Modern science makes every effort to make life easier for diabetics. If a few years ago each patient had to carry a syringe, then a device has already been developed that greatly simplifies the procedure for administering the hormone. Modern devices, called insulin pumps, are aimed at improving people's lives, moreover, they allow you to constantly monitor blood sugar and prevent the development of complications associated with the disease.
Device purpose
Modern devices are significantly different from those that were at the dawn of the creation of automated insulin pumps. Although the principle of their work remained the same. The insulin pump is designed to replace the insulin pens, which are a constant companion of people with diabetes. Before the appearance and distribution of this device, patients were forced to inject themselves insulin several times a day to maintain life. And the devices can be programmed by indicating the mode of insulin delivery and the required dosage. Moreover, depending on daily activity, you can set several options for the intake of the hormone in the body, choosing a dosage for individual needs.
Constant use of the pump allows you to lead a familiar lifestyle. The device, according to the programmed values, will itself enter the necessary dose of the hormone. Eating also does not cause any inconvenience, just press the special button on the device, and an additional amount of insulin will be injected under the skin.
Pump structure
Regardless of the manufacturer or the price of the device, all devices are similar. They consist of the following components:
- directly an insulin pump, which includes a mechanism for managing and processing information, batteries;
- a container for insulin, which is located inside the device;
- interchangeable set, it consists of a system of connecting tubes and cannula, through which the subcutaneous administration of the hormone is carried out.
The disadvantages of intensified therapy
The action of the pump is aimed at maximally replacing the pancreas. Previously, with intensified therapy, a person needed multiple injections of insulin, which they tried to imitate the natural mode of the body. In this case, the patient was injected with two types of hormone: ultrashort and prolonged action. The second type of insulin injection needed to be done twice a day (usually in the morning and evening). But the first type of this hormone was introduced when the need for it in the body increased, for example, when eating. Extra injections of ultrashort insulin are called a bolus. So, daily for a patient with diabetes it is necessary to do 2 injections of the hormone of prolonged action and at least 3 - short. But even such a regimen is not able to imitate the work of the pancreas, so patients are constantly faced with nocturnal hypoclycemia and with an increase in sugar in the morning.
The mechanism of action of the device
The automated administration of the hormone helps to get rid of the mass of associated problems. An insulin pump is designed to administer ultrashort insulin in small doses, which maximally simulates the body's natural functioning. Moreover, the volumes and frequency of administration are selected strictly individually depending on the needs of each individual person. That is, as much hormone enters the body as it needs at this moment. For this, an insulin pump is needed. Reviews of patients with diabetes note that their life improved with the beginning of using this device.
The principle of operation of the device is as follows. Inside the pump is a reservoir of insulin. It is connected using tubes to the cannula (plastic needle), which is inserted into the subcutaneous fat in the abdomen. A special piston with a set speed presses on the bottom of the tank, ensuring uninterrupted supply of the hormone. But, in addition to this, each insulin pump provides for the possibility of a bolus of insulin, which is necessary during meals. To do this, just press the special button.
Expendable materials
An automated device for injecting insulin can significantly simplify the life of diabetics. But at the same time, do not forget that its use is associated with a number of problems. The most important of them is the need to constantly purchase supplies for an insulin pump. These include:
- the reservoir in which the insulin is located;
- a cannula that is inserted under the skin;
- a catheter connecting the apparatus and the needle.
If the device is equipped with an additional function for controlling the glucose level, then the sensor, with which the sugar concentration is determined, is also a replacement material.
Indications for use of the pump
Removing reusable insulin injections from everyday life is the dream of every diabetic. Currently, almost every patient can buy an insulin pump. The reviews of many people who use these devices indicate that they do not mind the money spent.
So, it is better to purchase a pump for people who play sports, have a fairly active lifestyle, and for those who want to hide their illness from others. Also, such insulin therapy is preferable for children and adolescents, for women who plan to become a mother, and for those people who have diabetes complications. You can talk about the mandatory use of the pump in cases where frequent hypoglycemia is observed, and the morning syndrome with sharp jumps in sugar level is pronounced.
Cons of using the device
Before deciding to purchase this expensive device, it must be taken into account that it also has a number of shortcomings and contraindications for use. So, the main disadvantage is the price of pumps and supplies for them. The operation of the device costs patients 6-7 thousand per month. If a diabetic decides to purchase a device that independently controls the level of glucose, then the cost of its monthly use will increase by 2-3 times.
