RE: Pumper's Voice: A Pumping Primer

[Guest guest]

Great article for those who are considering the pump. I have

used one for 7 years and would not change back to syringes for anything!

I sent this to several others I know who are considering a pump.

Pumper's Voice: A Pumping Primer

Pumper's Voice: A Pumping Primer

Consider the pros, cons and function of insulin infusion pumps

by Scheiner, MS, CDE

More than 100,000 people in the United States use insulin pumps. Why

have so many abandoned their trusty syringes and made the switch? And

why isn't everyone using them? Should you consider using one? Nothing

sparks more debate among insulin users than the concept of pumps vs.

shots.

How does a pump work?

The pump is a beeper-sized device that contains a cartridge filled with

fast-acting insulin. It mimics your pancreas by releasing small amounts

of rapid-acting insulin every few minutes. This is called basal insulin,

and is designed to match the glucose released by the liver, thus keeping

the blood sugar level steady between meals and during sleep. When you

eat, you program the pump (with the touch of a button) to deliver a

larger additional dose of insulin right away. This is called an insulin

bolus, and is designed to match the carbohydrate level in the food.

Who should consider a pump?

All of you with Type 1 and those Type 2s who produce little or none of

your own insulin can consider a pump. You will need the ability to press

a few buttons with confidence, and should be prepared to test blood

sugar levels at least four times every day and learn how to count

carbohydrates to properly set the bolus levels. You'll need to keep good

written records of blood sugars, insulin doses, the carbohydrates you

eat, and physical activity.

You will also need to have adequate insurance to use an insulin pump or

be prepared to pay for it yourself; they cost around $6,000, and the

supplies that go with them cost $1,000 to $2,000 a year. Luckily, most

private medical insurance (including Medicare) now cover them.

Pump pros & cons

Before you jump to the pump, take a look at both the plusses and

minuses. Based on my 10 years' experience using shots, 12 years' on the

pump and feedback from over a thousand patients on both forms of

therapy, I present some benefits:

1. More stable blood sugars. Reductions in HbA1c are common in those

whose readings are often high on shots. There are also fewer " high to

low " and " low to high " swings.

2. Fewer low blood sugars. By using only fast-acting insulin, there is

no long-acting insulin peaking when you're not eating. This makes pump

therapy a good choice if you have frequent lows or an inability to

detect low blood sugars.

3. A more flexible lifestyle. Raise your hand if you can eat, sleep and

exercise at the same times every day. It's tough, right? The pump lets

you choose your own schedule.

4. Dosing accuracy. You'll get a bolus calculator that helps you

determine mealtime doses based on carb intake, blood glucose levels, and

the amount of insulin still active from previous boluses.

5. Precise dosing within tenths or twentieths of a unit.

6. Convenience. You don't have to draw up syringes every time you need

insulin; just reach to your side and press a few buttons.

7. No Shots. You change the pump's infusion set just two or three times

a week-no more discomfort from multiple daily insulin injections.

8. Easy adjustments for life's little circumstances. You can adjust the

pump's basal rate to permit good blood sugar control for things like

illness, seasonal sports, restaurant food and menstruation.

9. Weight Control. Eat what and when you choose; snacks are not required

when you use a pump.

10. Novelty. The " high-techness " of the pump can add a dimension of

excitement and fun to one's diabetes care.

.. and some drawbacks:

1. Cost. Although most insurance plans cover insulin pumps and supplies,

there are often

co-pays and deductibles.

2. A learning curve. Don't expect good control right away. It may take

you a few months to get the basal and bolus doses regulated and adjust

to using the pump.

3. Inconvenience. Wearing the pump around the clock, even during sleep,

can become awkward once in a while.

4. Technical Difficulties. As a mechanical device, pumps are prone to

occasional infusion set clogs, power failures, computer glitches and

damage due to typical wear and tear.

5. Skin Problems. Your skin can become irritated from the infusion set

adhesive.

6. Ketosis. The absence of long-acting insulin with pump use can present

a problem if insulin delivery is interrupted for more than a few hours.

