Olenik 4 Flashcards
which type of insulin do we use for pumps?
rapid acting ONLY
open loop system
1) blood glucose level
2) sensing (finger stick, CGM)
3) insulin delivery
hybrid closed-loop system
1) blood glucose level
2) sensing CGM
3) modulation (control algorithm)
4) insulin delivery
Hybrid closed-loop - “the self driving car”
manual mode
- basal rates are pre-programmed
- bolus for food and correction
- may be used with ot without CGM
Auto mode
- basal is automatically adjusted every 5 min
- bolusing for foos is necessary
- CGM required
Basal Rates
- can be measured as low as 10th or 100th of units
- can create “presets” for different setting
- basal rate can be changes for different times of day
Pump Correction Factors
- can program pump to know paient-specific factors
- attempts to guide to proper range
Glucose Targets
Blood Glucose Targets
- can sugget bolus insuln dosage
- can change goal for different times of day
Carb Ratios
program different setting for different tmes of the day
provides guidenace for bolus dosing
extended bolus interval
Cons of insulin pumps
- cost
- DKA risk
- kinked/clogged tubing
- infusion site falling off
- injection site reactions
- depot of insulin at injection site
- tech not always dependable
- oobtaining supplies
Pros of insulin pumps
- continuous infusion more closely mimics pancreatic function
- decreased risk of hypoglycemia and improved hypoglycemic awareness
- specificity of dosing (diff rates/goals for each pt/situation)
- tech always improving
Who should use pumps?
multiple daily injections
poor glycemic control despite basal-bolus therapy
comfortable self managing insulin dosage
comfortable with technology
maintains regular appointments/checks
financially capable/insured benefit
obtaining supplies
- can be very drawn out process
- each insurance plan varies in procurement processes
- most allow ordering of supplies from pumps manufacturers, then ship it to pt
- some prescription insurance plans cover “patch pumps” example: Omnipod (retail/mailorder)
