Common Questions
Q1. Why should I recommend pump therapy over multiple daily injections (MDI)?
The DCCT concluded that intensive insulin therapy, insulin pumps and MDI resulted in a decreased risk of developing long-term diabetes complications. However, MDI presents problems involving long-acting insulin's variability of absorption and lack of specificity, as well as the inconvenience of giving multiple injections.
Insulin pumps result in a more consistent blood glucose profile by allowing flexibility in meal time and size. Users experience fewer and less severe hypoglycemic episodes and have specific control over exercise responses. The insulin pump helps to control dawn phenomenon and schedule variability. They get precise and consistent insulin delivery, and control over their own therapy. Thus, pump therapy results in improved A1c values, diabetes management compliance, and improved quality of life.
Q2. How do I determine if a patient is a good pump candidate?
There are several important criteria to consider when recommending pump therapy. Patients should be highly motivated, responsible, and intellectually capable of operating basic pump functions. Pump therapy requires a minimum of four blood glucose tests per day, carbohydrate counting skills, and economic means of purchasing the required supplies.
The ideal candidates are those patients who are already practicing intensive insulin therapy with multiple injections and who have a solid grasp of how to make insulin adjustments for food and activity.
In addition, the most critical factor to consider is whether or not the patient has realistic expectations of what a pump can do for them. Those who think it will manage their diabetes for them, tend not to optimize the therapy.