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.
Types Of Insulin Pumps
Insulin pump availability can vary depending on a variety of factors. Also, insulin pump manufacturers may introduce new pumps or enhanced models, and phase out older models.
Additionally, some pumps may be recommended for certain ages or types of diabetes. Its important to talk with your doctor about choosing a pump. This can ensure your pump of choice is the right option for you, your insulin needs, and your lifestyle.
Examples of commonly used insulin pumps include:
Managing Patients With Type 1 Diabetes On An Insulin Pump
This section is meant to provide general information and guidelines on the management of patients using insulin pumps and should not replace care from or consultation with diabetes care providers who are experts in insulin pump therapy. Ideally, the patient is managed by a diabetes care team and is seen regularly by members of that team.
Upon initiation of insulin pump therapy, it is recommended that patients have face-to-face follow-up with their diabetes care providers within the first 3-14 days after starting.
As with patients on MDI, insulin doses for patients on insulin pumps should be adjusted regularly. Adjustments are made whenever BG patterns indicate a need. Typically, a pattern is established over a period of several days before changes are made, thus minimizing the potential for chasing BG levels. Once a change is made, the effectiveness of this change should be determined over several more days. The need for constant adjustments to meet the needs of the growing child and adolescent is the hallmark of insulin treatment in pediatrics.
Adjusting Basal Rates
Adjusting Meal Boluses
-
Test the 2-hour postprandial BG level to eval/uate effectiveness of meal bolus
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2 hours after meal target of < 160-180 mg/dL
Consider accuracy in carb counting as one cause for bolus ineffectiveness
Increase ratio to decrease amount of insulin given with bolus
Adjustments typically made in 10%-20% increments
Adjusting Correction Boluses
Managing Hypoglycemia
Causes
Treatment
Causes
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How Much Time And Effort Commitment Does Pump Therapy Require
Starting pump therapy requires commitment. It is not unusual to check blood sugars 8-12 times per day in the beginning of pump therapy to assess basal and bolus insulin needs. This often means lots of interruptions during the workday and during family time. It also means disturbing your sleep in order to take blood sugar readings in the middle of the night. Think about your schedule and commitments. Talk to your family for support. Plan ahead.
Is The Use Of Oral Or Other Injectable Antihyperglycemic Agents Recommended With Csii
The use of oral antihyperglycemic agents may be beneficial in type 2 diabetic patients treated with intensive insulin therapy in order to promote better glycemic control, reduce insulin requirement, and limit weight gain . Few studies have tested such a hypothesis in CSII-treated type 2 diabetic patients. An approach was proposed consisting of the maintenance of sulfonylurea together with CSII, with a titration of the oral antihyperglycemic agent aiming to control either fasting glucose or postprandial glucose level. Both strategies were safe and effective for lowering HbA1c . Metformin may be a helpful adjunct to CSII for long-term maintenance of HbA1c lowering together with weight gain limitation . In one study, CSII was provided overnight to type 2 diabetes patients not at goal on oral medications and effectively reduced fasting plasma glucose without occurrence of major hypoglycemia . Novel injectable antihyperglycemic agents such as glucagon-like peptide-1 analogs and mimetics have been recently combined with insulin therapy for the treatment of type 2 diabetes with positive results on weight reduction and glycemic control . It is foreseeable that combination therapy with CSII in type 2 diabetes will bring similar advantages. No study on type 2 diabetes management has yet demonstrated the efficacy of oral antihyperglycemic agents or glucagon-like peptide-1 analogs in adjunct with CSII in a randomized controlled fashion.
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The Government Of Canada’s Role
Health Canada regulates the safety, effectiveness and quality of medical devices imported into and sold in Canada, including medical devices like insulin pumps. As part of this work, we:
- review insulin pumps to make sure they meet our requirements for safety, quality and effectiveness before we grant a medical device licence to manufacturers
- monitor problems with insulin pumps on the market and work with manufacturers to correct them when problems are identified
- encourage Canadians to report complaints about insulin pumps and other medical devices to our Health Products and Food Branch Inspectorate
We also send safety information about medical devices to health care professionals and consumers.
If You Have Type 2 Diabetes Using A Pump Can Help You:
Overcome the Metabolic Syndrome
Pump use can be more effective than injections at lowering insulin resistance, reducing the amount of insulin needed, and lowering high triglycerides.
Bring Down High Morning Blood Sugar
High waking glucose is typical in Type 2 diabetes. Its caused by the liver producing and releasing excess glucose during the night. Using a pump, which can be programmed to change basal rates throughout the day, the patient can precisely adjust the amount of insulin to reduce this effect. Research studies have found that insulin levels often need to be increased by over 40% in Type 2 diabetes during the early morning hours to prevent high morning blood sugar.