Very high blood sugar can occur, and ketones may appear in the

bloodstream and urine.

7. Infusion Set Changes. You must change your infusion set every couple

of days. This 3-10 minute procedure involves numerous steps and can be

momentarily painful or traumatic for the novice pump user.

The next step

Discuss this decision with your doctor-it's an important one for you and

your family. If your doctor is not familiar with insulin pumps or

dismisses them as being a " waste of time, " consider finding a diabetes

specialist who is familiar with pump therapy. Ideally, find a doctor who

invites your input and works with diabetes educators who can assist you

with your pre-pump education and post-pump blood sugar management. If

this is not available to you, feel free to contact my office for

additional resources or direct support.

Insulin pump manufacturers and distributors offer information on their

web sites so you can learn more as you make your decision. Find out if

there are insulin pump support groups in your area; they are excellent

forums for meeting pump users and finding out about their experiences.

Editor's note: Scheiner is a Certified Diabetes Educator with a

private practice specializing in intensive diabetes management for

children and adults. He has had type 1 diabetes for 22 years and has

used an insulin pump for the past 12. He offers his services via phone

and the Internet to clients throughout the world. For questions or more

information, you may contact him at gary@..., or call

.

[Guest guest]

I am totally bind Mark and use the Disentronics Spirit pump. I do ned

help with changing the hourly rates of dosage and if a beep goes off I

have to ask a sighted person what number shows up on the pump.

Re: Pumper's Voice: A Pumping Primer

Thank you for the article. Are there any totally blind diabetics out

there

using a pump without sighted assistance?

Thanks,

Mark

Pumper's Voice: A Pumping Primer

Pumper's Voice: A Pumping Primer

Consider the pros, cons and function of insulin infusion pumps

by Scheiner, MS, CDE

More than 100,000 people in the United States use insulin pumps. Why

have so

many abandoned their trusty syringes and made the switch? And why isn't

everyone using them? Should you consider using one? Nothing sparks more

debate among insulin users than the concept of pumps vs. shots.

How does a pump work?

The pump is a beeper-sized device that contains a cartridge filled with

fast-acting insulin. It mimics your pancreas by releasing small amounts

of

rapid-acting insulin every few minutes. This is called basal insulin,

and is

designed to match the glucose released by the liver, thus keeping the

blood

sugar level steady between meals and during sleep. When you eat, you

program

the pump (with the touch of a button) to deliver a larger additional

dose of

insulin right away. This is called an insulin bolus, and is designed to

match the carbohydrate level in the food.

Who should consider a pump?

All of you with Type 1 and those Type 2s who produce little or none of

your

own insulin can consider a pump. You will need the ability to press a

few

buttons with confidence, and should be prepared to test blood sugar

levels

at least four times every day and learn how to count carbohydrates to

properly set the bolus levels. You'll need to keep good written records

of

blood sugars, insulin doses, the carbohydrates you eat, and physical

activity.

You will also need to have adequate insurance to use an insulin pump or

be

prepared to pay for it yourself; they cost around $6,000, and the

supplies

that go with them cost $1,000 to $2,000 a year. Luckily, most private

medical insurance (including Medicare) now cover them.

Pump pros & cons

Before you jump to the pump, take a look at both the plusses and

minuses.

Based on my 10 years' experience using shots, 12 years' on the pump and

feedback from over a thousand patients on both forms of therapy, I

present

some benefits:

1. More stable blood sugars. Reductions in HbA1c are common in those

whose

readings are often high on shots. There are also fewer " high to low " and

" low to high " swings.

2. Fewer low blood sugars. By using only fast-acting insulin, there is

no

long-acting insulin peaking when you're not eating. This makes pump

therapy

a good choice if you have frequent lows or an inability to detect low

blood

sugars.

3. A more flexible lifestyle. Raise your hand if you can eat, sleep and

exercise at the same times every day. It's tough, right? The pump lets

you

choose your own schedule.

4. Dosing accuracy. You'll get a bolus calculator that helps you

determine

mealtime doses based on carb intake, blood glucose levels, and the

amount of

insulin still active from previous boluses.

