Are Insulin Pumps A Form Of Artificial Pancreas
An artificial pancreas, also known as a closed loop insulin pump, is where an insulin pump works in conjunction with a continuous glucose monitor to automatically deliver the right amount of insulin without requiring instructions from the wearer.
To date, the insulin pumps that are commercially available do not function as an artificial pancreas However, a number of research trials have been carried out to assess the safety and effectiveness of a closed loop insulin pump and the technology may become available to people with diabetes at a future date.
The Freestyle Libre Sensor
So, unless youâve been hiding under a rock, youâll know what the FreeStyle Libre Sensor is, and Iâve done a mammoth post on it here. But, itâs not technically a CGM, but the closest thing to it for an affordable price.
It monitors your blood sugar my scanning a sensor placed on your arm and can bring indications of blood sugar rising or dropping. It can help you detect patterns too.
In 2019, the FreeStyle Libre 2 will be released which WILL have the capabilities to bring alarms to notify you of going low and high, making it a CGM.
It will probably be a postcode lottery again in the UK for who gets the new FreeStyle Libre, but if you canât wait until then, there is another solution.
How Is An Insulin Pump Attached
The insulin pump is attached to the waistband, for example, and the thin plastic tube with the cannula is attached to the skin on the abdomen. The insulin reaches the subcutaneous fatty tissue via the cannula. The needle can remain there for up to two days, after which it must be changed. Before inserting the needle, patients must disinfect the site to prevent infection. They can remove the needle when showering or swimming.
The small patch pump is stuck directly to the skin. On the underside of the pump is a cannula through which the insulin enters the subcutaneous fat tissue. The waterproof pump contains a supply of insulin and must be replaced entirely after a maximum of three days. After that, patients control it via remote control. The advantage of the patch pump is that it does not have a tube, which some people find annoying.
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What If You Do Forget Or There Is A Kink In The Cannula
The insulin used in the pump is ultra short acting. In practice, this means that you can go without insulin for a maximum of about two hours . If after those two hours there is still no insulin, then your body will switch to a different combustion. After all, you always need fuel and without the insulin, the fuel glucose does not reach the cells. The body therefore switches to ‘plan b’: Fats and proteins are now burned. As a result of this waste, so-called ketones are produced. You can measure these ketones with a ketone meter. If you have a pump, you will also get the ketone meter to check if your body has not started this kind of combustion. Why is this important? Ketones are not good for your body. They make you sick: you get nauseous, tired and start vomiting.
You’re actually measuring a high blood glucose level or one that rises very sharply to a high value and if you have the meter, the ketones as well. Your body needs to get insulin in as soon as possible. So also call the emergency line of your treatment team to discuss what to do. Don’t wait too long with this.
Where Do You Carry Your Pump
A very practical issue is where you leave your pump. Our diabetes nurses often get questions about this. Again, we’re happy to give you some places and options.
With a wireless pump
You can carry the wireless pump in various places. Your abdomen is of course a possibility, but also your upper arms, upper legs or lower back can be good places for you. Make sure that your pump can still be operated properly ????. You can discuss the locations with your diabetes nurse. There are also various straps and bags on the market for the wireless Omnipod. These allow you to “customize” your pump a bit to your liking.
For an insulin pump with a tube
With a clamp
A clamp allows you to clip the pump to the top of your waistband or to your pocket. For women, the center of the bra is often used. Clamps can be ordered from your diabetes device supplier.
With a strap, pocket or belt pouch
Special protective bands can also be ordered for your waist, thigh or arm. The manufacturer of your insulin pump has special accessories for this, which fit well and, if necessary, have anti-slip features.
Again, there are special solutions for women to wear their insulin pump in the bra. For example, with a bra pouch with clamp. With a pump bag, you can give your pump a more conspicuous place by wearing it on your waistband via a clip or strap. Pump bags are available in many styles through your device provider.
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Why Should I Use An Insulin Pump
The choice to use an insulin pump instead of injections usually comes down to personal preference. However, you may want to consider an insulin pump if:
- You have frequent low blood sugar reactions.
- You have a condition called gastroparesis, which causes a delay in your stomach’s ability to absorb food.
- You are planning to get pregnant.
- You want to use the pump’s bolus calculator functions to set up insulin doses.
About 25% of people with type 1 diabetes use an insulin pump. Some people switch between injections and pump use. For instance, children may use an insulin pump during the school year but not in the summer.
