General Practice 2022

Insulin pump: how it works and when é indicated

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Insulin pump: how it works and when é indicated
Insulin pump: how it works and when é indicated
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The insulin pump, or insulin infusion pump, is a small computerized device that releases insulin continuously for 24 hours and in very precise doses according to the person's needs, being indicated in cases of diabetes type 1 or type 2, as it works by mimicking the functioning of the pancreas.

Generally, the insulin pump uses fast-acting and/or short-acting insulin, as the pump is programmed to deliver small amounts of insulin throughout the day, continuously to keep blood sugar levels within the normal values.

This device can be used attached to the waist or arm, and connected to the body by a small cannula with a flexible needle in the abdomen and should only be used with indication of the endocrinologist. In addition, its use must be guided by a diabetes nurse or educator.

When is indicated

The insulin pump is indicated for the treatment of type 1 or type 2 diabetes, in cases where the body's production of insulin is not enough to control blood sugar levels.

This way, the insulin pump is indicated in the following situations:

  • Difficulty or forgetting to make insulin injections;
  • Inadequate control of blood glucose levels, even using insulin injections;
  • Broad variations in blood sugar levels during the day;
  • Fasting blood glucose levels above 140 to 160 mg/dL;
  • Difficulty controlling blood glucose at night;
  • Frequent or severe hypoglycemia crises;
  • Need to have a better quality of life;
  • Gestational diabetes;
  • Control of diabetes in women who wish to become pregnant.

This pump allows for better blood glucose control, as it offers a constant flow of insulin, in precise doses, so it is not necessary to use insulin injections during the day, being also a more comfortable option for treatment of diabetes.

How the insulin pump works

The computerized insulin pump has a chamber that delivers insulin continuously for 24 hours through a flexible tube or cannula, with a catheter inserted under the skin of the abdomen. This catheter must be replaced every 2 to 3 days, and in the first few days it is normal to feel a little discomfort in the skin where it was inserted.

The pump is about the size of a cell phone and releases insulin in a continuous and programmed way, as if it were the pancreas, allowing better control of blood sugar. However, even with the use of the pump, it is important to check blood glucose levels during the day, at least 4 times a day, or as directed by the doctor.

Another option is to use a computerized insulin pump with a glucose monitor, in which case the device checks blood sugar levels 24 hours a day and triggers an alarm when glucose levels are too low or very high, based on normal blood glucose levels.

Before starting to use the insulin pump, the person should receive training on how to use the pump by a nurse or diabetes educator.

Possible complications

Some complications may occur while using the insulin pump such as:

  • Hyperglycemia;
  • Hypoglycemia;
  • Diabetic ketoacidosis;
  • Skin infection where the catheter is inserted.

Furthermore, other situations such as pump malfunction, cannula disconnection, or incorrect pump configuration can impair insulin delivery, increasing the risk of complications.Therefore, it is important to receive training before starting to use the insulin pump, in order to ensure its proper functioning to receive the proper dose of insulin.

Where to buy the insulin pump

The insulin pump can be purchased directly from the manufacturer which can be Medtronic, Roche or Accu-Chek.

The insulin infusion pump and materials can be provided by SUS, however, a lawsuit is required with a detailed description of the patient's clinical situation and the need for the use of the pump by the physician and proof of that the patient cannot afford it and maintain monthly treatment.

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