Talking insulin pump

[Guest guest]

I am doing research and a design proposal for a talking insulin pump. I’m

curious as to how many people on this list:

a) currently use an insulin pump, and

don’t use an insulin pump but would use one if it had speech output

c) (for healthcare providers) work with one of the above

Please take a few seconds to answer this short survey! If all goes well with

this I am wanting to contact a pump company about it, but I am collecting

statistics for some preliminary research. If you’d like to e-mail me

off-list my e-mail is HYPERLINK " mailto:jen_jesso@... " jen_jesso@....

Also, if you know any other blind or visually impaired diabetics who could

fill this out, please feel free to pass it on. No names will be mentioned in

any of this, I am just collecting it to generate some numbers and

statistics.

Thanks!

Jen

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1:50 PM

[Guest guest]

jen, i may be interested if it was user friendly for the totally blind.

karen from canada

Talking insulin pump

I am doing research and a design proposal for a talking insulin pump. I'm

curious as to how many people on this list:

a) currently use an insulin pump, and

don't use an insulin pump but would use one if it had speech output

c) (for healthcare providers) work with one of the above

Please take a few seconds to answer this short survey! If all goes well with

this I am wanting to contact a pump company about it, but I am collecting

statistics for some preliminary research. If you'd like to e-mail me

off-list my e-mail is HYPERLINK " mailto:jen_jesso@... " jen_jesso@....

Also, if you know any other blind or visually impaired diabetics who could

fill this out, please feel free to pass it on. No names will be mentioned in

any of this, I am just collecting it to generate some numbers and

statistics.

Thanks!

Jen

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date: 2/2/2008

1:50 PM

[Guest guest]

cam arcoss this article today

MANY BLIND DIABETICS SUCCESSFULLY USE INSULIN PUMPS

by Ed

(This article appeared in VOICE OF THE DIABETIC, Volume 15, Number 2,

Spring 2000 Edition. Updated January 2005.)

Insulin pumps, which deliver continuous doses of insulin, are being

used by more and more diabetics, blind and sighted, to achieve better

diabetes control. Unfortunately, there are health professionals who

assume it isn't possible for a blind patient, or one with severe

vision loss, to operate an insulin pump. These individuals, and some

blind people, have the misconception that blindness is synonymous

with inability. They're wrong.

Most people with type 1 diabetes, sighted, blind, or visually

impaired, can successfully use an insulin pump if they desire. With

the pump, they can come closer to " normal, " non-diabetic blood

glucose, than with any other means short of a pancreas transplant.

Today's pump is the size of a deck of cards, or smaller, and is

highly computerized. Insulin runs from the pump, through a tube

(catheter or cannula), usually attached to the abdomen or thigh.

Insulin is delivered under the skin, through the tiny, flexible tube.

The user programs the pump for basal (continuous) delivery, small

amounts of short-acting insulin 24 hours a day. He/she also programs

the insulin pump for bolus insulin delivery, to receive extra insulin

just before eating. Insulin pumps have several different controls and

alarms, and your doctor may want you to spend a few days in the

hospital for training.

Current insulin pumps are easier to use than their predecessors; they

simplify dose computation -- but they do not set themselves. Insulin

pump users need to check their blood glucose often, at least four

times a day. Since only short-acting insulin is used, no mix of long-

and short-acting insulins, it is important the user check blood

sugars regularly to avoid really high or low blood glucose. Warning:

If the needle, or catheter, comes out from under the skin, there may

be no warning alarm to alert the user; dangerous ketones can start

building up in about one hour. With little or no insulin in the body,

ketoacidosis can develop in just a few hours. Note: Pump users say

the needle or cannula rarely, if ever, comes out; and if it does,

they can feel what happened. Additionally, if the needle has detached

from the skin, then insulin will flow onto the clothing, which will

after a while become wet. Most users should also be cognizant of

leaking insulin, as it smells very bad. To reiterate, it is important

that you closely monitor your blood sugars.

