160 likes | 282 Vues
This guide provides essential insights into the use of insulin pumps for individuals living with diabetes. It covers the basics of insulin pump therapy, including its definition, advantages such as lifestyle flexibility and improved glucose control, and disadvantages like infection risks and costs. It also details the available insulin pumps in Canada and outlines the process to obtain one through a doctor's referral and eligibility criteria for funding under the Ontario Assistive Devices Program. Empower yourself with knowledge about managing diabetes effectively!
E N D
TALK DIABETES 2015 November 13, 2015 Pumping Insulin 101 Bonnie Stone-Hope RN, CDE, BA
Objectives What is an insulin pump? Why choose an insulin pump? What are disadvantages of pump therapy? Which insulin pumps are available in Canada? Process to obtain an insulin pump. Assistive Devices Program in Ontario.
What is an Insulin Pump? - Medical device used by people with diabetes • Offers an alternative to MDI • Worn externally, delivers a continuous amount of rapid insulin 24 hours a day. • 3 components- pump, reservoir, and infusion set 1) pump has a battery and controls 2) reservoir (cartridge) holds insulin 3) infusion set, thin tube in skin
Pump delivers 2 types of insulin doses: - Basal insulin delivered continuously over 24 hours to keep blood glucose levels stable between meals. - Bolus insulin doses delivered by a push of a button on the pump, when eating or to correct high blood glucose levels.
Example of pump start orders • Start insulin pump with basal rate of 0.7 units per hour • Carbohydrate ratio of 15 grams for all meals • Insulin sensitivity of 1 units of insulin drops 2.5 mmol/L. • Insulin on board = 4 hours • Blood glucose target is 5.0 to 7.0 mmol/L.
Why choose an insulin pump? - Increased flexibility in lifestyle - Predictable insulin delivery - Precise insulin delivery - Tight blood glucose control - Reduce risk of severe hypoglycemia - Help manage “dawn phenomenon”
Disadvantages of Pump Therapy - Increased risk of skin infections - Risk of DKA (diabetic ketoacidosis) due to pump malfunction or absorption problems - Cost of supplies - Checking blood glucose at least 4 x daily
Pumps available in Canada In alphabetical order: Animas Ping Insulin Pump Animas Vibe Insulin Pump Omnipod Insulin Pump (GSK) Medtronic Veo Insulin Pump
Process to obtain a Pump • Family physician sends referral to specialist • Client assessed, if pump is a good option, pump orders written - DEMC at HDH for a pre-pump appointment • Client attends CHO-counting class, followed by 1:1 with RD • 3 hour appointment to start on pump therapy • Daily contact to make pump adjustments
Assistive Devices Program Criteria for funding: • Type 1 diabetes unable to achieve good blood glucose control with MDI • Commitment to ongoing blood glucose monitoring • Must attend diabetes education program registered with ADP
Assistive Devices Program • Funding of pump is 100% total cost of pump • Annual grant of $2400 per year to help cover cost of supplies • Paid to recipient in 4 cheques of $600 every 3 months • Renewal form sent every year, to be signed by specialist