What you need to know about:

Controlling Diabetes with an Insulin Pump and Glucose Sensor

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Overview of

Controlling Diabetes with an Insulin Pump and Glucose Sensor

in Thailand

An insulin pump is a device that functions similar to the pancreas by releasing insulin into the body at intervals as determined by the doctor, based on the patient’s needs. The insulin pump is a small, square-shaped device that can be clipped onto a belt or placed inside a patient’s pocket. The device consists of a tiny insulin container that should be changed every 3 days, as well as a flexible tube which is inserted just beneath the patient’s skin. Insulin pumps and glucose sensors assist type 1 and type 2 diabetes patients by controlling blood glucose levels day-to-day, allowing for an improved quality of life despite having diabetes.  An insulin pump can infuse insulin into the body in the 2 following ways:

1. Basal release – A small amount of insulin is continuously released into the body.

2 .Bolus release – An extra dose of insulin can be administered by demand before a meal based on the patient’s diet and according to blood glucose levels at various times of the day.   Generally, diabetic patients check their blood glucose levels using a device that pricks the fingertip and provides the patient with near instant readings. However, the glucometer cannot provide constant, continuous readings. In the past few years there have been developments in the field that allow

Continuous Glucose Monitoring or CGM to be done more easily, enabling diabetics to receive 24-hour blood glucose level readings.    

A glucose sensor is a tiny device that can easily be placed beneath the skin of a patient. It analyzes glucose levels in the interstitial fluid at regular intervals. For example, every 5 minutes and send these results via radio waves to the monitoring device. Patients can get a reading of their blood glucose levels and assess any trends related to increases and decreases, continuously, and at any time. Additionally, the device has a system in place to warn the patient when their blood glucose levels are too high or too low. Patients can use a glucose sensor alongside an insulin pump to help regulate their insulin levels more effectively.

Goals of

Controlling Diabetes with an Insulin Pump and Glucose Sensor

The Insulin pump and glucose sensor is suitable for diabetics who are not yet confident in regulating their own blood glucose levels. It helps patients in analyzing blood glucose levels for a period of 6 days at a time. Patients will be able to remove the monitor and download the results for their own analysis and to assess any trends that may have occurred. This can help a patient better understand how to regulate their blood glucose levels through insulin use and the medications they are taking. When using a continuous glucose monitoring device, patients still need to do at least 2 fingerstick blood tests per day to calibrate and ascertain the accuracy of the glucose sensor.

Price of

Controlling Diabetes with an Insulin Pump and Glucose Sensor

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Pros and cons of

Controlling Diabetes with an Insulin Pump and Glucose Sensor

Pros

-Helps patients observe and regulate their blood glucose levels, regulate symptoms, and better prevent complications from diabetes .

-Assists doctors by providing data related to the treatment, allowing for treatment and medication adjustments to be made if necessary.  

-Reduces risk of hypoglycemia.

-More convenient and less painful, as patients will not have to give themselves injections many times per day.  

-Insulin delivered closely mimics the body’s normal insulin secretion.  

-Improves the quality of life for the patient as it allows for greater flexibility, such as with eating, exercising, and traveling.  

-Insulin pumps are not for every diabetes patient, as some may feel uneasy about what is required. Also, during the initial stages of using an insulin pump, patients must spend an appropriate amount of time training themselves on how to properly and safely use the insulin pump.

Cons

-Monitoring glucose using the glucose sensor can sometimes give results that are inaccurate. This is because the sensor measures your glucose based on the interstitial fluid and not the bloodstream.  

-Patients can sometimes rely a bit too heavily on the readings and recommendations. For example, if the reading said that a blood glucose was dropping quickly there is a tendency that patients would trust it over how they actually feel, which can be detrimental in some instances  

-The glucose sensor will be attached to the body all the time, which can be annoying at times.

