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What is an insulin pump?
The insulin pump is a device for continuous insulin delivery. An insulin pump is composed of a pump reservoir similar to that of an insulin cartridge, a battery-operated pump, and a computer chip that allows the user to control the exact amount of insulin being delivered.
How big is an insulin pump?
Currently, pumps on the market are about the size of a standard communications beeper.
How does an insulin pump work?
The typical insulin pump is attached to a thin plastic tube (an infusion set) that has a soft cannula (or plastic needle) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen. The cannula is changed every two days. The tubing can be disconnected from the pump while showering or swimming. The pump is used for continuous insulin delivery, 24 hours a day. The amount of insulin is programmed and is administered at a constant rate (basal rate). Often, the amount of insulin needed over the course of 24 hours varies depending on factors like exercise, activity level, and sleep.
The insulin pump allows the user to program many different basal rates to allow for variation in lifestyle. In addition, the user can program the pump to deliver a bolus (large dose of insulin) during meals to cover the excess demands of carbohydrate ingestion.
How common is an insulin pump?
Hundreds of thousands of people with diabetes worldwide are using an insulin pump. Although insulin pumps were first used by people with type 1 diabetes, people with type 2 diabetes sometime use them as well. Many children successfully use insulin pumps. Insulin pumps allow for tight blood sugar control and lifestyle flexibility while minimizing the effects of low blood sugar (hypoglycemia). Newer models of the pump have been developed that do not require a tubing, in fact - the insulin delivery device is placed directly on the skin and any adjustments needed for insulin delivery are made through a PDA like device that must be kept within a 6 foot range of the insulin delivery device, and can be worn in a pocket, kept in a purse, or on a tabletop when working.
Probably the most exciting innovation in pump technology is the ability to use the pump in tandem with newer glucose sensing technology, known as an "artificial pancreas," that administers insulin based on actual glucose levels as determined by the glucose sensor. The first such device was approved by the US Food and Drug Administration (FDA) in September 2013. Manufactured by Medtronic, the device is approved for use in people with diabetes who are 16 years of age or older. With the new device, insulin delivery is halted if a pre-programmed glucose level threshold is met. In a recent study conducted on 95 patients in Australia, the use of sensor-augmented insulin pump therapy with automated insulin suspension reduced the rate of hypoglycemia in patients with type 1 diabetes. Further studies of this coupled "closed-loop" technology (continuously sensing and responding to the body's needs) are ongoing.
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Ly TT, Nicholas JA, Retterath A, et al. Effect of Sensor-Augmented Insulin Pump Therapy and Automated Insulin Suspension vs Standard Insulin Pump Therapy on Hypoglycemia in Patients With Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2013;310(12):1240-1247.
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Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with:
- and a diabetic diet.
Type 2 diabetes is first treated with:
- weight reduction,
- a diabetic diet,
- and exercise.
When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
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A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels. Foods that raise blood sugar levels are "high glycemic index foods;" examples include:
- Short-grain white rice
Foods that help maintain good blood sugar levels are foods that are low on the glycemic index, for example:
- Rolled or steel-cut oats
- Many fruits
- Non-starchy vegetables
Diabetic Home Care and MonitoringManaging your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
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Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include:
- Intense hunger
If your blood sugars become too have the following nearby as a quick treatment.
- Table sugar
- Glucose tablets
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Type 1 Diabetes
Type 1 diabetes mellitus (juvenile) is an auto-immune disease with no known cause at this time. Symptoms of type 1 diabetes include frequent urination, unintentional weight loss, dry and itchy skin, vision problems, wounds that heal slowly, and excessive thirst.
Type 1 diabetes is diagnosed with blood tests. Treatment for type 1 diabetes include insulin, a type 1 diabetes diet, and exercise.
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Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include fatigue, urine odor, unintentional
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