An insulin pump might be what you need if you are having major

problems controlling your blood glucose with insulin shots. You might

consider a pump if insulin injections do not keep your blood glucose

near a normal level, or if you have big glucose swings. Nighttime can

be difficult for some, because they have episodes of hypoglycemia, or

get up in the morning with high blood sugars before breakfast. The

pump can be programmed, so it can deliver less insulin at night and

more insulin before dawn, minimizing nighttime lows and before

breakfast glucose highs. We should all be monitoring our blood

glucose, working toward tight control. We should all be working with

our health care team to reach euglycemia, normal blood glucose.

You may be able to wear your insulin pump while bathing or swimming.

Some pumps are waterproof, and some come with a water protective

case.

Insurance

Some insurance companies will help with the cost of pumps and

supplies. They realize better diabetes control means less diabetes

complications, less time in the hospital, and a bottom line of less

expense for the insurance provider. Your doctor should be able to

help show insurance companies the value of covering the cost of pumps

and supplies.

As of April 1, 2000, Medicare began helping type 1 diabetics with the

cost of pumps and related supplies. For information, telephone: 1-800-

633-4227, and ask for " Durable Medical Equipment. "

Pump Manufacturers and Costs

Change has become quite rapid; new models and new manufacturers are

announced almost every month. Do some research -- much of

the " published information " is already incomplete and outdated, and

few sources mention all your options. The Internet is a great place

to start.

Animas (the R1000 and R1200 pumps)

Frazer, PA

1- or 1-

www.animascorp.com

Dana Diabecare (the Diabecare II)

New Orleans, LA

1- (in USA)

Korean-designed, built and sold all over the world

www.danapumps.com

Deltec/'s Medical (the Cozmo and Cozmonitor)

St. , MN

1- (in USA)

www.delteccozmo.com or www.smiths-medical.com

UK-based, the Cozmo includes a coupled meter (the Cozmonitor) and

Cozmanager computer software.

Disetronic Medical Systems, Inc. (former manufacturer of the D-tron

and H-Tron)

Fishers, IN 46038

1-

Disetronic is now part of Roche Diagnostics. Their new pump,

currently " in the pipleine, " will be marketed as the " AccuChek

Spirit. " Roche will sell it; Disetronic will support it, as they do

their D-Tron and H-Tron models. It's not available yet; we'll tell

you more when it's available.

www.disetronic-usa.com

Medtronic/MiniMed (the Paradigm 515 and 715)

1-

Sylmar, CA 91342

www.minimed.com

Minimed's Paradigm series pumps link (by wireless RF) with a

dedicated B-D blood glucose monitor, to ease computation of basal and

bolus dose.

Nipro

1- (in USA)

Miramar, FL 33025

www.nipro-diabetes.com

Osaka, Japan-based Nipro, a newcomer to the U.S. market, offers the

Amigo II pump.

On The Way:

The AccuChek Spirit (Roche Diagnostics, mentioned above). Also, under

the Aegis of LifeScan, Inverness Medical and Swiss R & D firm Debiotech

have been developing a tiny pump that attaches directly to the skin,

eliminating the long cannula. Researchers report they plan " to make

their pump the size of a credit card. " The new mini-pump will require

a concentrated insulin not yet perfected. No name has been put forth

for the mini-pump, but notes about it are already on the Internet.

Although many blind people successfully use insulin pumps, no pump

manufacturer to date has embraced the need to create a tactile or

talking insulin pump designed to ease independent nonsighted use. The

technology exists; all that has been lacking is manufacturer

interest. We, the Diabetes Action Network of the National Federation

of the Blind, have been actively lobbying manufacturers to create

such equipment.

The insulin pump is an amazing device. If you have type 1 diabetes,

and need to use insulin, the pump best approximates the function of a

healthy, non-diabetic pancreas. Can a blind diabetic use it, fill it,

program it, attach it, independently, without sighted aid? Absolutely.