Avoid Weight Gain
Excess weight is a common problem in Type 2 diabetes, and insulin use can lead to even more weight gain. The precise dosing available with a pump usually means you use less insulin overall, which leads to less weight gain while providing better glucose control. Entering carbs into the bolus calculator each time you eat tracks carbohydrate intake and reduces mindless eating. Pump use also reduces the frequency of hypoglycemia , so you wont need to eat to raise your blood sugar. Avoiding the additional calories that go along with treating lows will reduce weight gain.
Improve Control and Lower A1c
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Diabetic Supplies: Therapeutic Shoes And Inserts
Medicare Part B coverage includes therapeutic shoes or inserts for diabetics who have certain conditions ask the doctor who treats your diabetes if you need them. To make sure these supplies are covered by Medicare, please note:
- A qualified doctor must prescribe the shoes or inserts.
- A qualified doctor must provide and fit you for the shoes or inserts.
- Medicare Part B covers one pair of custom-molded shoes or one pair of depth-inlay shoes per calendar year.
- Medicare also covers two additional pairs of inserts each calendar year for custom-molded shoes and three pairs of inserts each calendar year for depth-inlay shoes.
- In certain cases, shoe modifications may be substituted for inserts.
- The supplier must have an order on file signed and dated by the treating doctor if you switch to a different supplier, you may need to have your prescription transferred or get a new prescription from your doctor. Make sure your supplier is enrolled in Medicare.
What Are Insulin Pumps
Insulin pumps are computerized devices which are quite handy due to their small size. These insulin pumps usually come in the size of a small cell phone. It comes with a flexible tube with a needle attached on one of its end.
This needle is inserted under your abdomen skin and secured with a tape. The insulin is administered through this the inserted needle.
Due to its compact size, you can easily attach the insulin pump on your belt, trousers, or even your bra. This makes it easy to keep the device concealed if you dont wish to make the pump visible to others.
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Why Is An Insulin Pump Would Be Beneficial For People With Type 2 Diabetes Would You Mind Kind Of Going Into Some Of The Misconceptions That People With Type 2 Have About Insulin Pumps
A lot of times, people living with Type 2 dont they will have coverage for an insulin pump and assume its only for people with Type 1. Its better to ask, instead, if they have a trusted care professional who can help them figure out how to obtain one. People with diabetes are super resourceful, so theyre willing to start doing the work themselves. You can just call your insurance and see if its covered as durable medical equipment or as a pharmacy benefit.
Is My Test Item Or Service Covered
How often is it covered? Medicare Part B doesnt cover insulin , insulin pens, syringes, needles, alcohol swabs, or gauze. Medicare prescription drug coverage may cover insulin and certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs. If you use an external insulin pump, insulin and the pump may be covered as durable medical equipment . However, suppliers of insulin pumps may not necessarily provide insulin. For more information, see durable medical equipment. Your costs in Original Medicare You pay 100% for insulin . You pay 100% for syringes and needles, unless you have Part D. To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount youll owe may depend on several things, like: Other insurance you may have How much your doctor charges Whether your doctor accepts assignment The type of facility The location where you get your test, item, or serviceContinue reading > >
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Omnipod Insulin Pump Cost
Omnipod is one of the most popular and most commonly used brands of insulin pumps. Omnipod insulin pumps are tubeless. Omnipod insulin pumps are very small and discrete, come in a variety of colors and can be worn on either the arm or a belt. Unlike many other brands, Omnipod records all the statistics of when and how much insulin is used to help doctors better treat the patient. Omnipod insulin pumps cost more than many other brands of tubeless insulin pumps. The average cost of an insulin pump made by Omnipod is around $7000. Omnipod also makes insulin pump cases.
How Does An Insulin Pump Work
The American Diabetes Association states that insulin pumps are small, computerized devices. They deliver insulin in a steady and continuous dose, or basal rate, which the user programs. They also deliver insulin as a surge dose, or bolus, under the users direction.
The insulin enters the body through a thin tube that attaches to a needle, which goes under the skin. People refer to the tube and needle together as an infusion set.
