Initiation and Management of Insulin Pump Therapy

1993 ◽  
Vol 19 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Suzanne M. Strowig
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Insulin Pump ◽  
Infusion Pump ◽  
Blood Glucose Control ◽  
Insulin Delivery ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Potential Risks

Insulin infusion pump therapy is a treatmertt option that facilitates achieving improved blood glucose control and lifestyle flexibility. These advantages are derived from the physiologic mode of insulin delivery and the pharmacologic advantages of using rapid-acting insulin. Patients who are sufficiently motivated and capable can learn to use the pump so that insulin adjustments can be made to compensate for changing circumstances. Although there are potential risks and side effects of using an insulin pump, these can be avoided through proper education and surveillance. The health care provider should be knowledgeable about the management of infusion pump therapy, including assessment of patient capabilities and practices, education, insulin adjustment, and techniques of use. The knowledge assists the health care provider in counseling patients to consider pump therapy and to manage patients already employing this mode of insulin delivery.

User- and Health Care Provider–Reported Outcomes for a Wearable Bolus Insulin Delivery Patch

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 995-P
Author(s):  
MARK PEYROT ◽  
RICHARD M. BERGENSTAL ◽  
DARLENE M. DREON ◽  
VANITA ARODA ◽  
TIMOTHY S. BAILEY ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Insulin Delivery ◽  
Bolus Insulin

Insulin Delivery Devices

2004 ◽  
Vol 17 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Kristine M. Stewart ◽  
Mary F. Wilson ◽  
Joan M. Rider
Keyword(s):  
Insulin Pump ◽  
Insulin Delivery ◽  
The United States ◽  
Tight Glycemic Control ◽  
Alternative Methods ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Patients With Diabetes ◽  
Insulin Pens ◽  
The 1960S

More than 6million Americans require daily injections of insulin. Insulin therapy, using the vial and syringe method, can be complicated and time consuming. Insulin pens were introduced in the United States in 1987 and have simplified insulin administration for many patients. Continuous Subcutaneous Insulin Infusion (insulin pumps or CSII) is being utilized to achieve and maintain tight glycemic control for personswith Diabetes Mellitus (DM). CSII therapy has existed since the 1960s. These insulin delivery devices provide improvements in flexibility, convenience, and freedom for patients-with diabetes. These devices may also help promote dosing accuracy and often improve compliance. CSII uses only rapid acting insulin, which has more reliable and predictable absorption. Gone are the days of sliding scales and feeding times to match the insulin delivery systems. This article focuses on insulin pen therapy and other alternative methods of delivering insulin including insulin pump therapy.

scholarly journals Characterization of Exercise and Alcohol Self-Management Behaviors of Type 1 Diabetes Patients on Insulin Pump Therapy

2016 ◽  
Vol 11 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Maria Adela Grando ◽  
Danielle Groat ◽  
Hiral Soni ◽  
Mary Boyle ◽  
Marilyn Bailey ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Real Life ◽  
Insulin Pump Therapy ◽  
Insulin Pumps ◽  
Pump Therapy ◽  
Diabetes Patients

Background: There is a lack of systematic ways to analyze how diabetes patients use their insulin pumps to self-manage blood glucose to compensate for alcohol ingestion and exercise. The objective was to analyze “real-life” insulin dosing decisions occurring in conjunction with alcohol intake and exercise among patients using insulin pumps. Methods: We recruited adult type 1 diabetes (T1D) patients on insulin pump therapy. Participants were asked to maintain their daily routines, including those related to exercising and consuming alcohol, and keep a 30-day journal on exercise performed and alcohol consumed. Thirty days of insulin pump data were downloaded. Participants’ actual insulin dosing behaviors were compared against their self-reported behaviors in the setting of exercise and alcohol. Results: Nineteen T1D patients were recruited and over 4000 interactions with the insulin pump were analyzed. The analysis exposed variability in how subjects perceived the effects of exercise/alcohol on their blood glucose, inconsistencies between self-reported and observed behaviors, and higher rates of blood glucose control behaviors for exercise versus alcohol. Conclusion: Compensation techniques and perceptions on how exercise and alcohol affect their blood glucose levels vary between patients. Improved individualized educational techniques that take into consideration a patient’s unique life style are needed to help patients effectively apply alcohol and exercise compensation techniques.

scholarly journals Health Care Provider Knowledge and Perceptions of FDA-Approved and Do-It-Yourself Automated Insulin Delivery

2019 ◽  
Vol 14 (6) ◽  
pp. 1017-1021 ◽  
Author(s):  
James A. Murray ◽  
Margaret F. Clayton ◽  
Michelle L. Litchman
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Insulin Delivery ◽  
Two Phase ◽  
Cross Sectional ◽  
Negative Attitudes ◽  
Federal Drug Administration ◽  
Fact Sheet ◽  
Do It Yourself