How it works:

Controlling Diabetes with an Insulin Pump and Glucose Sensor

The pump is attached to a thin plastic tube (an infusion set) that has a cannula (like a needle but soft) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen.   A variety of insulin pumps are available, and your diabetes care team can help you choose the best pump for you. In general, there are two types of pump devices:  

1. Traditional Insulin pumps have an insulin reservoir (or container) and pumping mechanism, and attach to the body with tubing and an infusion set. The pump body contains buttons that allow you to program insulin delivery for meals, specific types of basal rates, or suspend the insulin infusion, if necessary.  

2. Insulin patch pumps are worn directly on the body and have a reservoir, pumping mechanism, and infusion set inside a small case. Patch pumps are controlled wirelessly by a separate device that allows programming of insulin delivery for meals from the patch.  Many pumps connect wirelessly with blood glucose meters, which measure blood sugar levels using a drop of blood from your fingertip. Some pumps connect wirelessly with continuous glucose monitoring devices, which are inserted under the skin and monitor blood sugar levels all day long. Your health care provider will advise about which pump is right for you.  

Pumps vary in how much insulin they hold, whether or not the pump has a touch screen or is waterproof, and have a variety of advanced features as well as safety features. Safety and user features may include programmable bolus, customizable reminders, alerts for missed bolus dose or missed glucose measurement, and alarms in the event of a blockage that prevents the continuous infusion of the insulin through the pump. One of the integrated systems that combines insulin pump and continuous glucose monitoring sensor can also be programmed to suspend insulin delivery if the glucose levels reaches a preset low threshold level.

Preparation before

Controlling Diabetes with an Insulin Pump and Glucose Sensor

Pre - treatment

Patients have to meet with the doctor to discuss getting started with insulin pump treatment. Patients will also receive a detailed explanation and training in using an insulin pump from their doctor, diabetes nurse, and nutritionist. The process takes around 2-3 hours to complete. Patients are also required to have follow-ups and keep regular contact with the medical team.

Recovery after

Controlling Diabetes with an Insulin Pump and Glucose Sensor

Post - treatment

N/A

Risks & side effects

The area in which the device is attached is at risk of infection if the device is not changed properly every 3 days. There may be issues with how the device functions during use, such as insulin tubing becoming blocked or the insulin needle being bent.

FAQs:

Controlling Diabetes with an Insulin Pump and Glucose Sensor

What is the difference between basal insulin and bolus insulin deliver?

Basal insulin delivery can be thought of as the “background” insulin the body needs just to maintain basic functions without any regard to eating. The pump delivers the basal insulin in hundredths of a unit per hour, 24 hours a day. The amount is programmed each hour so the pump will match your different insulin pump needs throughout the day. This is impossible to do with insulin injections.   Bolus Insulin “Bolus” insulin is the extra burst of insulin needed to keep blood glucose (BG) levels from going too high after you eat carbohydrates and other nutrients, and to correct (lower) a high blood glucose.

What kinds of patients are eligible for using an insulin pump and glucose sensor?

Insulin pumps are suitable for type 1 diabetes patients, as well as type 2 diabetes patients whose pancreases are able to only produce very little amounts of insulin.    Insulin pumps are also suitable for:  -Type 1 diabetes patients who use subcutaneous insulin injections but are not able to control their blood glucose levels and/or whose blood glucose levels are continuously fluctuating.   -Type 1 diabetes patients who are planning a pregnancy and so are required to regulate their blood glucose levels.   -Those who often suffer from low blood glucose levels but do not show warning symptoms of low sugar (hypoglycemia unawareness).

How do continuous glucose monitors work?

Checking blood glucose with a meter only provides information about the blood sugar level at that specific point in time. It doesn't identify patterns or let you know whether blood glucose is rising or dropping. A monitor requires a small sensor which is inserted under your skin into fatty tissue. The sensor is connected to a transmitter that sends information to a receiver or smartphone. You will be able to see what you glucose level has been, what it is at that moment, and which way it's heading. Trends in blood sugar levels allow an individual to anticipate and prevent hyperglycemia and hypoglycemia. Some glucose monitor sensors even alert the user (and/or family members) when glucose goes too high or too low.

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