Insulin pumps offer more freedom for diabetes patients

Children and young adults who are diabetic need insulin to ensure good glucose control. But more than anything else, they need the freedom to do things that other children do school and at playfields. We guide you and your loved ones on how to best use insulin pumps with sensor to optimally manage the diabetics’ conditions. 

Ultimately, it is the patient that has to manage his or her condition on a daily basis. That is why we do our best to educate and inform our patients and their families, while offering excellent care that has proven to provide tight control over sugar levels.

Most of the patients at Diabeter use an insulin pump. The reason for this choice is that the pump offers more freedom in regulating diabetes. An insulin pump is a small wearable device that continuously administers ultra-short working insulin.

Better diabetes regulation

This insulin enters the body from the pump through a Teflon hose (insulin catheter). The system has to be replaced every two to three days. The pump can be programmed in advance and gives a small dose of insulin every hour. This is enough to meet the basic insulin need of the body. But with the push of a button it is also possible at any moment to add an extra amount of insulin. This is called a bolus. You’ll do this with a meal for instance, or to correct high blood glucose levels. The dosage of this extra insulin is done with a built-in computer (bolus calculator or wizard) which provides for a very precise regulation. While the extra insulin is calculated automatically, you administer the bolus yourself. We have learned that a successful pump treatment not only requires six to eight (sometimes more) measurements per day, but that you also – apart from the boluses for the three head-meals and the snacks per day – you add “correction boluses”. This means you will give a bolus treatment about seven times per day. The advantage of this intensive treatment is that for most people it leads to a better regulation and more freedom.

Why pump therapy?

People with type I diabetes can choose for a pump for a number of reasons. In most cases, they are not satisfied with the results of their pen treatment or the high amount of injecting puts a strain on them. In a lot of cases they have levels that are in the night (hypoglycemia), too high at the time of getting out of bed and a suboptimal regulation (high HbA1c) or strong fluctuations in their blood glucose levels.

Choosing for pump therapy is always a joint decision. The child, the parents and the medical team of Diabeter all have to stand behind it. Pump therapy is an intensive kind of treatment, demanding a different kind of diabetes regulation. Before somebody starts with pump therapy, schooling is needed. It calls for insight in how the blood glucose level is influenced and knowledge about the amount of carbo-hydrates in the food. Therefore both the child and the parents must be willing to invest a lot of time in getting to know the pump and learning how to use it. In a very young child, the role of the parents is extra important. In this case, a solution must also be found for operating the pump if the parents are not present, for instance during school hours.

Most of the time we see that people with an insulin pump are better able to regulate their blood glucose levels and have less fluctuations.

Training to avoid problems

Sometimes problems arise with the hose system, causing the insulin flow to stop. Then the glucose gets higher and it won’t take long before the patient notices this. In this case, direct action is needed to avoid further disorder (DKA: diabetic ketoacidose). This is easily avoided by regularly replacing the catheter (every two three days), measuring the blood ketones and direct telephone consultation if the glucose level doesn’t drop. This is all part of the training. Eventually, after a proper training and with correct use of the pump, people who use a pump are less often committed to hospital and have less disorders.

Regulating bij looking ahead

With a pump you get a better eye for trends to advance your regulation instead of just reacting to high and low levels. Regulating by looking ahead. We do this together, by reading the information the pump provides and with the use of Ther@piemail. Ultimately in most cases a monthly upload is advisable, but there will always be moments when this needs to be done several times a week or even daily.

Once you have insight in how the pump works and you are willing and motivated in using it, the insulin pump is a very good way of treatment for almost everybody with diabetes.