An insulin pump is a substitute for multiple daily injections
Insulin pumps are used to continuously deliver insulin to a person with type 1 diabetes.
Its most important feature is the continuous delivery of insulin to the blood throughout the day according to blood glucose levels without the need for continuous measurement of the level of sugar and without resorting to stinging several times
Accurate delivery of very small doses is useful for infants and children. It has also been noted that children who use the pump reduce the incidence of ketosis and coma by up to 90%.
Contributes to reducing the occurrence of long-term complications such as peripheral neuropathy and vascular inflammatory injury that causes diabetic foot and visual impairment
In an insulin pump we replace slow-acting insulin to meet basic needs with continuous infusion of rapid-acting insulin.
An insulin pump provides one type of fast-acting insulin in two ways:
A dose pumped out to cover the food eaten or to correct a high blood sugar level.
A base dose that is continuously pumped at an adjustable base rate to deliver the required insulin between meals and at night.
Users reported better quality of life compared to using other insulin administration devices. Improvement has been reported in type 1 and type 2 diabetes requiring insulin therapy
Using fast-acting insulin to meet basic needs provides relative freedom from the structured meals and exercise regimen that was previously necessary to control blood sugar with slow-acting insulin.
Programmable basal modifiers allow the scheduled delivery of insulin in different amounts at different times of the day. This is especially helpful in controlling events such as the dawn phenomenon that leads to low blood sugar during the night.
Many users feel that taking insulin from the pump is more convenient and discreet than an injection
Insulin pumps also make it possible to deliver more accurate amounts of insulin than can be injected with a syringe. This supports tighter control of blood sugar and glycated hemoglobin (HGBA1C) levels, which reduces the chance of long-term complications associated with diabetes. This is expected to result in long-term cost savings compared to multiple daily injections.
Many modern “smart” pumps have a “processor” that calculates the amount of insulin you need taking into account the amount of expected carbohydrates, blood sugar level and active insulin.
Insulin pumps can provide an accurate record of insulin use with their history lists. On many insulin pumps, this log can be downloaded to a computer and graphed for trend analysis.
Neuropathy is an unpleasant complication of diabetes resistant to usual treatment. There are reports of amelioration or complete disappearance of neuropathic pain with insulin pumps.
Numerous studies have shown that patients who use an insulin pump enjoy greater freedom in eating meals and enjoy good sexual health as chronic high sugar negatively affects sexual health .. The pump adjusts sugar levels, allowing the side effects to fade in the long run
Insulin pumps, cartridges, and infusers may be much more expensive than syringes used to inject insulin with many insulin pumps costing more than $ 12,000. Another disadvantage of using it is the necessity to follow up the battery that continues to work for a continuous month without the need to charge and the device has a battery indicator and an insulin tank indicator.
An insulin pump user can influence the fast-acting insulin profile through dose formation. Users can experiment with dosage forms to determine what works best for any given food, which means they can improve blood sugar control by adapting the dosage form to their needs.
There are two types of fixed doses for pump users
The first dose is the basic dose that is given to the patient before eating, in order to fade the sudden rise in sugar after eating high-sugar meals, and the basic dose is determined according to the type of food, the patient’s weight, and the amount of the meal he eats each time.
The second is the extended dose is a slow infusion of insulin that spreads over time. By pumping in a “square wave” form, the dose avoids a high initial dose of insulin that may enter the blood and cause low blood sugar before digestion can facilitate the entry of sugar into the blood. The extended dose also extends the effect of insulin beyond insulin alone. An extended dose is appropriate when covering high-fat, protein-rich meals such as steak, which will raise blood sugar for several hours after starting a dose. An extended dose is also beneficial for those with slow digestion.
Timing of the dose
Since the pump user is responsible for starting the dose manually, this provides an opportunity for the user to take a pre-dose to improve the insulin pump’s ability to prevent post-meal hyperglycemia. A pre-meal dose is just a dose of insulin given before it is actually necessary to cover the carbohydrates eaten.
Determine the base rate
Basal insulin requirements vary with different individuals and during the periods of the day. The basal rate for a certain period of time is determined by fasting with periodic assessment of the blood glucose level. Do not take food or insulin shots for 4 hours before or during the evaluation period. If the blood sugar level changes dramatically during the evaluation, the basal rate can be adjusted to increase or decrease insulin delivery to keep the blood sugar level roughly constant.
For example, to determine basic morning requirements, an individual must skip breakfast. Upon waking up, they will periodically test your blood glucose level until lunch. Changes in blood glucose levels are compensated for by adjustments in the morning basal rate. The process is repeated over several days, with changing the fasting period, until a basic 24-hour profile is formed that keeps blood sugar levels relatively constant. Once the basal rate of need for basic insulin for fasting is matched, the pump user will then gain the flexibility to skip or postpone meals such as sleeping late on the weekends or overtime on weekdays.
The pump user should be educated by a diabetic care professional about setting a basal rate before starting treatment with the pump.
Since basal insulin is provided as a fast-acting insulin, basal insulin can be increased or decreased immediately as needed at a temporary basal rate. Examples when this can be helpful include:
As a passenger during a long car trip, when more insulin is needed due to inactivity.
While driving on a long trip, to reduce the risk of hypoglycemia, a temporarily lower base rate can be programmed.
During and after spontaneous exercise or sports, when the body needs less insulin.
During illness or stress, when the primary demand increases due to insulin resistance.
When blood ketones are present, when additional insulin is required.
When you are on a long fast (such as Ramadan or Lent) when the basic requirements are less.
During menstruation, when additional basal insulin is needed
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