5. Precise dosing within tenths or twentieths of a unit.

6. Convenience. You don't have to draw up syringes every time you need

insulin; just reach to your side and press a few buttons.

7. No Shots. You change the pump's infusion set just two or three times

a

week-no more discomfort from multiple daily insulin injections.

8. Easy adjustments for life's little circumstances. You can adjust the

pump's

basal rate to permit good blood sugar control for things like illness,

seasonal sports, restaurant food and menstruation.

9. Weight Control. Eat what and when you choose; snacks are not required

when you use a pump.

10. Novelty. The " high-techness " of the pump can add a dimension of

excitement and fun to one's diabetes care.

.. and some drawbacks:

1. Cost. Although most insurance plans cover insulin pumps and supplies,

there are often

co-pays and deductibles.

2. A learning curve. Don't expect good control right away. It may take

you a

few months to get the basal and bolus doses regulated and adjust to

using

the pump.

3. Inconvenience. Wearing the pump around the clock, even during sleep,

can

become awkward once in a while.

4. Technical Difficulties. As a mechanical device, pumps are prone to

occasional infusion set clogs, power failures, computer glitches and

damage

due to typical wear and tear.

5. Skin Problems. Your skin can become irritated from the infusion set

adhesive.

6. Ketosis. The absence of long-acting insulin with pump use can present

a

problem if insulin delivery is interrupted for more than a few hours.

Very

high blood sugar can occur, and ketones may appear in the bloodstream

and

urine.

7. Infusion Set Changes. You must change your infusion set every couple

of

days. This 3-10 minute procedure involves numerous steps and can be

momentarily painful or traumatic for the novice pump user.

The next step

Discuss this decision with your doctor-it's an important one for you and

your family. If your doctor is not familiar with insulin pumps or

dismisses

them as being a " waste of time, " consider finding a diabetes specialist

who

is familiar with pump therapy. Ideally, find a doctor who invites your

input

and works with diabetes educators who can assist you with your pre-pump

education and post-pump blood sugar management. If this is not available

to

you, feel free to contact my office for additional resources or direct

support.

Insulin pump manufacturers and distributors offer information on their

web

sites so you can learn more as you make your decision. Find out if there

are

insulin pump support groups in your area; they are excellent forums for

meeting pump users and finding out about their experiences.

Editor's note: Scheiner is a Certified Diabetes Educator with a

private

practice specializing in intensive diabetes management for children and

adults. He has had type 1 diabetes for 22 years and has used an insulin

pump

for the past 12. He offers his services via phone and the Internet to

clients throughout the world. For questions or more information, you may

contact him at gary@..., or call .

[Guest guest]

I am totally bind Mark and use the Disentronics Spirit pump. I do ned

help with changing the hourly rates of dosage and if a beep goes off I

have to ask a sighted person what number shows up on the pump.

Re: Pumper's Voice: A Pumping Primer

Thank you for the article. Are there any totally blind diabetics out

there

using a pump without sighted assistance?

Thanks,

Mark

Pumper's Voice: A Pumping Primer

Pumper's Voice: A Pumping Primer

Consider the pros, cons and function of insulin infusion pumps

by Scheiner, MS, CDE

More than 100,000 people in the United States use insulin pumps. Why

have so

many abandoned their trusty syringes and made the switch? And why isn't

everyone using them? Should you consider using one? Nothing sparks more

debate among insulin users than the concept of pumps vs. shots.

How does a pump work?

The pump is a beeper-sized device that contains a cartridge filled with

fast-acting insulin. It mimics your pancreas by releasing small amounts

of

rapid-acting insulin every few minutes. This is called basal insulin,

and is

designed to match the glucose released by the liver, thus keeping the

blood

sugar level steady between meals and during sleep. When you eat, you

program

the pump (with the touch of a button) to deliver a larger additional

dose of

insulin right away. This is called an insulin bolus, and is designed to

match the carbohydrate level in the food.

Who should consider a pump?

