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34 Insulin pumps




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This article is from the Diabetes FAQ, by Edward Reid edward@paleo.org with numerous contributions by others.

34 Insulin pumps

An insulin pump provides a Continuous Subcutaneous Insulin Infusion, or CSII,
via an indwelling needle or catheter. That is, a small needle (similar to
those on insulin syringes) or tube is inserted through the skin and fixed in
place for two or three days at a time. An external box pumps insulin through
the needle steadily.

Pumps don't solve all the problems of treating diabetes for two main reasons:

1) The infusion is still subcutaneous, so the insulin still must be
absorbed before it can be used. Insulin from the pancreas goes directly
into the bloodstream and takes effect much more quickly.

2) Current pumps are open-loop -- that is, there is no feedback from blood
glucose (bG) to the pump. The patient must still self-monitor bG and
program the pump.

Nonetheless, many patients get much better results with a pump than from
intensive therapy without a pump, and those patients tend to be
extremely happy with the pump. It isn't clear at present how to decide
whether a given patient should use a pump. Different studies have
obtained varying results, ranging from 85% success to 85% dropout!
Unfortunately, no studies seem to have been done since the mid-1980s,
and the manufacturers have little motivation to fund the studies, as
advertising is more cost-effective for them. It is likely that the pumps
and pump therapy have become much more consistently successful since
then. A few important factors seem clear, though:

1) Motivation. A pump takes extra effort and attention.

2) Knowledge. If you aren't already familiar with intensive therapy,
think more than twice before jumping for a pump. You should
probably try intensive therapy with multiple injections first.

3) Treatment team. Successful users are backed by teams of physicians
and educators who are experienced *with pumps*. Don't try a pump on
your own (the manufacturers won't let you anyway), and don't try it
with inexperienced providers -- these are recipes for unnecessary
failure.

4) Funding. Pumps represent a nontrivial capital outlay. If you don't
have insurance or other public programs that will pay for the pump,
you will need personal financial resources.

Most or all pump manufacturers allow a trial period, so you can try a pump
without financial risk. You will probably know fairly soon whether you want
to continue with the pump.

I have removed the oudated insulin pump discussion previously posted here.

 

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