As I said, there are still people who believe otherwise, and some who

just don't know. Who are the " experts " in this case? The blind

pumpers who are doing it for themselves. Here's what they had to say

about their pumps:

Why should a blind diabetic consider the insulin pump?

, a blind pump user from Medina, Ohio, says: " I've

always wanted to be on the pump; it was a convenience thing. The pump

gives me more flexibility. If you're considering an insulin pump,

definitely really look into it, because it has given me independence

and freedom ... "

Tammy Rupp, a blind pumper from Carrolton, Georgia, says: " The good

thing about the pump is you can be really flexible. You don't have to

be on a schedule. You can be, but you don't have to be. "

Sally York, a blind pumper from Castro Valley, California, and past

Board Member of our National Federation of the Blind Diabetes Action

Network, says: " My MiniMed insulin pump has given me back my

independence. I can't imagine going back to life on multiple

injections. I can honestly declare my pump has given my life a

positive boost. "

What specialized techniques do you use to manipulate the pump without

sight?

" With respect to filling the syringe, " says Tom Tobin, a blind pumper

from Cleveland, Ohio, " I have developed a system that works well

without any sighted assistance. First, when filling the syringe, I

pull down on the plunger until the bottom of the syringe barrel and

the plunger are about the distance from the tip of my index finger to

my first knuckle; so as a measuring device, you always have your

knuckle.

" Then, as with a regular syringe, I tap the sides of the syringe

barrel and then push the insulin back into the vial. I repeat this

step until I cannot hear any 'bubbles' escaping when pushing the

insulin back into the vial; there should be a 'smooth' sound.

" Next, since air may trap at the top of the syringe itself, I pull a

little air into the syringe and push up on the plunger ever so

slightly until insulin comes out the tip of the needle; just a little

push. That completes filling the syringe.

" Next, while holding the syringe in my left hand, I take the infusion

tubing and remove the cover at the end of the tubing that goes over

the neck of the syringe, where the needle once was. Make sure there

is a snug fit as you tighten down the collar of the infusion set over

the neck of the syringe. (I sometimes use my teeth to make sure it is

really tight.) Then I put the plunger of the syringe on a flat

surface, usually a table top, and begin pushing down on the barrel of

the syringe, thus filling the infusion set. I want to stress, this

should be done very, very slowly to avoid any pocketing of air in the

tubing. If it is done right, there should be no air bubbles at all in

the tubing. Letting a drop fall on the back of your hand is fine,

although I put the needle guard at the other end of the infusion set

between my teeth, and use my tongue to feel when the drop falls.

Whatever works for you. "

Tom Ley, from Baltimore, land, a blind pumper and former

president of our NFB Diabetes Action Network, says: " The process of

filling my Mini Med 507 C pump with a fresh supply of insulin can be

performed successfully by a person using non-visual techniques. I

will cover the subject of inserting the cannula into the skin and

securing the cannula with tape. Let me say, at the beginning, that

not once in my two years of experience has the cannula ever crimped

or otherwise unsuccessfully seated itself under the skin when being

implanted. I also find this aspect of the process very easy non-

visually.

" It is much like giving a shot in many ways. Once the needle is

inserted into the skin, a piece of special tape is used to hold the

cannula in place. The tape is designed in such a way that is

extremely easy to position correctly without yet exposing the sticky

side of the tape. Once the tape is in place, three pieces of paper

that cover the sticky part of the tape must be removed. The pieces of

paper are pre-folded and shaped by the factory to make locating and

removing extremely easy.