But even if the patient can afford an insulin pump, do not forget about a number of contraindications. These include a clear decrease in visual acuity, up to blindness, a decrease in the intellectual level and existing allergic or inflammatory processes localized in the abdomen.
Pumps for children
Unfortunately, often the first type of diabetes begins to manifest itself in childhood. To make life easier for the baby, parents decide to replace the regular injection of insulin with a pump. But when choosing this device for a child, it is necessary to take into account a number of features. So, before buying, you need to pay attention to how fast insulin is delivered. If the child has a small daily dose, then it is better to pay attention to devices that can provide 0.025 or 0.05 units of the hormone every hour. For adolescents with a high need for insulin, it is better to choose devices with a large reservoir. It is also important that the pump is equipped with a signal that sounds when a bolus dose is skipped when eating.
For example, Medtronic has developed the Veo insulin pump for children. The compact size, ease of operation, constant monitoring of glucose levels and signals when it changes allow parents to monitor the condition of their babies. Also, the device will not allow you to miss the next bolus dose when eating, it will notify you of the rate of change in sugar concentration. But no matter what the device was purchased, it is necessary to control children of any age. Parents should carefully monitor the condition of the child and do not forget that the cannula is gradually clogged, and insulin ceases to flow in the right volumes. It is also important to monitor the battery level on the pump.
In addition, you need to choose the right supplies. For example, shorter needles are used for children, the length of the catheter is also selected individually.
How is the device used
If you decide and bought an automated device for administering insulin, then first of all, you need to figure out how the purchased insulin pump works. Installing it is as follows.
- Take out the insulin reservoir and remove the piston.
- The needle is inserted into the ampoule with the hormone, air is also let into it from the container for insulin. This must be done in order to prevent the formation of a vacuum during the collection of drugs.
- Using a piston, the hormone is pumped into the reservoir, after which the needle is removed. Air bubbles formed in the container must be squeezed out.
- The reservoir is attached to the catheter and inserted into the designated place in the pump. After that, it is necessary to drive insulin through the system tube and remove the remaining air. This is done before the catheter joins the cannula to avoid excessive insulin entering the body.
- The collection of the device is completed by connecting the needle to the system.
In addition to changing the reservoir, each patient should know how often it is necessary to change the cannula. This is done at least once every 4 days, regardless of which particular insulin pump is installed. Medtronic, for example, recommends changing the cannulas more often, because they can clog. With them, it is necessary to change the set for infusions: a needle and a catheter. But the tank can last up to 10 days.
Well-known manufacturers
Currently, in Russia there is not too much choice of devices that provide automated insulin input. Free access on the market are insulin pumps Medtronic and Accu-Chek. They have representative offices in Russia, so diabetics will not have problems with the acquisition of the necessary supplies.
The cheapest insulin pump Medtronic will cost the patient more than 80 thousand rubles. It will allow you to enter the hormone at a minimum rate of 0.05 units. in hour. But this manufacturer also offers more expensive options. They themselves are able to control the concentration of sugar, monitor changes in its level and warn of danger in case of an increase or decrease in its level. In addition, the device itself can recall the need for a bolus dose of the hormone during meals.
Accu-Chek (Roche) insulin pumps will cost a little cheaper, the most affordable option costs about 60 thousand rubles. This device uses 3 ml insulin penfill, not a reservoir. It also reduces operating costs. In addition, Roche has launched a fully waterproof pump equipped with a 315 hormone volume tank.
Development "Medtronic"
The leading American company Medtronic created the Paradigm insulin pump. The developed device allows you to bring treatment to a higher level. This is ensured due to the fact that glucose levels are always displayed in real time on the pump screen, they change every 5 minutes. This became possible after the development of a special sensor, which is attached in the same way as a cannula, and using radio frequency technology transmits data to the pump.
If sugar concentration changes, the 722 insulin pump will notify you with a special signal. This allows you to avoid hypo- or hyperglycemia by timely adjusting the level of insulin delivery. The most important drawback is the cost of this device, the price for it is 130 thousand rubles, and the most recent option costs almost 200 thousand. Consumables are also expensive, because the sensor and infusion set must be changed after 3-5 days.