Are insulin pumps for type 2 diabetics as well as type 1? Here's some information to help you decide.
As pumps for insulin get better and smarter, they are being pushed as the
next great thing for type 2 as well as type 1 diabetics who take insulin
every day. Should you get one?
An insulin pump is a small computer that can be told to deliver insulin in any amount all day long.
It uses a tiny needle and a catheter (medical grade tubing) to deliver rapid-acting insulin. Pumps can hold 100-300 units at a time.
The pump must be carried on you somewhere with the needle and/or catheter taped to your skin at the injection site.
Or a pump is taped to your arm to deliver insulin without tubing, and a lot of type 1 diabetics are using it. It is especially popular among active people for whom the tubing is a problem.
The rapid-acting insulin is dripped continuously into the fat layer under your skin by the pump at a rate decided by your doctors.
That is called your basal rate. It goes
into your body 24 hours a day almost like a pancreas would do it.
Before meals or snacks you give yourself a "bolus," which is a one-time insulin dose dialed into the pump based on how many carbs you are about to eat.
The math for deciding how much insulin is needed for each gram of carbohydrate is complicated because it is different for each person.
But doctors and insulin pump companies try to make it simple. After hours of questions and calculator work they figure out the right numbers for you.
After your pump is calibrated for you, all you have to do is put in how many grams of carbs you are going to eat.
The machine tells you how much insulin to dial into it. Some pumps are so smart they skip that step and dial the amount themselves.
The newer pumps "speak" to a special glucose monitor that tells them the size of insulin bolus you need when you check your blood sugar.
The best part about insulin pumps is they eliminate injections.
One insertion of a catheter needle every three days is all you need.
It replaces mealtime injections and 24-hour nighttime injections too.
Second, users tend to have an improved hemoglobin A1C, meaning tighter blood sugar control.
Third, there are fewer wide swings in blood sugar, which can happen when longer-acting insulins peak and level off.
The 12-hour insulins are notorious for unpredictable lows.
Last, you can exercise without "carbing up" first to avoid low sugar.
You simply dial down or turn off your pump based on your doctor's instructions, then turn it back on when you are finished exercising.
An insulin pump is small but most of us do not want it to be noticed at all.
You could wear yours like a pager with the tubing hidden. Pump companies have special holders.
Or you can attach it to the
waist of your pants, pocket, bra, trouser sock, underwear, belt, garter, wherever you like.
But if you hide it be sure you can get to it easily if you need to.
Some clothes have a pocket for digital players or phones, and those work great for insulin pumps too.
The tubeless pumps, like the OmniPod, are called patch pumps because they look like a lumpy patch on the upper arm.
Diabetic swimmers are using them because they are waterproof.
Instead of single use injections or insulin pens, insulin pumps have infusion sites.
Your abdomen is an obvious spot. The site must be changed every three days and the new site must be at least an inch from the old one.
You need to stay away from scars or your
belly button because they interfere with insulin absorption.
Infusion sets, the needle catheter and tubing, use tape to hold them in place.
If the tape irritates your skin you can
use paper tape. Active people sweat, or the tape rubs on their
clothes and gets loose, so they have to use special skin preparations that help tape
For swimming or bathing, they disconnect the tubing and turn off the pump or wear the new waterproof "patch pump."
Tubeless insulin pumps are getting smarter. Already there are glucose monitors that speak to your pump and tell it what size bolus you need.
That means you do not have to touch your pump at all until it is time to replace it after three days of use.
Implantable pumps are still in the research stage, but they will be surgically placed under the skin of your abdomen.
This means nothing shows, no tubing, and no injection site.
But the pump must be refilled by a syringe by you, and no one is sure how long they can be left without causing problems.
So they are not available yet, but you may be able to get in on the research if you apply and get accepted.
Then there is the closed-loop system that will inject insulin for blood sugar highs and glucagon for blood sugar lows. This is still in the development stage but it will be implanted and act as an artificial pancreas.
But the most exciting research is in transplanting beta cells into the pancreas to reverse type 1 diabetes. This will eliminate insulin pumps for type 1.
For all the children with type 1, this is the greatest hope.
As a type 2 diabetic, do you really want an insulin pump?
There is the long learning curve. Just picking a pump is complicated. You will need to look at and try several before you decide.
Once you've settled on one you may have to spend an entire day in the outpatient clinic or hospital to learn how to use it and get it calibrated for your needs.
You must know your
and insulin history in detail so the diabetic medical supply person can adjust the basal rate and bolus dose for you.
You will be checking your blood sugar with a glucose monitor more than ever now. Or you must get a new meter that talks to your pump.
The catheter (tubing) has to be inspected often. If it kinks, clogs or falls out, you will not be getting insulin anymore.
You also need instructions from your doctor about what to do if
you get sick or have a low blood sugar episode.
Insulin pumps are very expensive. Make sure your insurance covers pumps for type 2 diabetics.
Shop wisely. Make sure the supplies you will need are easy to get at your pharmacy or online.
Remember too that traveling with an insulin pump takes extra thought.
A lot of people love their pumps and the freedom they feel to eat when and what they like.
Maybe pumps are the wave of the future for type 2 diabetics who are insulin dependent. We'll see.
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