Insulin Pump

Insulin Pump

The insulin pump serves as a medical apparatus utilized in delivering insulin for managing diabetes mellitus, a therapy known as continuous subcutaneous insulin infusion. This device comprises:

- The pump itself, encompassing controls, a processing module, and batteries.
- A disposable insulin reservoir housed within the pump.
- A disposable infusion set, consisting of a cannula for subcutaneous insertion and tubing to connect the insulin reservoir to the cannula.

An insulin pump offers an alternative to multiple daily insulin injections via syringe or pen, enabling intensive insulin therapy alongside blood glucose monitoring and carbohydrate counting.

To initiate the use of an insulin pump, the reservoir is initially filled with insulin. While some pumps employ prefilled cartridges, others are filled with insulin prescribed for the user. Setup involves:

1. Preparing a new sterile empty pump reservoir.
2. Withdrawing the plunger.
3. Inserting the needle into an insulin vial.
4. Injecting air into the vial to prevent vacuum formation.
5. Drawing insulin into the reservoir and removing the needle.
6. Removing air bubbles from the reservoir.
7. Attaching the reservoir to the infusion set tubing.
8. Installing the assembly into the pump and priming the tubing.
9. Attaching the infusion site and priming the cannula if necessary.

An insulin pump replaces slow-acting insulin for basal needs with a continuous infusion of rapid-acting insulin. It administers rapid-acting insulin in two ways:

- A bolus dose to cover food intake or correct high blood glucose levels.
- A basal dose delivered continuously at an adjustable rate to meet insulin needs between meals and overnight.

Different bolus shapes can be employed by users to tailor the insulin delivery to their needs. These include:

- Standard bolus: Infuses insulin entirely at the bolus onset, suitable for rapid blood sugar correction.
- Extended bolus: Gradually infuses insulin over time, beneficial for high-fat, high-protein meals.
- Combination bolus: Combines a standard bolus spike with an extended bolus, ideal for high-carb, high-fat meals.
- Super bolus: Increases the standard bolus spike by temporarily halting or reducing the basal insulin delivery.

Users can also optimize bolus timing through pre-bolusing, injecting insulin before meal consumption to prevent post-prandial blood sugar spikes. Basal rates throughout the day can be customized to address individual insulin needs, such as reducing basal at night to prevent hypoglycemia in infants or increasing basal to counteract growth hormone-induced high blood sugar in teenagers.