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Insulin Pump
From Wikipedia, the free encyclopedia
An insulin pump is a device used for administering insulin in the treatment of diabetes
mellitus.
The device consists principally of three parts :
• the pump itself including controls, processing module, and batteries
• delivery tube to carry the insulin
• needle or more commonly a catheter inserted into the body subcutaneously
The insulin pump delivers a single type of fast-acting insulin in two ways :
• a basal (small) dose that is delivered constantly
• a bolus dose that is delivered before meals mostly for adults, after mostly for
children, or to correct high blood glucose (also known as blood sugar) levels
Because a single type of insulin is used, it is easier to determine the effect of a given
dose by looking at the delivery profile of that insulin. Insulin pumps also make it
possible to deliver much smaller amounts of insulin than can be injected using a
syringe, and to deliver boluses of insulin more frequently than is tenable via a
syringe. This provides tighter control over blood sugar and Hemoglobin A1c levels,
reducing the chance of long-term complications associated with diabetes.
Insulin pumps are used in tandem with a glucose meter (or "glucometer"), a separate
device that determines an individual's blood sugar level via a small drop of blood,
usually obtained via a lancet device on the fingertip, hand, arm, or other areas. The
glucometer can be completely independent (in brand and technology) from the
pump, or can be part of an integrated system, such as more recent versions of the
Minimed Paradigm, which allows for radio frequency (RF) communication from the
glucometer to the pump. The Cozmo Pump, made by Smith's Medical, works with
the Cozmonitor, a device made by Freestyle, attached to the back of the pump. The
pump receives glucose readings from this attached meter via infrared (IR). This
saves the user the trouble of inputing blood glucose readings into the pump, and
aides in the ease of determining the size of a bolus.
The amount of insulin delivered for a bolus is determined by the blood sugar level
and the grams of carbohydrates consumed. In all cases, delivery rates are
determined by the user in consultation with his endocrinologist. Currently there is no
means to automatically control the insulin delivery based on the blood glucose level
of the user. However, several manufacturers of pumps, including Medtronic
(Paradigm, Minimed), and Roche Diagnostics (Disetronic H-Tron and D-Tron) are
testing the concept of a closed-loop system but even if the concept is as promising
as it appears there remains the legal problem of what happens if the system is
incorrect. For example, continuous blood glucose monitoring technology can report
very wide variances of blood glucose. Using the non-US measuring system of
mmol/l (multiply by 18 to get mg/dL glucose readings used in U.S)a closed-system
that detects glucose of say, 15 mmol/l (270mg/dL) might dispense 10u of fast acting
insulin. If the patient has an actual glucose of 6 mmol/l (108 mg/dL) (within the
accepted glycaemic range), those 10 units of insulin could very quickly lead to
hypoglycaemic coma which if not recognised and treated can kill very quickly.
There is a lot more research to do on CBGM technology but the first closed-loop
systems may be made available for clinical trials by mid-2006.
Use of insulin pumps is increasing as it provides an easier means to deliver multiple
insulin injections for those using intensive insulin therapy. It's also interesting to note
that because of differences in health insurance and public funding, the US has about
150,000 pump users. In the UK, NICE have now ruled that if a diabetic patient's
doctor agrees that they should be using an insulin pump, they should apply to the
NHS and they will fund it. Therefore numbers are increasing but are still less than
the USA, there are around 1100 pump users in the UK by comparison.
"Closed loop" insulin pumps--whereby a continuous glucose monitoring system
(essentially an implanted glucometer) works in tandem with the insulin pump to
constantly monitor, dose, and control blood sugar levels--are currently in the testing
phase, and are not in wide distribution. However, some manufacturers are
introducing new devices that more fully integrate glucometers and pumps, such as
the Minimed Paradigm Real-Time pump, which comprises a glucometer that
measures interstitial blood sugar that communicates via RF with the pump to provide
a constant (updated every five minutes) real-time readout of blood sugar levels. This
is a significant advance over the separate-device approach, in which users test blood
sugar on average only four to six times a day. Minimed recommends, however, that
users still compare the results of the Real-Time system with an external glucometer
to confirm accuracy before dosing. As such, while this is one step closer to an
"artificial pancreas," it is not truly a closed-loop system.
References
• Diabetes Care Group blog on insulin pumps
• American Diabetes Association guide to insulin pumps
• Medicine.net guide for insulin pumps
• Review of Standard and New Features of Insulin Pumps
• Links for Seminars discussing diabetes issues and insulin pumps
• A pump users' support group
Click Here to Keep Learning about Insulin Pumps
download music online, dawn part.