" Then, the final step is to remove the needle from the Teflon

cannula. One simply must locate the large plastic end of the needle

protruding from the skin through a hole in the tape, twist it a

quarter of a turn, and pull out to remove. It is possible the cannula

might crimp as it is being inserted. However, it is standard

operating procedure to check your blood sugar an hour after changing

the pump set. If the sugar is abnormally high, then a set of

procedures should be followed to remedy the situation. This is no

different than what a pump user does any time blood sugars seem

unusually high. As said earlier, in two years, I have not yet

experienced any problems of this nature when changing my pump set. "

" One of the first things I learned was to line up my insulin bottle

with the needle and syringe that holds the insulin in the pump, " says

blind pumper Donna Blake, from Waterbury, Connecticut. " This may have

not seemed like much but at that time, I had never seen a Count-A-

Dose (tactile insulin measuring device that enables blind people to

accurately measure insulin without sight), nor had I heard about any

alternative techniques for taking care of insulin and blood sugar

needs.

" After I got the syringe filled, I devised a simple way to connect

the syringe to the tubing aseptically (in a sterile manner). I placed

my thumbs together guiding the hub of the syringe into the Leur lock

of the tubing. I drew the syringe back two fingers' width and this

gave me the correct amount of insulin for three days. Next, I

realized I had bubbles that I did not know about, so back I went to

step one. I found by pushing the insulin in and out of the bottle

several times (gently), I could eliminate almost all the bubbles-most

of the time, all the tiny bubbles.

" In order to ensure that all the air was out of the syringe, I would

lightly tap the syringe on the side of a table to bring the bubbles

to the top. Then I took the syringe, pulled a bit of air into it,

reinserted the needle into the bottle of insulin and shot out the

air. I then tapped the needle on the side of the table and pushed the

plunger until a few drops of insulin came out (you can really smell

the insulin). I connected the tubing and the syringe. I held the

syringe and the first few inches of tubing upright and slowly

depressed the plunger so the insulin filled the initial portion of

the tubing without bubbles. I continued pushing insulin through the

tubing until I felt a drop fall out and hit the back of my hand.

" I was almost ready to insert the needle/catheter. I began this stage

of the procedure after a shower where I scrubbed the site, where the

catheter was placed, thoroughly with soap. I dried this area off with

a clean towel, separate from my other towels. Next I prepared the

site with a liquid spray called " Sween Prep, " a protective skin

coating that keeps me from having an allergic reaction to the

adhesive placed over the catheter site. While this stuff dried, I

placed the syringe in the pump and primed two units of insulin

through. This step ensured that the syringe inserted snugly within

the pump and I did not miss any dose of insulin.

" When my site was ready to receive the catheter, I inserted the

needle just like anyone else with diabetes does giving an injection.

After I inserted the catheter, I pulled out the small (25-gauge)

needle and placed a protective tape over the catheter and now I could

go for about three to four days. "

What adaptive features are there to help you?

" It has a tone-activate button, " says Tammy Rupp. " You press it, and

it has a tone, and you count the tones for each unit you need, to get

your insulin bolus. Mine goes in whole units; it can go in half-

units, too. And it will automatically count it back to you so you can

check it.

" There's also a select button that you use with the activate button,

to clear the pump's alarm, if it goes off. There's an alarm for " low

battery, " for if something's wrong with the infusion set, or if the

pump is out of insulin. It beeps six times when you're out of

insulin. "

Blind pumper Anne Whittington, MBA, MSN, RN, CDE, from San Diego,

California, says: " Initially I was on the MiniMed. I found the

buttons cumbersome (with my rheumatoid arthritis) and the contrast

poor on the screen. In 1993, I switched to the Disetronic pump. The

audible alarms and crisp contrast met my needs well. "

says: " My insulin pump has a screen, which I cannot

read, that shows date and time, and when the alarm goes off, it tells

what the alarm is for. It has four buttons, and one of them is

the 'select' button, with which you select whatever screen you want.

I use it by counting. Once I hit the activate button, it beeps. And

it has the up and down arrows. When I do a bolus before I eat, I push

the button. Say I want ten units; I'll push the button up; it'll be

20 beeps. Then I push the activate button again, and it will replay

the number of beeps, each 1/2-unit of insulin, that I selected.

Another push on the activate button, and it will start giving me the

insulin. "

What about the cannula? Does it bother you? Is it safe?

