Insulin pump - installation, types, application

Modern science makes every effort to facilitate the life of diabetics. If a few years ago, every patient had to carry a syringe with him, now a device has already been developed that greatly simplifies the procedure for administering the hormone. Modern devices, called insulin pumps, are aimed at improving people's lives, moreover, they allow for constant monitoring of blood sugar and prevent the development of complications associated with the disease.

Intended use of the device

Modern instruments differ significantly from those that were at the dawn of the creation of automated insulin pumps. Although the principle of their work remained the same. The insulin pump is designed to replace insulin pens, which are a constant companion to people suffering from diabetes. Before the emergence and spread of this device, patients were forced several times a day to inject themselves with insulin to maintain life. And the devices can be programmed, indicating the mode of insulin delivery and the necessary dosage. Moreover, depending on the daily activity, you can specify several options for entering the body of the hormone, selecting the dosage for individual needs.

Continuous use of the pump allows you to lead a familiar lifestyle. The device, according to the programmed values, will itself introduce the necessary dose of the hormone. Food intake also does not cause any inconvenience, it is enough to press a special button on the device, and additional amount of insulin will be injected under the skin.

Structure of the pump

Regardless of the manufacturer and the price of the device, all the devices are similar. They consist of such components:

• Directly insulin pump, which includes a mechanism for control and information processing, batteries;
• The capacity for insulin, which is inside the device;
• A replacement set, it consists of a system of connecting tubes and a cannula, through which the subcutaneous administration of the hormone is carried out.

Disadvantages of intensified therapy

The action of the pump is aimed at replacing the pancreas as much as possible. Previously, with intensified therapy, a person needed multiple injections of insulin, which they tried to imitate the natural mode of the organism. In this case, the patient was administered two types of hormones: ultrashort and prolonged action. Insulin injections of the second type had to be done twice a day (usually in the morning and in the evening). But the first kind of this hormone was introduced when the need for it in the body increased, for example, when eating. Additional injections of ultrashort insulin are called a bolus. So, every day a diabetic patient needs to do 2 injections of the hormone of prolonged action and at least 3 - short. But even this regime is not able to simulate the pancreas, so patients constantly face nighttime hypoklikemias and with increased sugar in the morning hours.

Mechanism of action of the device

Automated hormone administration helps to get rid of a lot of accompanying problems. Insulin pump is designed for the introduction of ultrashort insulin in small doses, which maximizes the natural work of the body. At the same time, the volumes and periodicity of the administration are chosen strictly individually depending on the needs of each individual person. That is, the body receives as much hormone as it needs at this moment. For this, an insulin pump is also needed. Reviews of patients with diabetes note that their lives improved with the beginning of the use of this device.

The principle of the device is as follows. In the pump itself is a reservoir with insulin. It is connected with the cannula with a cannula (plastic needle), which is injected into the subcutaneous fat in the abdomen. A special piston presses down to the bottom of the tank at a set speed, ensuring an uninterrupted supply of the hormone. But, in addition, each insulin pump provides the possibility of bolus insulin, which is necessary during meals. To do this, just press a special button.

Consumables

An automated device for insulin administration can significantly alleviate the life of diabetics. But do not forget that its use is also associated with a number of problems. The most important of them is the need to constantly purchase consumables for an insulin pump. These include:

• The reservoir in which insulin is located;
• A cannula that is inserted under the skin;
• A catheter connecting the apparatus and the needle.

If the device is equipped with an additional function to control the level of glucose, then to the replacements is another sensor, by which the concentration of sugar is determined.

Indications for use of the pump

Multiple-use insulin injections are a dream of every diabetic from everyday life. Currently, almost every patient can be purchased an insulin pump. The feedback of many people who use these devices indicate that they do not feel sorry for the money spent.

So, getting a pump is better for people who are engaged in sports, lead a fairly active lifestyle, and those who want to hide from their surrounding illness. Also, such insulin therapy is preferable for children and adolescents, for women who plan to become a mother, and for people who have complications of diabetes. Talk about the mandatory use of the pump can be and in those cases where there is frequent hypoglycemia, and pronounced morning syndrome with sharp jumps in the level of sugar.

Disadvantages of using the device

Before deciding to buy this expensive device, it is necessary to take into account that it also has a number of shortcomings and contraindications to the application. So, the main disadvantage is the price of pumps and consumables for them. The operation of the device costs the patients 6-7 thousand per month. If a diabetic decides to purchase a device that independently controls the level of glucose, then the cost of its monthly use will grow by 2-3 times.

