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I have wanted to write about the insulin pump that I have been using. So, here is a brief review on the Paradigm Insulin Pump.

I have been on pump therapy since September 2006 and it is just fantastic. I do not know how I lived without it all these years.

This article is to make the lives of many Type 1 Diabetics worth living.

Okay, hope this piece of information is useful to everybody.

Before I start, I would like to introduce you to a few key terms

1. BG (Blood Glucose) Target

Keeping your BG targets within range is very important to help you get along with your diabetes problem.

2. Basal Rate

Basal Rate or Background Insulin is needed to maintain your target BG values when you are not eating. You could say that it is a background insulin to keep your sugars within your BG target range when you are not eating.

3. Bolus

Bolus is the dose of insulin “on demand”. Bolus may be used as a Meal Bolus or a Correction Bolus. Meal Bolus is for increasing or decreasing your “on demand” insulin based on the foods you choose to eat. Correction Bolus may be used to lower an elevated BG.

Now that you have been introduced to these three key terms, I shall begin…

Theory of Insulin Pump Therapy

Insulin pumps deliver insulin closer to the way the human pancreas delivers insulin than any other method of treating diabetes.

All people, with or without diabetes, need background insulin for normal functions of the body without food. They also need a dose of insulin “on demand” when food is eaten. People without diabetes can trust that their pancreas will produce this insulin for them. People with diabetes need to take insulin in a way that is most like the way a pancreas produces it.

Most people with diabetes who take more than one daily injection, use long-acting insulin. This takes care of their background insulin needs. They take fast-acting insulin for food. When using an insulin pump, only fast-acting insulin is used. You control when and at what rate your insulin is delivered.

Since the pump uses only fast-acting insulin, you will no more need to follow as rigid a schedule as you did before. There is no long-acting insulin telling you when you should eat or when you will need more insulin.

Insulin Pump therapy is really exciting because not only can your blood glucose be easier to manage, your lifestyle can be easier too.

The Insulin Pump has two types of insulin delivering techniques:

1. Basal rate: The specified dosage is administered to the body through out the day and night.
2. Meal bolus: this is the ‘on demand’ insulin.

Advantages

1. The main reason to have a pump is to have complete control on your sugar level on a continuous basis.
2. The frequency of Hypoglycemia (low Blood Glucose level) and Hyperglycemia (high Blood Glucose level) will come down drastically by using the insulin pump as per directions.
3. BG level is easier to manage
4. Better lifestyle

Disadvantages

Insulin Pump does have a few drawbacks.

1. Slightly longer learning curve
2. Equipment is more expensive
3. As it is electronics, it needs better care

I am using Paradigm Insulin Pump Model 715 from Medtronic Minimed. This is the most well known and highly respected brand for Insulin Pumps.

Different Types of Bolus

The different types of bolus available for different kinds of meals:

1. Normal Bolus

This is for a meal rich in carbohydrates.

2. Square-Wave Bolus

This Bolus is used when you have a very oily and fatty meal. What this exactly does is that it pumps in the insulin over a period of time specified by the user.

3. Dual-Wave Bolus

This is a combination of Square-Wave and Normal Bolus. The pump first asks the user how he/she wants to split the insulin for Square-Wave and Normal Bolus. And then it executes the Normal Bolus first and then the Square-Wave over the specified time period.

4. Easy Bolus

This is a feature which has a maximum capacity to deliver 2 units of insulin. The user just has to press the ‘UP ARROW’ key and press the ‘ACT’ button.

BG Reminder

This is a very smart feature of this pump. It signals the user to check his/her blood sugar at the specified time that the user inputs.

If you are new to Pump therapy, you will need the following data from your healthcare professional. Get this information before going to your pump start appointment. If you are unsure, contact your healthcare professional or pump trainer for guidance.

1. Basal Rate

Basal insulin is needed to maintain your target glucose values when you are not eating. Your pump allows up to 48 basal rates to be programmed. Your healthcare professional may only have you program one or two basal rates when you start pump therapy.

2. Meal Bolus

Deliver a meal bolus before eating carbohydrates. Your insulin to carbohydrate ratio is the amount of insulin required to cover a given number of carbohydrates or exchanges. This ratio gives you an idea of how much of an insulin bolus you should take when eating carbohydrates.

3. Gram Counting

1.0 unit of insulin for __________ grams of carbohydrate

4. Exchange Counting

___________ units of insulin for each carbohydrate exchange

5. BG Targets

Keeping your BG within target range is key to living well with diabetes. Your healthcare professional should help you decide these targets.

6. Insulin Sensitivity

Insulin sensitivity is used to decide a correction bolus for a high BG. This is how much your blood glucose will be dropped with 1 unit of insulin.

1 unit of insulin will lower BG __________ mmol/L.

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