You can use an insulin pump to give your body insulin, but you still need to check your blood sugar level. By checking your blood sugar regularly, you can make sure that the pump and the infusion are working correctly.
Whats The Difference Between A Traditional Insulin Pump And A Patch Pump
Traditional insulin pumps push insulin from a chamber within the pump through tubing to a site on the skin that is connected to a smaller flexible plastic tube . The cannula is a few millimeters long and delivers the insulin underneath your skin.
Insulin patch pumps also use a flexible plastic tube under the skin, but the insulin delivery chamber and the cannula are part of one pod that sits in the skin with an adhesive patch. You can place the patch directly on your belly or arm. There is no external tubing with a patch pump, and its controlled wirelessly with a handheld controller.
The tubing and cannula are removed and replaced every two to three days. A healthcare provider called a Diabetes Care and Education Specialist will show you how to do this.
Common insulin pump brands include:
- Medtronic .
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For Whom Is An Insulin Pump Unsuitable
In the case of children, patients or their parents must use the insulin pump. If they cannot operate the device safely, the insulin pump is unsuitable.
It is also a prerequisite that patients can safely control and use diabetes treatment with insulin injections and blood glucose monitoring if the pump fails.
Why Should You Choose London Diabetes Centre To Provide Your Insulin Pump
The right insulin pump can allow you to take control of your diabetes and live life to the full. It may be particularly suitable for children. NHS restrictions mean that many people in the UK are unable to get a pump, or may be offered a device that doesnt best meet their needs. The London Diabetes Centre provides expert assessment, a wide-range of the most up-to-date insulin pumps and the education needed to ensure you can use the pump properly.
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Pump Safety Is A Commitment
The one absolute requirement for using a pump is that you and/or your caregivers are ready and willing to do what it takes to use the pump safely. Most diabetes providers and insurance companies require that you check your blood glucose at least four times per day before you go on an insulin pump. Checking blood glucose is important because it will warn you if your pump stops working right, or your infusion set stops working. This can cause high blood glucose levels and cause you can go into diabetes ketoacidosis, which is very serious and dangerous. Checking blood glucose levels frequently will alert you to this possibility and will prevent the development of ketones.
A pump might be considered for:
People who like the idea of a pump. If this is what you want, or you want for your child, and it can be used it safely, then it should be used.
Active people, who benefit from changes in basal rates or suspending the pump when exercising.
People who have frequent low blood glucose reactions.
Anyone who has delays in absorption of food from the stomach .
Women planning pregnancy.
People who want to use the pumps bolus calculator functions to determine insulin doses.
Other factors to consider:
The insulin pump doesnt take away the need to check blood glucose and give insulin before meal.
There are technical aspects to using a pumpsetting it up, putting it in, interacting with itthat are more complicated in some ways than using injections.
Other Factors To Consider:
- The insulin pump doesnt take away the need to check blood sugar.
- There are technical aspects to using a pumpsetting it up, putting it in, interacting with itthat are more complicated in some ways than using injections.
- If it breaks or falls off, the person wearing it needs to be ready to give insulin by injection any time it is needed.
- It can be expensive, so find out which pumps are covered by your insurance and if those pumps meet your needs.
- All pumps are an extra piece of hardware attached to your body, either with tubing or attached to your skin. There are many clever ways to wear pumps and hide them from view, but they do take a bit of getting used to at first.
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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?
What Are The Risks Or Complications Of Insulin Pumps
Insulin pumps have a low risk of complication. Pumps provide more precise insulin doses than injections, so pumps may carry less risk for people who struggle with calculating their dosages.
Possible cons of using an insulin pump can include:
- Inability to hide the tubing or pump with non-patch styles.
- Higher cost than injections.
- Pumps breaking or tubing becoming disconnected.
There is also a risk of setting up the pump incorrectly. Its crucial to use the insulin pump properly and continue to check your blood sugar regularly. If you dont, you might not get the insulin you need, which can be dangerous and even life-threatening. First-time users should ask their healthcare provider for setup instructions.
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When Should I See My Healthcare Provider
If you have diabetes and are curious about insulin pump options, talk with a healthcare provider or a Diabetes Care and Education Specialist. There are many types of insulin pumps on the market. Ask your provider which option is right for you.
