Insulin pumps: Matching your insulin to your lifestyle

New Delhi, Mar.5 (ANI): Six years ago, the use of insulin pumps, a diabetes treatment device that promised to give insulin-dependent diabetics a normal lifestyle free from constant insulin injections, found few takers in India. The reason was the prohibitive cost.

As some doctors said then, each pump cost as much as a small car.

Fast forward to 2009, and for a more health conscious India, especially those associated with the tag 'Gen Next', the insulin pump, a pager-sized device which can be clipped to clothing, is a must have. It actually mimics a healthy human pancreas and delivers programmed rhythmic continuous drips of insulin all day long, through a tube attached to the body.

Additional amounts, if required after meals, can be delivered on request, opines Dr. Vikas Alhuwalia, senior consultant (Diabetes and Metabolism), and President of the New Delhi-based Diabetes Care Foundation of India.

According to Dr. Ahluwalia, insulin pump-based diabetes therapy helps keep blood sugar levels closer to normal than what can be done with one or two injections per day.

As a diabetic, he says the main goal should be to bring blood glucose levels under control in order to increase your chances of a complication-free life. Balancing the day-to-day demands of diabetes with other life demands, he adds, has become very challenging in today's fast track life.

Rather than getting an insulin injection and matching your life to how the insulin is working, an insulin pump matches your insulin to your lifestyle, he emphasizes.

Experts like Dr. Ahluwalia are convinced that insulin pumps enable tighter glucose control than any other insulin delivery method for many diabetes patients.

Maintaining tight blood glucose control is associated with a reduction in the incidence and severity of long-term diabetes complications (such as blindness, impotence, kidney failure, amputation, and heart disease) and lower healthcare costs.

Insulin pumps can also provide better quality of life as compared to traditional injection therapy.

How do insulin pumps work?

Insulin pumps deliver rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. The insulin doses are separated into basal rates, bolus doses to cover carbohydrate in meals, correction or supplemental doses.

Basal insulin keeps your blood glucose levels in range between meals and overnight by delivering insulin continuously over 24 hours. Requirement may be differ at different times of the day and night.

The Bolus dose is an additional insulin dose given for meals to cover the carbohydrate in each meal or snack and if one has high blood sugar (outside target range) before meals. This can be done simply by the use of buttons on the insulin pump. If one eats more than planned, simply program a larger bolus of insulin to cover it

Where to put the pump?

An insulin pump is not bigger than the size of a standard pager and it can be attached to a waistband, pocket, bra, garter belt, sock, or underwear. While sleeping the pump can be kept next to you on the bed or wear it on a waistband, armband, leg band, or clip it to the blanket, sheet, pajamas, stuffed toy, or pillow with a belt clip.

Although insulin pumps are water resistant, caution is advised while taking a bath. The best thing to do is to disconnect it during activities such as swimming, bathing, or showering. However some pumps can be placed on the side of a tub, in a shower caddy, or in a soap tray. Special cases are also available which can be hanged from your neck or from a shower curtain hook.

While exercising or playing sports, you can wear a strong elastic waistband with a pump case or wear it on an armband where it is visible. Women can tape the insulin pump to the front of their sports bra.

Advantages of Using an Insulin Pump

Eliminating multiple daily insulin injections

Insulin pumps are more accurate than injections

Improvement in A1C

Lower chances of large swings in blood glucose levels

Easy dose adjustment - if your glucose level is high or you feel like eating, just increase the insulin dose by pushing the little button on the pump

Provides flexibility with meals

Improves quality of life

Reduces severe hypoglycemic episodes (low blood glucose)

Eliminates unpredictable effects of intermediate- or long-acting insulin Disadvantages of Using an Insulin Pump

May cause weight gain

Can cause diabetic ketoacidosis (DKA) if the catheter comes out and you don't get insulin for hours

Expensive

Can be bothersome since you are attached to the pump most of the time

Can require a hospital stay or maybe a full day in the outpatient center to be trained

There are pluses and minuses to using a pump. Even though using an insulin pump has disadvantages, most pump users agree the advantages outweigh the disadvantages.

For further queries on the above subject, Dr. Vikas Alhuwalia can be reached at the following e-mails: [email protected] or [email protected]. For appointments: Mobile: 9910328390 or landline +91 11 26167893. He can also be contacted at the Diabetes Institute B-4/234, Safdarjang Enclave, New Delhi-29 By Dr. Vikas Ahluwalia (ANI)