Background: Automated insulin delivery (AID) technology may reduce variability in blood glucose, resulting in lower risk for hypoglycemia and associated complications, and by extension improve quality of life. While clinical trials, research, and patient experience have consistently demonstrated the value of AID, this technology is still inaccessible to many patients. Patient-driven innovation has resulted in alternative do-it-yourself (DIY) solutions to available off-the-shelf AID devices. Method: This two-phase cross-sectional observational study addressed health care provider (HCP) perceptions of AID as well as the perceived need for, development of, and evaluation of an AID fact sheet comparing the most commonly used Federal Drug Administration approved AID and DIY AID devices. Results: Negative attitudes toward the use of DIY AID were low. The majority of HCPs saw their lack of knowledge about how DIY AID work to be the greatest barrier to answering patient questions about what is available (74.4%). Additionally, the majority of HCPs (64.5%) indicated they were either “likely” or “very likely” to use the fact sheet when answering patient questions about AID options. Conclusion: Increased awareness and utilization of AID technology offer hope to further reduce the burden of diabetes, but there is a need to bridge the knowledge gap about DIY AID. A fact sheet provides a way to facilitate discussions of this emerging technology between HCPs and patients. Next steps could investigate additional ways to put needed information in the hands of HCPs.

scholarly journals Tissue Response to Subcutaneous Infusion Catheter

2019 ◽  
Vol 14 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Ershuai Zhang ◽  
Zhiqiang Cao
Keyword(s):  
Insulin Infusion ◽  
Insulin Pump ◽  
System Development ◽  
Subcutaneous Tissue ◽  
Infusion Pump ◽  
Tissue Response ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Wear Time ◽  
Increased Risk

Insulin infusion pump, continuous glucose monitoring (CGM), and insulin infusion set (IIS) have been developed to be increasingly feasible for people with type 1 diabetes (T1D). Several recently approved CGMs are transitioning from 7-day to 10-day wear time without the need for fingerprick recalibration. Nevertheless, studies and improvements on IIS, a critical part of insulin pump therapy, have been limited. In particular, the recommended wear time of IIS is still 2-3 days, which can hardly match the current duration of CGM for potential closed-loop system development. It is generally believed that both the inserted catheter and the subsequent infused insulin drug could induce particular subcutaneous tissue response and skin-related complications at the infusion site. In certain cases, poor glycaemic control, increased risk of hypoglycemia, and serious cosmetic impact on people with diabetes were observed. Skin complication has also been attributed as an important factor resulting users to discontinue insulin pump therapy. This article provides the rare systematic review of IIS induced subcutaneous tissue responses and skin complications, including the impacts from the inserted catheters, the subcutaneous infused insulin, and the adhesive or tape used to immobilize the catheter. The FDA’s recommendation for the frequency of IIS change was further discussed. Future studies on this topic are required to further understand the IIS-related problems, and future strategies could be developed accordingly to significantly reduce the incidence of these problems, extend the wear time, and increase the acceptance of insulin pump based therapy.

scholarly journals Rapid Changes in Serum Testosterone in Men with Newly Diagnosed Type 2 Diabetes With Intensive Insulin and Metformin

2021 ◽  
Author(s):  
Yun Hu ◽  
Bo Ding ◽  
Yun Shen ◽  
Reng-Na Yan ◽  
Feng-Fei Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Pump ◽  
Blood Glucose Control ◽  
Serum Testosterone ◽  
Insulin Pump Therapy ◽  
Newly Diagnosed ◽  
Pump Therapy ◽  
Testosterone Levels ◽  
Metformin Group

Objective: To investigate the effect of metformin on testosterone levels in men with type 2 diabetes mellitus (T2DM). <p>Methods: Seventy men with newly diagnosed drug naïve T2DM, HbA<sub>1c</sub> >9.0% (75mmol/mol) were treated with intensive insulin pump therapy for 5 days to achieve glucose normalization. They were randomized to control (continued on intensive insulin only) and metformin (plus metformin) groups (1:1) for one month. Testosterone was measured at baseline, randomization, and after one-month treatment. </p> <p>Results: Total, free and bioavailable testosterone increased significantly within 5 days (all <i>p</i><0.001). After one month, compared to controls, the metformin group had lower total (12.7 vs 15.3 nmol/L), free (0.20 vs 0.24 nmol/L), and bioavailable (4.56 vs 5.31 nmol/L) testosterone (<i>p</i> all <0.05).</p> <p>Conclusions: In men with T2DM, one-month oral metformin may decrease serum testosterone levels independent of blood glucose control. The effects of long-term metformin on testosterone in men need further study.</p>

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