Insulin Pump Therapy
What are the benefits to pumping insulin?
By Gary Scheiner, MS CDE
Insulin pump therapy offers a number of unique and important advantages over traditional insulin injection therapy. Here are our "top 10":
1. Better overall blood sugar control. Research has shown that people who use insulin pumps have lower A1C's than people who take insulin by injection. But forget about statistics. What's more important is that pump users see fewer highs and fewer lows, and spend more time within a healthy blood glucose range.
2. Less trouble with lows. By eliminating long-acting insulin and replacing it with basal insulin that can be matched to each person's individual needs, the incidence of daytime and nighttime hypoglycemia is greatly reduced. Delayed or missed meals are not a problem. Adjustments can easily be made for exercise. And today's pumps make adjustments for "insulin on board" (insulin that is still active from previous boluses) when calculating doses necessary to bring high readings down to normal. The result: fewer, shorter, and less severe bouts of hypoglycemia.
3. A flexible lifestyle. There are not many people who can keep the same schedule day after day. With an insulin pump, you choose when to have your meals and snacks, when to exercise, and when to sleep. Shift work and travel across time zones is much easier to manage when using an insulin pump.
4. Precise dosing. Insulin pumps are capable of delivering doses to the nearest tenth, twentieth, or fourtieth of a unit with pinpoint precision. The pump is an ideal choice for those who are sensitive to small doses of insulin, such as children and lean, active adults.
5. Convenience. Forget about the hassle and social stigma of drawing up syringes or sticking yourself with a pen every time you need insulin. With the insulin pump, taking insulin is easy and discreet, anytime and anywhere. Simply press a few buttons and your insulin is automatically delivered. And if you're the type who doesn't care for needle sticks, you'll be delighted to know that pump use only requires one needle stick every 2-3 days (to change the infusion set) rather than at every meal and snack.
6. No Math. Figuring out mealtime insulin doses can be complicated. Factors include the quantity of carbohydrate to be consumed, the premeal glucose level, anticipated physical activity, and the amount of insulin still active from previous boluses. The pump's built-in bolus calculator makes dosage determinations fast, easy and accurate.
7. Easy adjustments. Variety is the spice of life. From long holiday meals unexpected exercise, pumps have special features that make it easier to manage glucose levels in a variety of situations. Temporary, immediate adjustments can be made to basal insulin levels. Bolus insulin can be delivered all at once or over an extended period of time for slowly-digesting meals. And alternative basal patterns can be used for long-term changes in health status or lifestyle.
8. Weight Control. Whether your interest is in gaining or losing weight, the insulin pumps gives you the power to adjust your food intake and incorporate activity as you see fit.
9. Better control with exercise. Without long-acting insulin to cause untimely blood sugar drops during exercise, hypoglycemia is less common with pump use. Pre-meal bolus adjustments make after-meal exercise easy, and temporary basal rate reductions make blood sugars more manageable with prolonged activities.
10. Data collection. Not many people enjoy keeping written records of their daily diabetes-management activities. Insulin pumps store a wealth of data (including blood sugar levels, insulin delivery and carbohydrates) that can be displayed on-screen or downloaded to a computer.
Gary Scheiner is the 2014 AADE Diabetes Educator of the Year and author of "Think Like A Pancreas". He has had type-1 diabetes since 1985, and offers diabetes management consulting services worldwide via his website, www.integrateddiabetes.com.
After about a month off the Omnipod and using MDIs again, I’d adjusted to the details of the Lantus and Humalog dance. My skin wasn’t chronically itchy and sensitive. My pants didn’t irritate my pod site. And my blood sugars were surprisingly better controlled. I experienced consistently in range numbers compared to the variability of the Omnipod. Last month, the CDE said something that I know I’ve heard before but it hit a chord. Her own daughter was type 1 and switched between...