or snack according to how much carbohydrate is in the food. This is called a bolus.
- As of 2007 most pumps have a calculator feature that will help decide the right dose for you, based on your individual guidelines. They also have special blood glucose meters that send the results directly to the pump with wireless, infra-red technology.
- Only rapid or fast acting insulin is used in the pump.
- The insulin pump delivers insulin through a thin plastic tube inserted under the skin . This insulin infusion set is changed every 2-3 days.
How Often Insulin Pumps Need To Be Replaced
Infusion sets can be expensive, so some patients may try to extend the use of it for as long as possible. This can be dangerous, though, as you run the risk of infection or of having high blood sugar levels.
Therefore, it is recommended that infusion sets that have metal needles be replaced every one to two days. Infusion sets with a soft cannula should be replaced every two to three days.
Patch pumps are a little different since they do not have infusion sets. The battery on the Omnipod insulin pump will last no more than 80 hours. However, it will start reminding you to replace the insulin pump at hour 70 or so.
It is important to replace your insulin pump regularly and rotate application sites. Not taking these steps can lead to skin irritation and infections.
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Why Prick When You Can Scan1
The FreeStyle Libre flash glucose monitoring system is designed to liberate patients from the hassles of glucose monitoring.
How it works.
1.APPLY THE SENSOR
The FreeStyle Libre sensor is applied on to the back of the upper arm with a simple, disposable device called an applicator. When the sensor is applied, a thin, flexible and sterile fibre is inserted just under the skin. It is held in place with a small adhesive pad.
2. SCAN SENSOR
To obtain a glucose reading, simply perform a quick, painless 1-second scan of the reader over the sensor. This scan gives you more information than monitoring with blood glucose test strips, without the need for routine finger pricks2. The FreeStyle Libre system also offers optional FreeStyle Libre software to generate concise reports to assist with the analysis of glucose data.
3. GET READING
Each scan of the reader over the sensor gives a current glucose reading, the last 8-hours of glucose history, and a trend arrow showing if glucose is going up, down, or changing slowly. The reader can scan through clothing**.
*Data on file. Abbott Diabetes Care**The reader can capture the data from sensor when it is placed between 1cm to 4cm from sensor.
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Which Pump Is Best
All insulin pumps have benefits and drawbacks. Your choice will depend on whatâs most important to you. Do you want easy setup? Low up-front cost? Ease of use? Since most insurance companies will replace your pump only after several years of use, itâs important to find one that works for you.
Some things to think about:
- Which is best for your lifestyle: a traditional pump, tubeless pump, or pump with handheld remote?
- Pump reservoirs hold between 176 and 315 units of insulin. Kids may be fine with smaller reservoirs adults may want larger.
- Can the pump deliver insulin in small amounts? Kids and people who are very sensitive to insulin may want one that does.
- Does the pump come with carb counts of common foods to help you decide how much insulin you need?
- Can the pump interact with a blood glucose meter or continuous glucose meter ?
- Does the pump software work with your phone or laptop?
Mechanism Of Operation Of The Insulin Pump How Does Insulin Get Into The Body
Your insulin pump has a compartment for the insulin reservoir, from which insulin is injected into the body using an infusion set. Installation of the infusion set is performed using a special device for the introduction of the infusion set a serter. The insulin itself is injected through a small flexible tube located under the skin. The infusion set is connected to the reservoir using small tubing that can be detached as needed .
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