Elsea, a blind pumper from Sylmar, California, says: " The

insulin is delivered through a needle or cannula, which is placed

anywhere you'd give an injection with a syringe. I only use my

abdomen; I find it easier and more reliable. I use a Teflon cannula

called 'Tenders,' made by Disetronic. I find them easy to insert and

very forgiving. In fact, if you have any neuropathy in your hands,

you may actually find these cannulas and cartridges quite a blessing,

as they're fatter and larger than regular syringes. The 'Tenders' are

inserted at an angle, anything up to 45 degrees or so. I just hold it

at a slant, push it in and don't worry about it! As you might expect,

once you insert the cannula and remove its insertion needle, it is

held in place with tape. With the 'Tenders' infusion set, the tape is

part of the cannula, so I no longer find myself holding something in

place while searching for a piece of tape somewhere on a table! It's

designed for one-handed operation by a sighted person, which means we

can do it easily and comfortably with two.

" Only once, during an exuberant 'good morning,' did my guide dog

reach up and catch her paw in the tubing. It's a weird feeling when

you catch the tubing on something, but it takes real effort to knock

out the cannula. "

" I'm not afraid the catheter would fall out, " says . " I

use three pieces of medical tape holding it in, and never in the

months I've been using it has it come out, unless I mean to, when I'm

taking it off. You have to really tug on it sometimes to get it off-

the tape is very sticky. Although there's no alarm that would sound

if it fell out, you would definitely know-you would notice. For one,

my shirt would be soaked with the insulin!

" Once you get used to wearing the cannula, and to the need to rotate

it, you can tell if something's wrong. I can tell if the tape's

loose. Usually on the third day, the tape gets a little looser than

the first or second days, since you've taken three showers since you

attached it. "

" I can honestly say I feel practically no discomfort at all from the

cannula that delivers my insulin, " says Tom Ley. " I find its presence

far more comfortable than taking four insulin injections per day. "

Do you have any advice for blind diabetics who are considering

the insulin pump?

" A lot of people say to me, 'Oh, I want the pump and I don't want to

get injections anymore,' " says blind pumper Tricia Kline, from

Doylestown, Ohio. " They think the pump is the easy way out. And I

would say, unless you have the commitment to continue, if you think

all you have to do is get a pump, and then you can eat anything you

want to, that you don't have to do this and that, and you don't have

to do blood sugar testing, unless you are committed to do that and

really work at it, you won't succeed with the pump. Its not 'less

work.' Sure, some people think you throw out your injecting needles

and that, but it's still a big commitment. And unless you're willing

to do that, and willing to, and have the confidence to do your own

adjustments, you won't succeed with the pump. You have to develop,

with your doctor, a sliding scale; like 'if my blood sugar is this

much, then I take this much insulin, or if it's low I take this much

less.' You get to know your body. But unless you're willing to gain

this much confidence in yourself to be able to make these changes on

your own, you will drive your doctor crazy. "

Anne Whittington says: " Before selecting the company with the best

pump for you, consult your diabetes management team members. These

team members go beyond your doctor, and include your nurse dietitian,

blind rehabilitation specialist, and whoever else may be assisting

you in learning about the pump and its day-to-day operation. Also,

please speak with customer service representatives from the major

companies before you select a pump. Explain to them your needs as a

blind person. "

" With the MiniMed pump at my side, " says Tom Ley, " I'm eagerly

beginning a new phase of my life with diabetes. After 25 years, I

welcome days free from insulin injections. I'm excited about the

prospect of fewer high and low blood sugar incidents, and I will

enjoy my new mealtime flexibility immensely. I'm comfortable,

confident, and

>

> jen, i may be interested if it was user friendly for the totally

blind.