But even if the patient has an insulin pump on his pocket, do not forget about a number of contraindications. These include the apparent drop in visual acuity, including blindness, a decrease in the intellectual level and the existing allergic or inflammatory processes localized in the abdomen.

Pomps for children

Unfortunately, often type 1 diabetes begins to manifest itself in childhood. To facilitate the baby's life, parents decide to replace the constant insulin injections with a pump. But when choosing this device for a child, it is necessary to take into account a number of features. So, before buying, you need to pay attention to the speed with which insulin is delivered. If the child has a small daily dose, then it is better to pay attention to the devices capable of providing 0.025 or 0.05 units of the hormone every hour. For adolescents with a high need for insulin, it is better to choose devices with a large reservoir. It is also important that the pump be equipped with a signal that sounds when a bolus dose is missed while eating.

For example, Medtronic developed the Veo insulin pump for children. Compact size, easy operation, constant monitoring of glucose level and signals when it changes allow parents to monitor the condition of their babies. Also, the device will not allow you to skip the next bolus dose while eating, notify about the rate of change in sugar concentration. But no matter what the device was bought, it is necessary to control children of any age. Parents should carefully monitor the child's condition and do not forget that the cannula is gradually clogged and insulin stops coming in the right amount. It is also important to monitor the level of battery power on the pump.

In addition, you need to choose the right supplies. For example, for children shorter needles are used, the length of the catheter is also selected individually.

How the device is used

If you decide and bought an automated device for the introduction of insulin, then first of all you need to understand how the acquired insulin pump works. Installation of it is as follows.

1. It is necessary to get a reservoir for insulin and remove the piston.
2. The needle is inserted into the ampoule with a hormone, air is also introduced into it from the tank for insulin. This must be done in order to prevent the formation of a vacuum when medication is being prescribed.
3. With the aid of the piston, the hormone is pumped to the reservoir, after which the needle is removed. The air bubbles formed in the tank must be squeezed out.
4. The reservoir connects to the catheter and is inserted into the allotted space in the pump. After this, it is necessary to drive insulin through the tube of the system and remove the remaining air. This is done before the catheter joins the cannula in order to avoid excessive ingestion of insulin into the body.
5. The collection of the device is completed by connecting the needle to the system.

In addition to changing the reservoir, each patient should know how often it is necessary to change the cannula. This is done at least once every 4 days, no matter what type of insulin pump is installed. Medtronic, for example, recommends changing the cannula more often, because they can become clogged. With them, it is necessary to change the set for infusions: the needle and catheter. But the tank can last up to 10 days.

Famous manufacturers

Currently in Russia there is not too much choice of devices that provide automated input of insulin. Free access to the market is represented by insulin pumps "Medtronic" and Accu-Chek. They have representative offices in Russia, so diabetics will not have problems with purchasing the necessary supplies.

The cheapest insulin pump "Medtronic" will bypass the patient more than 80 thousand rubles. It will allow to enter a hormone with a minimum speed of 0,05 units. at one o'clock. But this manufacturer offers more expensive options. They are able to control the concentration of sugar, monitor changes in its level and warn about the danger in the event of an increase or decrease in its level. In addition, the device itself can remind you of the need to introduce a bolus dose of the hormone during meals.

Insulin pumps Accu-Chek (Roche) will cost a little cheaper, the most affordable option is about 60 thousand rubles. This device provides for the use of insulin pen- phyll with a volume of 3 ml, rather than a reservoir. This also reduces operating costs. In addition, Roche released a fully waterproof pump equipped with a volume reservoir for 315 units of the hormone.

Developments "Medtronic"

The advanced American company Medtronic has created an insulin pump Paradigm. The developed device allows you to bring the treatment to a higher level. This is due to the fact that on the pump screen the glucose level is always displayed in real time, they change every 5 minutes. This became possible after the development of a special sensor that is attached in the same way as a cannula and transmits data to the pump using radio frequency technology.

If you change the sugar concentration, the insulin pump 722 will notify you about this with a special signal. This avoids hypo- or hyperclycemia by timely correcting the level of insulin delivery. The most important disadvantage is the cost of this device, the price for it is 130 thousand rubles, and the latest version costs almost 200 thousand. Costly materials are also inexpensive, because the sensor and the infusion set need to be changed after 3-5 days.