INSULIN
PUMPS: A NEOTERIC CONCEPT
Belsy Boban, 5th Pharm D
Conventional
therapy with multiple injections of insulin daily often fails to provide smooth
control of blood sugar in Insulin dependent diabetic patients. Attempts at
achieving continuous normoglycemia have resulted in the development of insulin
infusion systems. It is now uniformly accepted that by long term good control
of the diabetic state the vascular complications can be either avoided or
postponed.
Insulin Pumps
Insulin pumps are small computerized devices that deliver insulin in
two ways:
ñ
In a steady measured and continuous dose (the "basal"
insulin)
ñ
As a surge ("bolus") dose, at your direction, around
mealtime.
Doses are delivered through a flexible plastic tube called a
catheter. With the aid of a small needle, the catheter is inserted through the
skin into the fatty tissue and is taped in place. The insulin pump is
not an artificial pancreas (because you still have to monitor
your blood glucose level), but pumps can help some people
achieve better control, and many people prefer this continuous system of
insulin delivery over injections. Pumps can be programmed to releases small doses of insulin
continuously (basal), or a bolus dose close to mealtime to control the rise
in blood glucose after a meal. This delivery system most closely
mimics the body's normal release of insulin.
How Does an
Insulin Pump Works?
The insulin pump
was first detected and used in U.K. The essential principle of operation of
this pump is that, infused continuously by a battery driven motor at a rate of
66ul/hour for a duration of up to 76 hours at which time the insulin has to be
reloaded into the syringe. The 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.
In recent years,
insulin pump technology has improved considerably. Today's pumps such as
the ‘DANA R’ works simply in which oil are smaller and less
complicated to use and have advanced safety features and alarms. In addition
developments in infusion technology have reduced the potential for blockage of
the tube and hence the risk of ketoacidosis. The potential complications of
ketoacidosis and infusion site problems can be minimized through careful
selection of patients, proper education, adequate self-care skills and appropriate
hygiene precautions.
Where do you have (wear) it?
·
Most
people simply attach the pump to their belt or waistband using a clip or case.
·
You
can also keep it in your pocket.
·
If
you are wearing a dress you could attach it to your arm or leg under your clothes.
·
When
sleeping many people place the pump next to them on the bed, place it under the
pillow or attach it to their clothing.
·
Pump
manufacturers say the pump is very rugged and will withstand being dropped on
the floor or the occasional soaking. However, you should try to avoid that from
happening.
Advantages of an insulin pump
ñ No more injections
ñ The pump is more
accurate
ñ They improve HbA1C
ñ Blood glucose levels
fluctuate less badly
ñ Easier diabetes
management
ñ More leeway on your
eating times
ñ More leeway on what
you eat.
REFERENCE
1.
V.S Sheeja*, M.Harikrishna Reddy, Jibinc Joseph, Divya Reddy. N. Insulin
Therapy in Diabetes Management. International Journal Of Pharmaceutical
Sciences Review And Research.2010; 2(2):98-105.
http://www.medicalnewstoday.com/info/diabetes/insulinpump.php
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