Insulin pump reshaping lives
Megan Feddersen — Staff WriterArticle Photos
FAIRMONT - Managing diabetes is key to living with diabetes. The repercussions of uncontrolled blood-sugar levels are serious - but diabetics today have a tool to help them.
Insulin pumps, when they were first marketed, were the size of a backpack, then they dropped down to shoebox size, and now, they're hardly noticeable. Attached to a person's waistband, the pump might easily be mistaken for any other electronic gadget people carry around with them. It's about as big as pack of cigarettes, or maybe a cell phone.
Robin Arndorfer is a registered nurse and certified diabetes educator in Fairmont Medical Center's healthy living department. She has seen patients with all types of diabetes using insulin pumps, and all ages, from 5 to 95.
Insulin pumps work by mimicking the body's normal functions. For someone who doesn't have diabetes, the pancreas delivers a small amount of insulin (the basal rate) to cover regular body functions, and larger amounts of insulin (the bolus rate) when that person eats.
The insulin pump delivers the basal rate based on calculations to determine how much insulin a diabetic needs to get through the day. Different amounts of basal can be programmed into the pump for different parts of the day. For example, a person might need more insulin in the morning.
The insulin pump doesn't do everything automatically, however. Diabetics have to give themselves a dose of insulin when they eat - but that doesn't involve a shot. The pump has a reservoir of insulin to cover three days of food intake. After that, the reservoir must be refilled.
Unfortunately, insulin pumps don't eliminate needles altogether - but they do cut down from 4 to 6 shots per day - or 120 per month - to about 12 pokes per month. The adhesive patch that secures the cannula - thin, flexible tubing through which the insulin enters the body under the skin - against the abdomen should be replaced every three days. To replace the cannula, the patient pulls off the infusion set (the adhesive patch and cannula) and injects another infusion set. The needle feels no different than a regular injection of insulin. The needle is pulled out, and the cannula remains under the skin, connecting the person to the insulin pump.
"It's just a tool," Arndorfer said, "like a glorified insulin syringe with bells and whistles."
By pushing a button on the insulin pump, a diabetic can look back 24 hours at what their blood-sugar levels have been doing. Regulating the blood-sugar level is essential for correct use of insulin pumps and managing diabetes, and the insulin pump simply makes this easier, especially for people who live active lives and don't want to be slowed down by their diabetes.
"It gives them their life back," Arndorfer said.
People can still maintain their regular routines with the pump, including showering, swimming, sports and yes, sex. The tubing attached to the infusion set to the insulin pump can easily be removed and attached, without re-inserting the cannula.
Insulin pumps aren't for everyone, but 99 percent of the people using the technology will not give their pumps back, Arndorfer estimated.
"I wish they'd find a cure," she said. "Put me out of business - that would be fine. But diabetes isn't going away, so we need to learn to better manage it."
Diabetes is a progressive disease that becomes more challenging to control over time.
"People may need to do more with activity, nutrition and medications. And pump therapy is one way to help them manage and have better control," she said.
Without maintaining consistent control, complications can gradually develop. Elevated glucose levels can damage the heart, kidneys, nerves and small blood vessels in the eyes.
Arndorfer described glucose as a sticky substance in the blood. Higher glucose levels stick in the blood vessels, and then "things don't flow as well as they should."
When this happens to the blood vessels at the back of the eye, pressure builds and, over time, the vessels can't withstand that pressure and they burst. To a certain extent, the same thing can happen elsewhere in the body, like the heart and the brain, causing cardiac arrest and strokes.
"Insulin should be your best friend," Arndorfer said.
Besides insulin, Arndorfer encourages diabetics to eat healthy foods - allowing the occasional treat - and balance their diet with activity, which lowers blood-sugar levels.
But she doesn't beat up on patients who don't follow her suggestions, and she absolutely never uses the word "noncompliant" in her office. She figures anyone asked to conform to a 1,200-calorie diet and exercise 30 minutes three times per day would struggle from time to time.
"Diabetes is very challenging emotionally," she said. "There are ups and downs with diabetes. Do they always live the way they should? No ... but I hope to provide tools to get them back on track."
"I try to look at the person for who they are and how I can help them as a whole person. There is no perfect, and I'm not out for perfect. I'm out for improvement."
