Practical Benefits: Pump Basal Aspects continued

This curve of action means that it is difficult to meet an individual’s basal needs across the full day there are likely to be times insulin delivery is either too high resulting in hypoglycemia, or too low resulting in hyperglycemia. Insulin pump therapy allows for this curve to be precisely aligned to the individual’s needs.

Potential Problems:   •Too much in middle of the night?   •Too little late in the day?   • General Inconsistency

One way to improve stability with injected insulin is to go to a multiple shot a day model, however this is still not an ideal fix and the likelihood of compliance is reduced and the burden on the user is increased.

•Too much in middle of the night?   •Midday peak requires consistent mealtimes   •Poor coverage of post-lunch peak   •General Inconsistency

Long lasting insulins have the benefit of fewer injections but do not have the ability to meet the needs of those with times of marked increase in liver glucose output and a single dose may not last the same duration for everyone, leaving gaps in coverage.

• Failure to offset dawn phenomenon   • Too much in middle of  the day?   • 1 shot may not last full 24 hrs

Pump therapy is the best way to most precisely meet a patient’s basal insulin needs over the full day and night with minimal burden on the patient. This provides the most stability and consistency for the patient.

Basal insulin can be matched to the body's daily needs.

This stability has many benefits.

 

Stable blood glucose between meals and overnight

 

This means the patient can:

Skip/delay meals without dropping

Vary sleep and work schedules

They will have fewer issues with travel/time zone changes

They can correct for dawn effect

No long-acting insulins (more consistent insulin action)

Immediate, temporary basal adjustments possible 

There are many obvious practical benefits to insulin pump therapy including:

The patient can dose very precisely (.1 or .05 units),

It's more convenient because they can give insulin anytime, anywhere.

“Unused Insulin” adjustment prevents the stacking of boluses, and

The rate of delivery can be extended.

Additionally, the insulin delivery history is stored in the pump.

One needle stick every 3 days (approximately),

And the pumps have a built-in bolus calculator.