Quite a few health care providers prefer the insulin pump because its slow release of insulin mimics the way a normally working pancreas would release insulin. Studies vary on whether the pump provides better blood glucose management than multiple daily injections. Another advantage with the insulin pump is it frees you from needing to measure insulin into a syringe.
How does it Work?
An insulin pump is a medical device continually delivering insulin under the skin through a catheter. It’s usually connects somewhere within the waist area. There’s a new generation of insulin pumps, known as a patch pump. Currently patch pumps are only available from OmniPod. Patch pumps adhere right to the skin with no catheter tubing showing. It then infuses insulin directly beneath the skin.
Both pump delivers insulin at an hourly rate. For instance, the rate might be 1.1 units an hour. However, the pump delivers different rates at different times during the day depending on the patient’s insulin infusion (or basal) rates which are programmed into the pump.
The amount of insulin delivered depends upon two things. First by the amount of carbohydrate a patient eats using insulin to carbohydrate ratio, and then by the correction factor, or the ratio of the number of milligrams per deciliter (mg/dl) a patient’s blood sugar will likely be lowered by one insulin unit. If the patient eats 60 grams carbohydrate at meals and has an insulin-carbohydrate ratio of one insulin unit to 15 grams carbohydrate, the patient’s insulin injection at that meal would 4 units.
On the other hand, if a patient has a correction factor of one unit to 50 points of blood sugar, the pump should give an additional injection of 2.5 units to lower his blood sugar from 245 mg/dl to your needed level of 120 mg/dl.
To use an insulin pump a patient must be capable of manage it. This involves knowledge at several levels. First, patients must understand how to insert the catheter when using the pump, or the best way to attach the newer patch pump to their abdomen. They have to likewise be able to push the right buttons on the pump to supply proper insulin doses and adjust the basal rates.
Then the patient needs to be skilled in carbohydrate counting so they can easily deliver correct insulin doses at mealtimes. And they must be willing to check their blood glucose levels four or five to six times each day. This assures that they detect a pump failure which will help prevent hyperglycemia and diabetic ketoacidosis (DKA, in type 1 patients).
Patient awareness is vital for the reason that no long-acting insulin is used in type 1 patients who use pumps and they also need to correct high- or low-blood sugars before they are clinically observable as well as symptomatic.
Insulin pump therapy is almost never needed to maintain life because insulin can be easily injected under the skin. Most insurers will cover insulin pump therapy in circumstances where insulin pump therapy will significantly improve level of diabetes care and control of and above multidose insulin (MDI) therapy. This includes cases where:
The glucose control in multidose insulin therapy is not best with glycated hemoglobin (Hba1c>) than the ADA (American Diabetes Association) recommended goal of 7%. An endocrinologist, who will be in a position to help the patient learn to use and the pump and adjust basal and correction doses, prescribes the pump.
Diabetes Type 1 or 2
The patient has type 1 diabetes. However, in several situations patients with type 2 diabetes will benefit from the pump also. Presence of hypoglycemia in spite of adjustments in insulin doses and utilizing carbohydrate counting to assist decide pre-meal insulin doses in patients who will be using MDI therapy.
Presence of hyperglycemia-especially as revealed by high morning readings (Dawn phenomenon) where increasing basal rates of insulin in the early morning hours is needed to better control blood sugar levels.
Insurers will need medical charts from your prescribing doctor as well as blood sugar logs from the patient to prove that there is real medical necessity.
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