> karen from canada

>

> Talking insulin pump

>

>

> I am doing research and a design proposal for a talking insulin

pump. I'm

> curious as to how many people on this list:

>

>

>

> a) currently use an insulin pump, and

>

> don't use an insulin pump but would use one if it had speech

output

>

> c) (for healthcare providers) work with one of the above

>

>

>

> Please take a few seconds to answer this short survey! If all goes

well with

> this I am wanting to contact a pump company about it, but I am

collecting

> statistics for some preliminary research. If you'd like to e-mail me

> off-list my e-mail is HYPERLINK " mailto:jen_jesso@... " jen_jesso@...

> Also, if you know any other blind or visually impaired diabetics

who could

> fill this out, please feel free to pass it on. No names will be

mentioned in

> any of this, I am just collecting it to generate some numbers and

> statistics.

>

>

>

> Thanks!

>

>

>

> Jen

>

>

> No virus found in this outgoing message.

> Checked by AVG Free Edition.

> Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date:

2/2/2008

> 1:50 PM

>

>

>

>

[Guest guest]

,

Both NFB and ACB hhve ben trying oot get the pump manufacturers to do

accessible pumps. No one, no matter what yu say, seem very interested.

Re: Talking insulin pump

same here. I've been trying to convince Minimed-medtronic to work on a

talking pump, and when I send my feelings in an email, I get the

refreshed page with " thank you for your comments, we will consider them

in the future. When I call the customer serice number from their site,

the rep states that it is relatively easy for for a blind person to

memorize the button pushes and beeps to know what to do. I asked them to

get a pump in their hand. They do. I then tell them to close their eyes

and set 3 seperate basal rates on it. They seem befuddled. Then I inform

them that the warnings are all display driven, with a beep to notify the

user that the pump is in trouble, but the warning for alow insulin

volume is the same as a low battery signal. I don't have my wife with me

all the time, and I can't pay for a personal assistent who's sole job

would be to read my pump display.

I've been working on this company since 2003. I've decided to write a

letter and send it to the company, the AMA, NFB, and Lovee , head

coach for the Chicago Bears foot ball team, who's mother is a blind

diabetic. I guess having some celebrity help out wouldn't hurt.

Talking insulin pump

I am doing research and a design proposal for a talking insulin pump.

I'm

curious as to how many people on this list:

a) currently use an insulin pump, and

don't use an insulin pump but would use one if it had speech output

c) (for healthcare providers) work with one of the above

Please take a few seconds to answer this short survey! If all goes well

with

this I am wanting to contact a pump company about it, but I am

collecting

statistics for some preliminary research. If you'd like to e-mail me

off-list my e-mail is HYPERLINK " mailto:jen_jessoshaw (DOT)

<mailto:jen_jesso%40shaw.ca> ca " jen_jessoshaw (DOT)

<mailto:jen_jesso%40shaw.ca> ca.

Also, if you know any other blind or visually impaired diabetics who

could

fill this out, please feel free to pass it on. No names will be

mentioned in

any of this, I am just collecting it to generate some numbers and

statistics.

Thanks!

Jen

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date:

2/2/2008

1:50 PM

[Guest guest]

I use the Disetronics Spirit, but sure wish it was talking!

Talking insulin pump

I am doing research and a design proposal for a talking insulin pump.

I'm

curious as to how many people on this list:

a) currently use an insulin pump, and

don't use an insulin pump but would use one if it had speech output

c) (for healthcare providers) work with one of the above

Please take a few seconds to answer this short survey! If all goes well

with

this I am wanting to contact a pump company about it, but I am

collecting

statistics for some preliminary research. If you'd like to e-mail me

off-list my e-mail is HYPERLINK

" mailto:jen_jesso@... " jen_jesso@....

Also, if you know any other blind or visually impaired diabetics who

could

fill this out, please feel free to pass it on. No names will be

mentioned in

any of this, I am just collecting it to generate some numbers and

statistics.

Thanks!

Jen

No virus found in this outgoing message.

Checked by AVG Free Edition.

Version: 7.5.516 / Virus Database: 269.19.19/1256 - Release Date:

2/2/2008

1:50 PM