Why Are Insulin Pumps Used
Pumps offer a steady stream of insulin so that you can have fewer needle sticks. Theyre also a good option for children or anyone who has trouble remembering their insulin injections. Because insulin pumps stay attached to the body, some people find an insulin pump more convenient than insulin pen injections.
A Pump May Be A Good Choice For:
- People who like the idea of a pump. If this is what you want, or what 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 sugar 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.
Does Insurance Cover An Insulin Pump
When it comes to your diabetes management, cost should not prevent you from accessing advanced diabetes technology. Our team will work with you to help ensure that you can experience the benefits of insulin pump therapy.
PRIVATE INSURANCE Most private insurance companies cover insulin pumps under the durable medical equipment portion of your policy. Depending on your insurance coverage, you might have to pay a deductible and/or percent of the cost . If your deductible and out-of-pocket maximum has been met, the insulin pump might be covered at 100% by your insurance.
GOVERNMENT INSURANCE Government insurances such as Medicare and Medicaid may cover insulin pumps depending on the state and other requirements. A patient’s out-of-pocket cost under government insurance varies depending on the policy.
INSURANCE PROCESSING When you start the process of getting an insulin pump, you do not have to worry about the paperwork. Medtronic will help you every step of the way by verifying your insurance, providing an estimated out-of-pocket cost, collecting the documents from you and your physician, and submitting all the required documents to your insurance company.
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Traveling With A Pump
When traveling , you should always carry several days of extra supplies and all supplies and medications should be kept in your carry on. Make sure all medications, including insulin are in their original container with the prescription label on it. It doesnt hurt to have a letter from your provider stating you are wearing a medical device. Carry syringes and back up long-acting insulin with you when you travel, just in case. Dont forget extra batteries or your charger cable for you pump or CGM.
Your pump is OK to go through screening, but not through the Xray machine. You can also request a pat down rather than having to remove your pump.
If you are going out of the country, many pump companies will offer you a loaner pump to take with you just in case of a malfunction. Its also helpful to change the time on your insulin pump once you arrive at your destination, otherwise you basal rates will not be programmed correctly.
If you are going through a very large time change, talk to your educator about how and when to change the time for your basal. Also, if you are going to be more active on your vacation, you may just plan to set a complete separate basal pattern for while you are away. Just make sure to set an alarm in your phone or leave yourself a note at home to change your time or basal pattern back when you return.
What Are The Drawbacks
Using an insulin pump isnt always the best option for everyone. Lets take a closer look at some of the drawbacks of this device.
An insulin pump and daily injections are both effective methods of controlling your blood sugar levels. Whats most important is that you monitor your blood sugar carefully and follow your doctors instructions for managing your diabetes.
Its very important that you spend time with a diabetes educator or your doctor to learn how to use your insulin pump properly.
Before you start using an insulin pump, its important that you know how to:
Most pumps contain a bolus dose calculator. This helps you calculate how much extra insulin you may need based on your daily carbohydrate intake.
Some pumps also offer an extended bolus option. This allows you to administer the dose over 2 to 3 hours. This option can help prevent hypoglycemia, or low blood sugar. Hypoglycemia is a potentially dangerous condition.
You must change the insulin in the pump according to the manufacturers recommendations. For example, rapid-acting insulin formulations such as lispro and aspart must be replaced every 144 hours or every 6 days, according to a 2019 study. Glulisine, on the other hand, should be replaced every 48 hours.
Remember that insulin pumps cannot do everything to manage your diabetes. You play the most important role in managing your care, including:
- checking your blood sugar regularly
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Pump Therapy In Pregnancy
It is possible to have a healthy pregnancy with diabetes, while on injections. An insulin pump is typically the preferred method of insulin delivery during pregnancy, mainly because insulin needs vary so much throughout the pregnancy, tight control is ideal and the risk of hypoglycemia on a pump is lower than on injections. Not to mention, several pumps have integrated CGMs which are extremely helpful to a pregnant woman aiming for tight control.
Less insulin is needed during the first trimester and 2-3 times the amount of insulin may be necessary by the third trimester. Good blood glucose control before and during pregnancy lead to better outcomes regarding the baby. Starting a pump prior to pregnancy is ideal, but not always the case. A pregnant woman is a great candidate for an insulin pump if she is agreeable to the therapy. Private insurance and government insurance tend to provide good coverage. For more information read our article on Pre-existing Diabetes & Pregnancy.
Possible issues with pump therapy during pregnancy are:
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.
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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 .