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Insulin Pump Therapy For Adults And Children With Type 1 Diabetes
KEY POINTS: · Both NICE and SIGN guidance recommend that insulin pumps be seen as a routine clinical option in the treatment of Type 1 diabetes in many adults and children. · There is evidence to suggest that insulin pump therapy helps both adults and children with diabetes to improve HBA1c,reduce hypoglycaemia and manage their blood glucose levels in the long-term · Although NICE and SIGN guidelines set out standards for both adults and children as to who could benefit from an insulin pump, variation exists as to the uptake of insulin pumps around the UK · Insulin pump therapy should be offered to all adults and children with Type 1 diabetes who could benefit from it · Awareness of insulin pump therapy should be raised among people with Type 1 diabetes, their families and healthcare professionals · Appropriately trained teams of healthcare professionals in both paediatric and adult diabetes services should be available in all areas to identify suitable patients, initiate and support insulin pump therapy · Local arrangements should be put in place to support the development of local insulin pump centres · Insulin pump centres should maintain comprehensive patient records and participate fully in national auditsContinue reading > >
What Is The Level Of Satisfaction And Quality Of Life In Type 2 Diabetic Patients On Csii
In two randomized parallel-group studies, treatment satisfaction, diabetes impact, and diabetes satisfaction scores improved over time with both CSII and MDI treatments . The satisfaction score did not differ between MDI and pump in the older population , while the CSII group had greater improvement in overall treatment satisfaction compared with MDI in the younger population . The 36-Item Short Form Health Survey physical and mental composite score did not change significantly within and between groups in the older population . When CSII and MDI were compared in a crossover fashion, the satisfaction subscores were comparable between CSII and MDI . A multicenter observational study found after 1 year that health status evaluated in 61 patients on CSII was maintained in 75% and improved in 20% of the patients . Another 3-year study found an improvement of quality of life stated by the Diabetes Quality of Life and SF-36 questionnaires .
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Why Might Your Doctor Recommend An Insulin Pump
Your doctor might encourage you to get an insulin pump if:
- You have big swings in your blood sugar levels.
- You cannot find an insulin dose that keeps your blood sugar under control without also causing low blood sugar.
- Your lifestyle makes it hard to stop and give yourself insulin injections.
- Your eating and activity schedule changes often, so you need a more flexible insulin schedule.
- You need to inject yourself with insulin often.
What Are The Advantages Of Insulin Pump Therapy Over Daily Injections For Type 2 Diabetes
Studies have shown that A1C reduction can significantly reduce the occurrence of long-term complications.1,2 With insulin pump therapy, you can worry less about your risk for long-term complications, such as:
Cardiovascular complications1,2
Insulin pump therapy may reduce some of the hassles associated with other therapy options:
- Syringe or insulin pen
- Oral medication
- Using more insulin
Insulin pump therapy is clinically proven to reduce A1C better than multiple daily insulin shots for people living with type 2 diabetes.3
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Key Points To Remember
- An insulin pump can free you from a strict regimen of meals, sleep, and exercise, because you can program it to match your changing schedule.
- After you learn how to work with a pump, it can make living with diabetes easier. But it takes some time and effort to learn how to use the pump to keep it working properly and to control your diabetes.
- When you use a pump, you will need to check your blood sugar many times a day or use a continuous glucose monitor. You will need to carefully count the grams of carbohydrate that you eat.
- Using an insulin pump can keep your blood sugar at a more constant level so that you don’t have as many big swings in your levels. People who use pumps have fewer problems with very low blood sugar.
- Many insurance companies cover the cost of insulin pumps, but they have strict guidelines that you will have to follow before they will pay.
Why Are Insulin Pumps Used
People who have diabetes dont make enough insulin naturally. Instead, they have to use insulin injections to manage their blood sugar.
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.
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Can You Explain The Difference Between The Medical Side Which Is Durable Medical Equipment Versus Pharmacy Benefits
On your medical side, its your primary insurance card. So, the big insurance companies that you think about are the ones that would cover it on the medical side. There are different amounts and deductibles, what they cover, and you would use your insurance at a DME company. Think of this as a warehouse for diabetes supplies that has a contract with your insurance company to provide you with pumps or supplies for your health care at a discounted rate because theyre in-network together. So, if its on your medical side, you want to make sure that you know who the durable medical equipment provider is that would fulfill your order.
What Questions Can People With Type 2 Ask Their Healthcare Providers To Get Them To Advocate On Their Behalf For An Insulin Pump
Make sure that theres an infrastructure at your clinic that can support you. Because of resource management or staffing in certain clinics, there may not be someone who understands how to download or interpret data from your insulin pump. Next, do research to see if your pump would be covered and how, or you can ask someone at your clinic to find out for you. Then, youll want to ask your provider if theyll be able to help you with your pump. If not, ask if they know who can. Dont take no for an answer always ask yourself what the next step is. A lot of patients Ive met have primary care providers whove directed them to someone who can help with their pump journey. Also, if youre in a rural area and an endocrine specialist is far from you, you can do a remote visit to get started on pump therapy and the diabetes care and education that follows.
This content was made possible with support from Insulet, a Founding Partner of Beyond Type 2.
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