Pump insulin therapy

The introduction of insulin using an electronic device that provides round-the-clock subcutaneous delivery of a hormone with the necessary time period is a pump insulin therapy. This method allows you to control glycemia and reduces the risk of complications.

[1], [2], [3],

Indications for the procedure

Indications for use:

• Frequent sharp jumps (decrease / increase) of glucose in the blood.
• Uncompensated form of the disease.
• Facilitating the method of administration of the drug.

[4], [5], [6], [7]

Technique of the pump insulin therapy

Treatment has several modes:

1. Bolus speed - the patient independently controls the periodicity and dosage of the medication. This regimen is used before eating or when sugar is raised in the blood. The drugs of short and ultrashort action are recommended.
2. Continuous feeding with minimal doses - this mode mimics the normal functioning of the pancreas. Allows you to abandon the use of synthetic hormones prolonged action.

The main plus of the pump is that there is no need to administer the medication yourself. This method is contraindicated for patients with mental disorders and the impossibility of self-care for elderly patients (poor eyesight, limb tremor).

Pump insulin therapy in children

A popular device used to compensate for carbohydrate metabolism in pediatric patients is the pump. It is a micropump with an electronic device for multiple injections. Since the device automatically supplies the drug, it is very convenient for treating children and patients who do not have the time or opportunity to inject.

The main indications for pump insulin therapy in children:

• No need for frequent and painful pricks.
• Maximum physiological intake of insulin in the body.
• Absence of psychological discomfort.
• Reducing the risk of hypoglycemia.

The disadvantages of the pump method include:

• High cost of the device.
• The need to monitor the battery level of the device.
• Sensitivity of the device to electromagnetic waves.
• The risk of developing inflammatory reactions at the location of the needle that is feeding the medicine.
• Children with insufficient amounts of subcutaneous tissue can bend the catheter and stop feeding the hormone.

The pump can operate in two modes:

1. Background - the supply of a drug provides a stable baseline level of insulin in the blood. The mode mimics the normal operation of the pancreas. Dosage for normal functioning of the body is chosen by the attending physician and depends on the rhythm of life, physical activity and other characteristics of the patient.

The device can be programmed for a different rate of hormone administration - every 30 or 60 minutes. In this case, the minimum step of drug delivery is 0.01 units. Typically, the background mode is used to compensate for 1/3 of the daily dose of the drug.

2. Bolus - the frequency of administration of the drug depends on the number of meals, that is, the hormone is injected before each intake. To determine the optimal dosage, it is necessary to measure the glucose level in the blood before each injection for several days. 30% of the dosage is administered before breakfast, 15% before lunch, 35% before dinner and the remaining 20% before bedtime.

As a rule, for children use two or three times the introduction of the drug. In this case, hormones are combined with a short and medium activity period. In patients of childhood, insulin sensitivity is higher than in adults, so a step-by-step dosage adjustment (within 1-2 units) and careful monitoring of parents and doctors is necessary.

When choosing drugs for the treatment of children, an advantage should be given to short-acting human insulin analogues:

• Do not cause allergic reactions.
• Rapidly lower the blood sugar level.
• Quickly destroyed.

This allows you to maximize the supply of drugs to work healthy pancreas.

Despite all the advantages of using the pump, patients must strictly adhere to diet and lead an active lifestyle. Also, the risk of failure of the device should be considered, which can lead to sharp jumps in glucose levels and the development of ketoacidosis. The final decision on the introduction of this method is taken by the doctor together with the parents.