Growth HormOne Research SocietyLecture by Dr. (Prof.) I. P. S. Kochar
Paediatric & Adolescent Endocrinologist & Diabetologist

Insulin Pump Therapy

When a person has diabetes, it is best to take insulin as close to the way the pancreas delivers it as possible. An insulin pump comes closer to delivering insulin the way a pancreas does than any other delivery method. Insulin pump therapy is considered the "gold standard" in diabetes management because it provides the best glucose control. There are two basic reasons pump therapy provides better control:

1) The pump only uses rapid-acting insulin (U100).
2) The pump delivers rapid-acting insulin similar to the way the human pancreas delivers insulin. It delivers both basal and bolus insulin in very precise amounts.
An insulin pump delivers basal and bolus insulin similar to a pancreas

Basal Insulin

The pump delivers small amounts of basal insulin 24 hours a day. Basal insulin covers your insulin needs between meals and through the night. The amount of basal insulin the pump delivers can be adjusted to match your body's varying insulin requirements throughout the day. For example, if you need less basal insulin during the night than during the day or more insulin during the early morning hours than the afternoon, your pump can be programmed to deliver basal insulin at different rates and times to match your needs. Once basal rates are set, the pump will continue to deliver the same basal rate profile every day until you program it to deliver different basal rates.

The pump delivers basal insulin 24 hours a day, and can be programmed to match your body's insulin needs.

Bolus Insulin

The pump can also deliver boluses (large single doses) of insulin. A bolus is given when you eat food that contains carbohydrate, or when you have a high blood glucose (BG) level. You control the amount and time each bolus is given. The amount of each bolus is determined by your current BG reading, the number of grams of carbohydrate you plan to eat, and other settings (such as your target glucose range) that are programmed into your pump. (You will learn more about programming your personal pump settings later.) Once your settings are programmed, all you will need to do is enter your BG reading and the amount of food you are planning to eat. Your pump will calculate and recommend the amount of bolus insulin to deliver. If you agree with the suggested bolus amount, simply confirm the bolus recommendation by pressing the activate button on the pump. Once the bolus is confirmed, the pump delivers the bolus of insulin rapid-acting insulin which provides improved glucose control not possible with injections. This improved control occurs because the pump delivers tiny amounts of rapid-acting insulin each hour. Rapid-acting insulin is reliable and consistent in the way it is absorbed and used by your body. Basal insulin is programmed to match your body's hourly insulin needs, and can easily be adjusted.

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