Some insulin-dependent diabetics and their doctors are turning to insulin pump therapy as a means to improve diabetes control. But as with all people with diabetes self-care is another tool an insulin pump is as effective as its use. The concept of a pump to deliver insulin slowly under the skin through a small self-inserted a plastic catheter. The progressive delivery of insulin designed to mimic the normal release of insulin in people without diabetes.
When food is eaten, this is the work of diabetes to determine the dose and schedule of the pump to deliver it. Although simple in theory, the insulin pump can be difficult in practice. Insulin pumps are expensive, costing thousands of dollars. In addition, annual operating costs of a pump may be $ 1,500 or more. Patients must have a prescription from your doctor, and approval of health insurance. In the era of rising medical costs, some insurance companies have begun to reduce the coverage of insulin pumps.
Insulin pumps are aggressively promoted to diabetics. Pump companies extol the virtues of their products, which are considerable. And doctors also are targets. But insulin pump therapy is not a part of medical school training and even some endocrine specialists get little to no formal education in their use. Knowing this, pump companies offer initial training to any diabetic starting an insulin pump.
One common practice I’ve seen is for a doctor to prescribe an insulin pump to a diabetic in very poor control with the expectation that the pump itself will turn things around. This is a gamble. Often the reasons for poor control are due to a lack of quality ongoing diabetes education, or even poor motivation by the diabetic to take charge of his or her condition.
Proper use of an insulin pump requires a good working knowledge of how insulin, food and exercise interact, plus good troubleshooting and problem solving skills. Learning how to use an insulin pump is like learning to drive a car. A short encounter with a pump trainer usually fails to provide the preparation needed to master a device, which I’ve likened to a Swiss army knife with dozens of attachments.
I adopted a phrase I heard which summarizes a disturbing practice that remains prevalent in the diabetes industry: “pump and dump.” This is when the person with diabetes receives minimal education and little ongoing training for a device that, in theory, could improve both quality and quantity of life.
The best defense against “pump and dump” is to know it exists. I’ve seen far too many diabetics get started on an insulin pump without the proper support and ongoing training, then struggle. Pumping insulin is best considered a lifelong learning experience.
Diabetics represent a kind of market. Diabetes companies want to make profits. Altruism is attractive to customers and physicians, but both need to be informed consumers. Insulin pumps are remarkable tools, but not a panacea.