Insulin pumps can offer a flexible option for insulin delivery. The pump works by sending continuous insulin or insulin surges directly into your bloodstream. Many people with diabetes find insulin pumps to be more convenient than insulin injections. Insulin pumps arent permanent. You can change your mind and return to injections if you dont like using an insulin pump. There are many insulin pump brands on the market. Speak with your healthcare provider to figure which option is right for you.
How To Get An Insulin Pump
To get a pump for free, youll have to meet certain criteria set by the National Institute for Health and Care Excellence .
If you live in England and Wales, youre over 12 years old and have type 1 diabetes, you need to meet one or more of the following criteria:
- You cant get to your target HbA1c without severe hypos.
- Your HbA1c remains high despite carefully trying to manage your diabetes.
If you live in Scotland or Northern Ireland, the criteria is different. Your healthcare team will give you advice on whether you meet your local criteria for getting a pump and what the next steps are.
If youre thinking about an insulin pump for your child, the criteria is different. Pumps are recommended for children under 12 when multiple daily insulin injections arent practical or appropriate. Make sure you speak to your diabetes specialist about if this is the best option for your child.
We understand that trying to get an insulin pump can be very frustrating, and you might feel disappointed if you cant get one. If you have any questions at all, or you just need someone to talk to, call our helpline.
Pumps are currently not available for people with Type 2 on prescription. You can self-fund, but make sure you have a discussion with your healthcare professional if youre thinking of trying one.
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The Pump Therapy As A System: How Does The Insulin Get Into Your Body
The insulin pump has a compartment that holds a reservoir that is filled with insulin. From the pump’s reservoir insulin is infused into your body through an infusion set . The infusion set is inserted to your body by the infusion set insertion device and is infusing through a tiny flexible tube called cannula that sits just underneath your skin. The infusion set is connected to the reservoirs through a small tubing and you can easily disconnect and reconnect it from your body whenever you want to. This can be helpful, for example when you want to swim, shower or play sports.
What Is An Insulin Pump
An insulin pump is a small electronic device that gives your body the regular insulin it needs throughout the day and night.
There are two types of insulin pump:
Both are attached to your body by a tiny tube called a cannula, which goes just under your skin. Youll need to learn how to change the cannula yourself, which eventually becomes really easy.
You need to change your cannula every two or three days and make sure you move to a different place every time you change it. This is really important because you can develop lipohypertrophy, which is where your body forms hard lumps that stop insulin working properly. You should also change sites to stop itching and rashes that form if you stick with the same site for too long.
A tethered pump is attached to your body by another small tube that connects to your cannula.
The pump itself usually has all the controls on it and can be carried on your belt, in a pocket, or in a body band. You can wear it under your clothes if you dont want it to be on show.
Tethered pumps can be different in things like colour, screen size and some have extra features like Bluetooth remotes.
You attach patch pumps directly on to your body where youve chosen to place your cannula. People tend put them on their legs, arms or stomachs.
Patch pumps have no extra tubing, which means the pump sits directly on your skin and it works by using a remote.
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Why Choose Pump Or Pen Therapy
Our motto in advising our patients is that the form of insulin delivery should suit you, but increasingly we will advise you to use diabetes technology to achieve your desired goals. We know by now, that the more you use technology, the better your diabetes goals and guidelines can be achieved, such as an HbA1c of 7%. Before starting insulin pump therapy, we, as practitioners, impose some conditions on your knowledge of diabetes control, such as carbohydrate counting, uploading your blood glucose values to us at least every four weeks and, not unimportantly, keeping in touch with your diabetes team.
Insulin Pumps: Relief And Choice
For people living with diabetes who are tired of injections, an insulin pump can bring welcomed relief. Insulin pumps are small, computerized devices that deliver insulin in two ways:
- In a steady measured and continuous dose , or
- As a surge dose, at your direction, around mealtime.
Doses are delivered through a flexible plastic tube called a catheter. With the aid of a small needle, the catheter is inserted through the skin into the fatty tissue and is taped in place. The tube/needle combination is called an infusion set.
The pumps can release small doses of insulin continuously , or a bolus dose close to mealtime to control the rise in blood sugar after a meal. This delivery mimics the body’s normal release of insulin.
The insulin pump may integrate with your continuous glucose monitor to help understand how your blood glucose is being affected and change the amount of insulin in some cases. Pumps can help some people reach their blood sugar targets and many people prefer this continuous system of insulin delivery over injections.
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