Insulin Pump Therapy.ppt

Insulin Pump Therapy Gary Scheiner MS, CDE Integrated Diabetes Services 333 E. Lancaster Ave., Suite 204 Wynnewood, PA 19096 (877) 735-3648 Gary@ Insulin Pump Therapy 101 How Pumps Work Pros Cons Strategies for Success Q A What A Pump IS Beeper-sized, battery-operated. A way of giving insulin. Worn externally. Programmable for individual needs. Pump Evolution Pump Evolution Pump Evolution Pump Evolution Insulin Used In Pumps Rapid-Acting Analogs are Preferred Aspart (Novolog) Lispro (Humalog Glulisine (Apidra) Modes of Delivery Basal Bolus Basal Insulin Steady “Drip” of Insulin Matches Glucose Released by Liver Meets Body’s Basic Energy Needs May Need Different Settings at Different Times of Day Bolus Insulin Given to “cover” carbs in meals and snacks. Used to “correct” high blood glucose levels Insulin Infusion(aka “getting under your skin”) Durable, clog-resistant tubing carries insulin from the pump to the infusion set*. The infusion set delivers insulin into the fatty layer below the skin. Set uses either a flexible plastic catheter (canula) or a steel needle. Almost always disconnectable near the infusion site. Infusion Set Types Infusion sets vary by: Angle of insertion Canula length Plastic vs. steel Tubing length Infusion Set Insertion Soft plastic canula inserted by way of an introducer needle. Mechanical “inserters” are available for some types of insusion sets. Clinical Advantages of Pump Therapy Reduction in HbA1c1 Less BG Variability2 Reduction in duration, frequency and severity of hypoglycemia3 Better psychosocial outcomes quality of life4 Clinical Advantages of Pump Therapy 1 Bode et al; Diabetes Care 1996; 19:324-7 Weinzimmer et al; Pediatrics 2004; 114: 1601-5 5 Nations Trial; Diabetologia 2004; 47 (1): #82 DeVries et al; Diabetes Care 2002; 25:2074-80 2 DeVries et al. Diabetes Care. 2002 Nov; 25(11):2074–80 Diabetes Nutr Metab. 2004 Apr;17(2):84-9 N. Weintraub et al: Arch Pediatr Adolesc Med. 158: 677-684, 2004 3 Hi