Diabetes - Insulin Pumps
An insulin pump is a battery-powered, computerized device about the size of a deck of cards. Inside the pump is a syringe of shortacting insulin with a gear-driven plunger. A thin tube, 21 to 43 inches long, is attached to the pump. At the other end of the tube is a needle or catheter. You insert the needle or catheter under your skin, usually in your abdomen or thigh. Insulin is delivered through the tube and needle or catheter into your body.
You programme the pump. You tell it how much insulin you want and when you want it. You tell the pump to give you tiny amounts of short-acting insulin continuously throughout the day and night, just the way a normal pancrease would. Then you tell the pump to give you extra insulin just before you eat.
Your wear an insulin pump pretty much all the time, either inside or outside your clothes. A pump may be water-proof or come with a water-proof case for showers and swimming.
You can, of course, take the pump off. If you'll have the pump off for more than I hour, you may need a short of short-acting insulin. Check your blood glucose to be sure. Yes, you still need to test your blood glucose. At least four tests a day are recommended.
What the Pump can do for You
Get your blood glucose level closer to normal. This is called tight control. If your insulin shots have not controlled your blood glucose levels, in insulin pump might work better for you.
Smooth out blood glucose swings. If you have frequent blood glucose swings, the insulin pump can help smooth them out.
Take care of the night-time lows and the morning highs. Your body need less insulin at night than at dawn. If you try to lower the dose of your evening insulin shot to avoid low blood glucose at night, you won't enough insulin in the morning. Then you'll have high blood glucose when you wake up.
With an insulin pump, you can programme it to give you less insulin at night and more insulin before dawn. That way you avoid night-time low blood glucose and morning high blood glucose.
Ketoacidosis. When your body has too little or no insulin, you risk getting ketoacidosis. Ketoacidosis is a dangerous buildup of ketones in your blood.
If the tube to your insulin pumps gets blocked or twisted or the needle comes out, you won't be getting insulin, and you may not know it. (Pumps do have alarms that signal when the tube is blocked, the insulin is low, or the battery is low. But they don't signal when the needle has come out.)
Ketones can start to build up in 1 hour. Ketoacidosis can develop in as little as 6 hours. Your best protection is to check your blood glucose levels often. If your blood glucose level is over 250mg/dl, check your urine for ketones.
Infection. The place where the needle or catheter enters your body may become infected. To lessen your chances of infection, clean the area before your insert the needle or catheter, change sites within the area every 48 hours (See Insulin Shots), and use an antibiotic ointment and protective cover.
Skin allergy. You may have an allergic reaction around the needle or catheter site. Try non-allergenic tape or Teflon catheters.
Costs and Insurance
Pumps cost between $3,000 and $5,000. Supplies for a month, including blood glucose monitoring strips, cost about $300. If you think you may want a pump, talk to your doctor. Learning how to use a pump can take some time. Your doctor may want you to be in the hospital for a few days when you first get a pump so that you can learn all about how to use it.
In India it is not available at present but few people who got it from abroad are using. By next year it would be available but the cost factor and maintenance would be a problem.
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