DIABETES TECHNOLOGY: PUMPS, SENSORS, AND BEYOND Flashcards
(60 cards)
What is a continuous subcutaneous insulin infusion (CSII) device?
A small, wearable, portable device that delivers preprogrammed and user-adjusted doses of insulin both continuously and in boluses.
More commonly known as an ‘insulin pump’, this device is used in lieu of multiple daily injections (MDIs).
What are the components of a CSII device?
The main components include:
* Insulin pump
* Reservoir
* Infusion sets
Each component plays a crucial role in the delivery of insulin.
How does the insulin pump work?
It delivers basal insulin continuously and boluses based on user input for food intake and corrections.
Basal infusion rates and bolus settings are tailored to each patient’s needs.
What settings are programmed into the insulin pump?
The settings include:
* Carbohydrate-to-insulin (CI) ratio
* Correction factor (CF)
* Blood glucose targets
These settings help the pump calculate the necessary insulin for meals and corrections.
What type of insulin is used in a CSII device?
Rapid-acting insulin, such as:
* Lispro (Humalog)
* Aspart (Novolog)
* Glulisine (Apidra)
Rarely, concentrated insulin (U-500 regular insulin) is used for those with significant insulin resistance.
How does CSII improve glycemic control?
It improves glycemic control by:
* Better matching of basal insulin delivery
* More consistent and accurate bolus dosing
Preprogrammed CI ratios and CFs reduce the risk of calculation errors.
True or False: Long-acting insulins are used in insulin pumps.
False
Intermediate or long-acting insulins are not used in insulin pumps.
Fill in the blank: The _______ is a cartridge that holds a three-day supply of rapid-acting insulin.
reservoir
The reservoir is changed every three days when the insulin infusion site is changed.
What is the function of the infusion set in a CSII device?
It is inserted subcutaneously to deliver both basal and bolus insulin.
The infusion set includes a fine needle that is removed after insertion, leaving the cannula under the skin.
What is a carbohydrate-to-insulin (CI) ratio?
It is the grams of carbohydrates that will be covered by one unit of bolus insulin.
This ratio helps determine the amount of insulin needed for meals.
What is a correction factor (CF)?
An estimate of how much each additional unit of bolus insulin is expected to lower an elevated premeal blood glucose.
It is also known as the insulin sensitivity factor.
How does the insulin pump calculate bolus doses?
It uses preprogrammed settings for carbohydrate intake and blood glucose levels to determine the necessary bolus.
This automated calculation helps reduce manual errors.
Fill in the blank: Insulin pumps allow for bolus delivery in increments smaller than _______.
a half unit
This feature allows for more accurate dosing, particularly for insulin-sensitive patients.
What is the significance of varying basal insulin rates in insulin pumps?
They closely mimic true physiology by adjusting insulin delivery according to the body’s needs throughout the day.
This flexibility can enhance glycemic control.
What kind of insulin is used in a CSII device?
Rapid-acting insulin such as lispro (Humalog), aspart (Novolog), and glulisine (Apidra)
Rarely, concentrated insulin (U-500 regular insulin) is used for individuals with significant insulin resistance.
How does CSII improve glycemic control?
Through better matching of basal insulin delivery and more consistent bolus dosing
Reduces risk of math errors and allows for easier administration of insulin boluses.
Who is a good candidate for an insulin pump?
Patients with inadequate glycemic control despite intensive therapy with MDIs, high glucose variability, or those desiring more flexibility
Candidates must be motivated and knowledgeable about diabetes self-management.
Are insulin delivery settings on a CSII device universal?
No, they must be titrated to each patient’s individual needs
Frequent monitoring and consistent follow-up with healthcare professionals are essential.
What basic knowledge does a patient need to be started on an insulin pump?
Carbohydrate counting, understanding insulin pump functions, and responding to real-life scenarios
Awareness of how to avoid and respond to hypoglycemia is also important.
How much patient input is required to safely and effectively operate an insulin pump?
Considerable input is required, including frequent blood glucose testing and estimating carbohydrate contents
Patients must also change infusion sites every 3 days.
What are the major challenges for patients who use insulin pumps?
Accurately counting carbohydrates and frequently checking blood glucose levels
Challenges also include device-related issues like leaking insulin or kinking of the cannula.
What are the major complications that patients face while using a CSII device?
Inadequate glycemic control, hyperglycemia, and hypoglycemia
Correcting settings to eliminate hypoglycemia takes priority.
What are the major differences between the insulin pumps currently available on the market?
Major brands include Medtronic, T-Slim, and Omnipod
Omnipod pumps do not require tubing and can communicate with CGMs for continuous glucose monitoring.
Fill in the blank: The type of insulin that is NOT used in insulin pumps is _______.
Intermediate or long-acting insulins
