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What is insulin pump therapy and how does it work?

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What is insulin pump therapy?

Through the following simple questions and related answers, you can get an understanding of what an insulin pump is and how insulin pump therapy works, helping you keep your glucose levels under control whilst maintaining your lifestyle.

What is a pump and how does it work?

An insulin pump is a small electronic device, about the size of a mobile phone. It can be easily carried on a belt, inside a pocket, or even attached to a bra thus becoming virtually invisible to others and allowing a very discreet therapy.

The pump can help you more closely mimic the way a healthy pancreas functions. The pump, through a Continuous Subcutaneous Insulin Infusion (CSII), replaces the need for frequent injections by delivering precise doses of rapid-acting insulin 24 hours a day to closely match your body's needs.

  • Basal Rate: A programmed insulin rate made of small amounts of insulin delivered continuously mimics the basal insulin production by the pancreas for normal functions of the body (not including food). The programmed rate is determined by your healthcare professional based on your personal needs. This basal rate delivery can also be customised according to your specific daily needs. For example, it can be suspended or increased / decreased for a definite time frame: this is not possible with basal insulin injections.
  • Bolus Dose: Additional insulin can be delivered "on demand" to match the food you are going to eat or to correct high blood sugar. Insulin pumps have bolus calculators that help you calculate your bolus amount based on settings that are pre-determined by your healthcare professional and again based on your special needs.

 

What are the benefits of insulin pump therapy and how can it help you achieve better glucose control?

Insulin pump therapy offers multiple clinical benefits over multiple daily injection therapy such as1,2:

  • better HbA1c control
  • fewer hypoglycaemic events
  • reduction in glycaemic variability

It can help to better manage the need for insulin dose adjustment, particularly for meals and overnight and can thus help to achieve better glucose control.

With its ability to adjust insulin delivery, the MiniMed® 640G insulin pump can also provide the following advantages:

  • Easier dosing: calculating insulin requirements can be a complex task with many different aspects to be considered. In the MiniMed® 640G pump, the built-in Bolus Wizard® feature helps to ensure accurate dosing by taking into account any insulin already in the body, the current glucose levels, carbohydrate intake and personal insulin settings.
  • Greater flexibility: the MiniMed® 640G pump can be instantly adjusted to allow for exercise, during illness or to deliver small boluses to cover meals and snacks. This can easily be done with a touch of a button. There is even a temporary basal rate option to proportionally reduce or increase the basal insulin rate, during exercise or illness, for example.
  • More convenience: the MiniMed® 640G offers the additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate Bolus Wizard® calculations and to deliver insulin boluses discreetly.

The pump therapy as a system: how does the insulin get into your body?

The insulin pump consists of:

  1. A compartment that holds a reservoir.
  2. The reservoir which is filled with insulin.
  3. From the pump's reservoir, insulin is infused into your body through an infusion set.
  4. The infusion set is inserted into your body and is infused through a tiny flexible tube called a cannula that sits just underneath your skin.
  5. The infusion set is then connected to the reservoirs through a small tube which can be easily disconnected and reconnected from your body whenever you want to. This is helpful, when people want to swim, shower or play sport.

         medtronic-insulin-pump-components

Components of the insulin pump therapy system^

All MiniMed® infusion sets and reservoirs are meant to work as a system with the pump by providing an innovative interface designed for a more secure fit than a standard connection. The core part of this system is the MiniMed® Connection which is patented* and on every infusion set.

1. Insulin Pump

A small durable electronic device that has:

  • Buttons to program your insulin and navigate through the menu
  • A LCD colour screen to show what you are programming
  • A battery compartment to hold 1 AA alkaline battery
  • A reservoir compartment

2. Reservoir

A plastic cartridge that holds the insulin is locked into the insulin pump. It comes with a transfer guard the blue piece at the top that is removed before inserting the reservoir into the pump. This assists with pulling the insulin from a vial into the reservoir. A reservoir can hold up to 300 units of insulin and is changed every two to three days when you change the infusion set. The MiniMed® reservoirs have been designed to make filling a convenient process.

3. Infusion Set

An infusion set includes a thin tube that goes from the reservoir to the infusion site on your body. The cannula is inserted with a small needle that is removed after it is in place. It goes into sites (areas) on your body similar to where you would give insulin injections. The infusion set is changed every two to three days. MiniMed® infusion sets are available with a wide range of features (cannula type, length and inclination) so that you can choose the right infusion set for your comfort and protection.

References:

1. J. C. Pickup and A. J. Sutton Severe hypoglycaemia and glycemic control in Insulin Dependant Diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion Diabetic Medicine 2008 :25, 765–774.

2. Bergenstal RM1, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN, Joyce C, Perkins BA, Welsh JB, Willi SM, Wood MA; STAR 3 Study Group. Sensor-augmented pump therapy for A1C reduction (STAR 3) study: results from the 6-month continuation phase. Diabetes Care. 2011 Nov;34(11):2403-5. doi: 10.2337/dc11-1248. Epub 2011 Sep 20.

* Ly T.T, Nicholas J.A., Retterath A. et al. Reduction of Severe Hypoglycemia with Sensor-Augmented Insulin Pump Therapy and Automated Insulin Suspension in Patients with Insulin Dependant Diabetes [abstract]. Diabetes 2013; 62 (supplement 1): 228-OR. ^ Components sold separately.