All of you with Type 1 and those Type 2s who produce little or none of

your

own insulin can consider a pump. You will need the ability to press a

few

buttons with confidence, and should be prepared to test blood sugar

levels

at least four times every day and learn how to count carbohydrates to

properly set the bolus levels. You'll need to keep good written records

of

blood sugars, insulin doses, the carbohydrates you eat, and physical

activity.

You will also need to have adequate insurance to use an insulin pump or

be

prepared to pay for it yourself; they cost around $6,000, and the

supplies

that go with them cost $1,000 to $2,000 a year. Luckily, most private

medical insurance (including Medicare) now cover them.

Pump pros & cons

Before you jump to the pump, take a look at both the plusses and

minuses.

Based on my 10 years' experience using shots, 12 years' on the pump and

feedback from over a thousand patients on both forms of therapy, I

present

some benefits:

1. More stable blood sugars. Reductions in HbA1c are common in those

whose

readings are often high on shots. There are also fewer " high to low " and

" low to high " swings.

2. Fewer low blood sugars. By using only fast-acting insulin, there is

no

long-acting insulin peaking when you're not eating. This makes pump

therapy

a good choice if you have frequent lows or an inability to detect low

blood

sugars.

3. A more flexible lifestyle. Raise your hand if you can eat, sleep and

exercise at the same times every day. It's tough, right? The pump lets

you

choose your own schedule.

4. Dosing accuracy. You'll get a bolus calculator that helps you

determine

mealtime doses based on carb intake, blood glucose levels, and the

amount of

insulin still active from previous boluses.

5. Precise dosing within tenths or twentieths of a unit.

6. Convenience. You don't have to draw up syringes every time you need

insulin; just reach to your side and press a few buttons.

7. No Shots. You change the pump's infusion set just two or three times

a

week-no more discomfort from multiple daily insulin injections.

8. Easy adjustments for life's little circumstances. You can adjust the

pump's

basal rate to permit good blood sugar control for things like illness,

seasonal sports, restaurant food and menstruation.

9. Weight Control. Eat what and when you choose; snacks are not required

when you use a pump.

10. Novelty. The " high-techness " of the pump can add a dimension of

excitement and fun to one's diabetes care.

.. and some drawbacks:

1. Cost. Although most insurance plans cover insulin pumps and supplies,

there are often

co-pays and deductibles.

2. A learning curve. Don't expect good control right away. It may take

you a

few months to get the basal and bolus doses regulated and adjust to

using

the pump.

3. Inconvenience. Wearing the pump around the clock, even during sleep,

can

become awkward once in a while.

4. Technical Difficulties. As a mechanical device, pumps are prone to

occasional infusion set clogs, power failures, computer glitches and

damage

due to typical wear and tear.

5. Skin Problems. Your skin can become irritated from the infusion set

adhesive.

6. Ketosis. The absence of long-acting insulin with pump use can present

a

problem if insulin delivery is interrupted for more than a few hours.

Very

high blood sugar can occur, and ketones may appear in the bloodstream

and

urine.

7. Infusion Set Changes. You must change your infusion set every couple

of

days. This 3-10 minute procedure involves numerous steps and can be

momentarily painful or traumatic for the novice pump user.

The next step

Discuss this decision with your doctor-it's an important one for you and

your family. If your doctor is not familiar with insulin pumps or

dismisses

them as being a " waste of time, " consider finding a diabetes specialist

who

is familiar with pump therapy. Ideally, find a doctor who invites your

input

and works with diabetes educators who can assist you with your pre-pump

education and post-pump blood sugar management. If this is not available

to

you, feel free to contact my office for additional resources or direct

support.

Insulin pump manufacturers and distributors offer information on their

web

sites so you can learn more as you make your decision. Find out if there

are

insulin pump support groups in your area; they are excellent forums for

meeting pump users and finding out about their experiences.

Editor's note: Scheiner is a Certified Diabetes Educator with a

private

practice specializing in intensive diabetes management for children and

adults. He has had type 1 diabetes for 22 years and has used an insulin

pump

for the past 12. He offers his services via phone and the Internet to

clients throughout the world. For questions or more information, you may

contact him at gary@..., or call .