Treating Diabetes With Insulin Pumps and Continuous Glucose Monitors
Insulin Pumps for Treating Diabetes
Since I was diagnosed with Type 1 diabetes in 2003, I have worn a small computer attached to my waistband. Its an insulin pump - and it has completely changed my life with respect to management of the disease.
Instead of having to take multiple shots each day, the wearer simply presses some buttons on the pump whenever he or she decides to ingest carbohydrates. And, unlike the long-acting insulin which is required to give the diabetic a baseline amount of insulin to counteract the stored energy (glucose) that is naturally released by the body during the day, an insulin pump is programmed to give microshots of short acting insulin, approximately every 15 minutes over a 24 hour period.
Sound complex? Well, yes - it is. However, management of diabetes (whether Type 1, or advanced Type 2) requires the patient or his caregiver to keep track of carbohydrates, activity levels and administer just the right amount of insulin to keep blood sugar levels from going too high or too low. Thirty years ago, management of diabetes was much more of a guessing game than it is today. Blood sugar meters were not small and portable like they are now. In fact, fifty years ago, diabetic patients literally did guess at blood sugar levels based on the amount of sugar in their urine! If you have sugar coming through in your waste, then your blood sugar levels are definitely too high!
System Works Like an "External Pancreas"
Computers Used by Diabetics
- Blood sugar meter (measures the amount of glucose in the patient's blood, based on units of mg/dl and can alert to hyperglycemia and hypoglycemia)
- Insulin pump (administers insulin continuously (baseline) and when directed to by the patient to counteract ingested carbohydrates)
- Continuous glucose monitor (implanted subcutaneously and programmed to communicate with an insulin pump. Will either direct injection of additional insulin when glucose levels go too high, or will sound an alarm when levels fall too low, altering the patient to eat or drink something)
Benefits of Using Computerized Equipment to Treat Diabetes
Whether you simply have a blood sugar meter, or are completely wired up with an insulin pump and/or continuous glucose monitor, these devices can assist you as the diabetic patient, as well as the doctor, in a number of ways.
First, diabetes records are stored on a meter and the pump. Each time I go to the doctor, he takes my meter and pump and downloads the information off of each. From the meter, a spreadsheet is created showing lows, highs, time of day during testing, how many tests a day, average readings, and graphical information to help determine when blood sugar readings are out of range. This gives a complete picture of the diabetic's readings for at least the prior three months. From there, adjustments can be made to determine to help correct overnight lows, or post-meal highs.
Second, an insulin pump can help you with calculations concerning the amount of a "bolus," or shot you should take with a meal, or to correct a high blood sugar episode. Based on information you program into the pump regarding your own body's sensitivity to insulin, the time that has passed since your last bolus, your current blood sugar level, and the number of grams of carbohydrate you are preparing to ingest, the pump will tell you how much of a shot to take. You still have to count carbs and test your blood independently (unless you have a continuous glucose monitor), but for those people with limited math skills, the computerized technology is great!
Third, if adjustments need to be made based on your A1C tests (average blood sugar level over about 3 months), it is simple just to program in a higher or lower baseline rate into your insulin pump. You can also have higher or lower baseline rates based on time of day, or the day of the week. Also, unlike with shots of long-acting insulin, which remain effective all day long, a diabetic on an insulin pump can often take off the device when exercising so as to prevent hypoglycemia.
Read About Diabetes Insulin Pumps
What is an Insulin Pump?
An insulin pump generally consists of a computer, reservoir container - which is where the insulin is inserted - and a battery. Many run on a single AAA battery. Alarms will sound when the battery needs to be replaced and when the reservoir of insulin is low. In order to convey insulin from the pump to the patient, tubing is connected between the reservoir and the infusion site.
An infusion site is prepared on the patient by washing a small area on the belly or buttocks with IV prep. A small catheter is inserted under the skin with a 1-2 inch thin needle, which is then backed out of the skin leaving the tubing in place. Infusion sites need to be changed every 3-4 days so as to prevent infection. But, as you might imagine, a single needle poke every 3 days is a far cry from 4-6 sticks a day.
For an example of how this is done, see the video below.
Changing Infusion Site with Insulin Pump
Insulin Pumps are Easy Enough for Children to Operate
Insulin Pumps are Especially Helpful for Children with Type 1 Diabetes
Parents of children with Type 1 diabetes are usually thrilled to use a pump, instead of wrestling with giving multiple shots a day. They are amazingly easy to use, once they've been mastered.
For very young children and babies, the pump can be worn in a backpack and can be programmed into a "lock" position to prevent inadvertent button pushing. Even toddlers can be taught to properly use an insulin pump and self-administer insulin. Having your child take responsibility for their own diabetes is a huge bonus, particularly when you cannot always be by his or her side.
What do These Computerized Diabetes Treatments Cost?
Diabetes care, unfortunately, is very expensive. Even with insurance, the cost of insulin, test strips, ketone strips and needles will run you about $100 - with co-pays.
An insulin pump is approximately $5,000, and may be covered by insurance. The policy that I had in 2003 required me to pay 10% of the cost of the pump, and I had to be pre-approved by the insurance company as having a "need" for the pump. (Gee, I'm not producing any of my own insulin - does that count?) Pump supplies will run you about $150 each month. The trade-off for these expenses is much improved health and the freedom to eat more often, if I desire.
I have not yet tried a continuous glucose monitoring system, but obviously there will be additional costs associated. Again, the benefit of improved diabetes health may justify the situation, and the prevention of dangerous highs and lows is definitely worth the cost in my book!
Inserting a Continuous Glucose Sensor
Talk to Your Doctor About Diabetes Care
If you wish to have more information about an insulin pump and how it may work for you or a loved one, I highly recommend that you discuss the matter with your doctor. An endocrinologist is the type of specialist that you'll need to see in order to manage diabetes.
Better diabetes health can be attained. The medical advances that have been achieved through treatment with blood sugar meters, insulin pumps and continuous glucose monitoring systems are truly amazing. You're one step closer to a healthier body and a longer life!
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