Pumper’s Voice: A Pumping Primer

[Guest guest]

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]

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]

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 have no sight left (it's totally dark when my eyes are open), and I'm

using a Minimed paradigm 7xx (can't remember what model I'm using). The

pump has some features which are handy, such as an EZ bolus, which allows

you to program the pump to give a set number of units with each push of the

up button, but to set up any of the settings, you need sighted assistance.

I, along with several people I've " bumped " into on some lists have been

advocating a talking insulin pump, and I have talked to several pump

trainers at some diabetic education centers who have said that they too are

trying to get the pump companies to make a talking pump. Seems that the

pump companies advocate their bottom line more than diabetic patient's

health. But, I keep on working on some way to get them to realize that the

need is there.

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 .

>

>

>

>