There's no substitute for the body's own blood sugar control
mechanism, but insulin pumps may be the next best thing, say diabetes
An insulin pump is a compact, pager-sized, computerized device
that can be worn on a belt. It is connected to the body via a flexible plastic
tube through which insulin is delivered. The pump releases insulin in a steady,
continuous background or "basal" dose, but also allows the wearer to
add an additional dose, or "bolus" of insulin when needed, such as
before a meal or snack.
Randy Jackson’s struggle with obesity began as a child in Louisiana, with its super spicy, often super-fatty cuisine. Even as an adult, Jackson still doesn't dream of sugarplums at Christmastime. Instead, he dreams of waltzing andouille sausage and grits, jigging jambalaya, and shimmying beignets and bread pudding with bourbon sauce.
“For the old Dawg, a holiday party was a chance to have something to eat, drink, and be merry, but the new Randy does not drink or eat at parties,” says Jackson, 52,...
"It provides more stable insulin deliveries and smoothes
out glucose fluctuation compared with injections," explains Howard A.
Wolpert, MD, senior physician and director of the insulin pump program at the
Joslin Diabetes Center in Boston, in an interview with WebMD. "I think the
advantage from a lifestyle standpoint is what attracts many people, because it
does allow people much more flexibility in terms of eating times."
Although people with diabetes can now use an ultra long-lasting
insulin (insulin glargine) that releases an even basal dose for 24 hours after
injection, Wolpert notes that "with glargine people still need to take
multiple injections whenever they're going out to eat or whenever they're going
to have a snack. With a pump it's much more convenient in terms of just having
to press a button and get insulin delivered. For people eating out, if they're
not certain what they're going to be eating they can take an initial bolus or
pulse of insulin, and as the meal proceeds they can take further insulin
depending on their [food] intake."
The pump also can help control the release of glucose during
exercise, Wolpert says. Insulin levels normally drop during exercise to allow
the release of stored glucose for use by the exercising muscles, but people who
inject insulin may find it hard to predict how much insulin to have on board
prior to exercise. In contrast, those who use pumps can more easily adjust the
dose to their body's minute-to-minute-demands. "For the motivated patient
who wants to lose weight through exercise, one can do it much more effectively
if one's on a pump than say on insulin injection," Wolpert tells WebMD.
But while the insulin pump is for many people an improvement
over multiple daily injections, it requires a dedicated and savvy operator to
make it work. The user still has to perform multiple daily blood tests to check
for glucose levels, and must know how to program in the right insulin dose
after each test; currently available pumps can neither sense current glucose
levels nor can they automatically adjust insulin levels.
"It's just a different tool for delivering insulin; the
person still needs to input the doses, and to get the most out of the pump one
still has to be pretty knowledgeable and skilled in diabetes self-management.
It's not a tool for the novice," Wolpert says.
"It isn't right for everyone," agrees Michael Freemark,
MD, professor of pediatrics and chief of the endocrine and diabetes division at
Duke University Medical Center in Durham, N.C. "It requires a strongly
committed family and an experienced diabetes team."
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People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
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