From Wikipedia, the free encyclopedia
An insulin pump is a device used for administering insulin in the treatment of diabetes
mellitus.
The device consists principally of three parts :
• the pump itself including controls, processing module, and batteries
• delivery tube to carry the insulin
• needle or more commonly a catheter inserted into the body subcutaneously
The insulin pump delivers a single type of fast-acting insulin in two ways :
• a basal (small) dose that is delivered constantly
• a bolus dose that is delivered before meals mostly for adults, after mostly for
children, or to correct high blood glucose (also known as blood sugar) levels
Because a single type of insulin is used, it is easier to determine the effect of a given
dose by looking at the delivery profile of that insulin. Insulin pumps also make it
possible to deliver much smaller amounts of insulin than can be injected using a
syringe, and to deliver boluses of insulin more frequently than is tenable via a
syringe. This provides tighter control over blood sugar and Hemoglobin A1c levels,
reducing the chance of long-term complications associated with diabetes.
Insulin pumps are used in tandem with a glucose meter (or "glucometer"), a separate
device that determines an individual's blood sugar level via a small drop of blood,
usually obtained via a lancet device on the fingertip, hand, arm, or other areas. The
glucometer can be completely independent (in brand and technology) from the
pump, or can be part of an integrated system, such as more recent versions of the
Minimed Paradigm, which allows for radio frequency (RF) communication from the
glucometer to the pump. The Cozmo Pump, made by Smith's Medical, works with
the Cozmonitor, a device made by Freestyle, attached to the back of the pump. The
pump receives glucose readings from this attached meter via infrared (IR). This
saves the user the trouble of inputing blood glucose readings into the pump, and
aides in the ease of determining the size of a bolus.
The amount of insulin delivered for a bolus is determined by the blood sugar level
and the grams of carbohydrates consumed. In all cases, delivery rates are
determined by the user in consultation with his endocrinologist. Currently there is no
means to automatically control the insulin delivery based on the blood glucose level
of the user. However, several manufacturers of pumps, including Medtronic
(Paradigm, Minimed), and Roche Diagnostics (Disetronic H-Tron and D-Tron) are
testing the concept of a closed-loop system but even if the concept is as promising
as it appears there remains the legal problem of what happens if the system is
incorrect. For example, continuous blood glucose monitoring technology can report
very wide variances of blood glucose. Using the non-US measuring system of
mmol/l (multiply by 18 to get mg/dL glucose readings used in U.S)a closed-system
that detects glucose of say, 15 mmol/l (270mg/dL) might dispense 10u of fast acting
insulin. If the patient has an actual glucose of 6 mmol/l (108 mg/dL) (within the
accepted glycaemic range), those 10 units of insulin could very quickly lead to
hypoglycaemic coma which if not recognised and treated can kill very quickly.
There is a lot more research to do on CBGM technology but the first closed-loop
systems may be made available for clinical trials by mid-2006.
Use of insulin pumps is increasing as it provides an easier means to deliver multiple
insulin injections for those using intensive insulin therapy. It's also interesting to note
that because of differences in health insurance and public funding, the US has about
150,000 pump users. In the UK, NICE have now ruled that if a diabetic patient's
doctor agrees that they should be using an insulin pump, they should apply to the
NHS and they will fund it. Therefore numbers are increasing but are still less than
the USA, there are around 1100 pump users in the UK by comparison.
"Closed loop" insulin pumps--whereby a continuous glucose monitoring system
(essentially an implanted glucometer) works in tandem with the insulin pump to
constantly monitor, dose, and control blood sugar levels--are currently in the testing
phase, and are not in wide distribution. However, some manufacturers are
introducing new devices that more fully integrate glucometers and pumps, such as
the Minimed Paradigm Real-Time pump, which comprises a glucometer that
measures interstitial blood sugar that communicates via RF with the pump to provide
a constant (updated every five minutes) real-time readout of blood sugar levels. This
is a significant advance over the separate-device approach, in which users test blood
sugar on average only four to six times a day. Minimed recommends, however, that
users still compare the results of the Real-Time system with an external glucometer
to confirm accuracy before dosing. As such, while this is one step closer to an
"artificial pancreas," it is not truly a closed-loop system.
References
• Diabetes Care Group blog on insulin pumps
• American Diabetes Association guide to insulin pumps
• Medicine.net guide for insulin pumps
• Review of Standard and New Features of Insulin Pumps
• Links for Seminars discussing diabetes issues and insulin pumps
• A pump users' support group
Click Here to Keep Learning about Insulin Pumps
download music online, dawn part.
All text is available under the terms of the GNU Free Documentation License (see Copyrights for details).
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