Do I Need To Consider My Diet While Using The Pump
Absolutely! You should be considering your diet whether you have diabetes or not. Benefits of healthy eating are not limited to good blood sugar control and weight management. Eating a variety of foods found close to nature can give you more energy, clearer thinking and help you fight off viruses and other bugs. Its important to choose foods high in fiber, low in saturated fat, and eat fruits and vegetables daily.
People with diabetes are typically quite focused on their carbohydrate intake. But data suggests that paying attention to fat content can also help blood sugar control. High fat foods can slow the absorption of carbohydrates into your blood stream. High fat foods can also cause insulin resistance. How does an insulin pump helps with this? Well, the insulin pump give you the ability to deliver insulin to meet the needs of a high fat, high carb meal. Its referred to as a dual wave bolus. It will give you part of the insulin up front, and then you can set the duration in which the rest of the insulin is delivered.
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Getting Started With An Insulin Pump
Once you have talked with your diabetes care team and have become comfortable with all of the options on your insulin pump, you and your team will need to do the following in order to get you started.
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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How Do I Qualify For A Pump
Insurance companies have specific requirements for qualifies for a pump. The majority of companies cover a pump for people with Type 1 diabetes, some cover pumps for people with Type 2 diabetes on multiple daily injections. To learn more check our in-depth guide on diabetes health insurance coverage.
Typical requirements are as follows:
- 30-90 days of blood sugar logs, checking ideally ~4 times per day
- Provider notes from your last 1-2 office visits
- Some insurance companies require formal diabetes education classes or 1:1 sessions
- Some insurance companies require formal diabetes education classes or 1:1 sessions
- Medicare and some insurance companies may require a c-peptide lab test with a fasting glucose done at the same time .
The pump company will ask you or your doctor questions about your diabetes, such as:
- do you have dawn phenomenon
- severe glycemic excursions
- have you required any assistance with a low BG or have you been hospitalized for DKA
- are you pregnant
- is your A1c elevated
How An Insulin Pump Works
The device releases insulin almost the way your body naturally would: a steady flow throughout the day and night, called basal insulin, and an extra dose at mealtime, called a bolus, to handle rising blood sugar from the food you eat. You program the pump for both basal and bolus doses. If you eat more than normal, you can program a larger bolus to cover the carbs in your food. A bolus can bring down high blood sugar at other times, too.
The pump is about the size of a smartphone. You attach it to your body using an infusion set: thin plastic tubing and either a needle or a small tapered tube called a cannula you put under the skin. The place where you put it in — your belly, buttock, or sometimes thigh — is called the infusion site. Some pumps come with inserters for easier placement even in hard-to-reach areas.
Insulin pumps use short-acting and rapid-acting insulin, but not long-acting, since the pump is programmed to deliver a small amount continuously to keep your blood sugar levels even.
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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.
Advantages Of Using A Diabetes Insulin Pump
Some advantages of using an insulin pump instead of insulin injections are:
- Using an insulin pump means eliminating individual insulin injections
- Insulin pumps deliver insulin more accurately than injections
- Insulin pumps often improve HbA1C. HbA1c is a measure of long-term blood glucose levels. Research investigating the efficacy of insulin pump therapy in relation to blood glucose levels suggests that it can improve HbA1c, especially in those with an elevated HbA1c and in those who have been unable to reduce their HbA1c with multiple daily injections.
- Using an insulin pump usually results in fewer large swings in your blood glucose levels
- Using an insulin pump makes delivery of bolus insulin easier
- Insulin pumps allow you to be flexible about when and what you eat
- Using an insulin pump reduces severe low blood glucose episodes
- Using an insulin pump eliminates unpredictable effects of intermediate- or long-acting insulin
- Insulin pumps allow you to exercise without having to eat large amounts of carbohydrate
It is important that you have realistic expectations about insulin pump therapy. It is not a cure for people who require insulin to manage their diabetes but a way of delivering insulin that may offer increased flexibility, improved glucose levels and improved quality of life.
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How Do I Choose An Insulin Pump
There are a variety of insulin pumps by different manufacturers on the market. All insulin pumps work in the same basic manner but will vary in their specific functions and features. Your diabetes educator can support you in the process of choosing an insulin pump and help you to work out which one is best for you.
Diabetes insulin pump technology is constantly changing. Be sure to thoroughly research the various insulin pumps you are interested in and make an informed choice. If you have any questions about insulin pump functions speak to your diabetes educator, or the relevant insulin pump company representatives who will be able to help you.
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.
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