Talk:Insulin pump/Archive

merging article with artificial pancreas

I would like to remove this section and replace it with a link to the artificial pancreas main article. Can I paste the removed text into the discussion of the ap article, so that it can be considered for inclusion?Mbbradford 18:23, 11 November 2006 (UTC)

question

Diabetes Pumps: Interesting concept. How is the needle inserted into the body? <<< In many cases, the needle--surrounded by a plastic sheath--is inserted into the desired location by use of a spring loaded device. Medtronic's devices are called "Quick Serters." The needle is then removed, leaving the flexible sheath behind as the delivery point for insulin. Most users change their infusion site, tubing, and resevoir every 3-5 days, to avoid infection, irritation and possible physical resistance to insulin delivery in the given area.

The infusion set is usually on the stomich or hip.

Sloppy Article

This article is poorly written. Some remarks:

Insulin is not pumped out continuously. It's every 3 minutes for most pumps, and in 0.1 unit increments with Minimed.

Reply: continuous is the concept here, as in the medical term continuous subcutaneous insulin infusion. Considering a spurt of insulin is coming periodically (few minutes) and the duration of the rapid insulin is 3.5 hours, it seems continuous to me.Mbbradford 07:06, 11 November 2006 (UTC)

"Amount of insulin delivered" is based on a *lot* of things, like metabolism, weight, insulin sensitivity, etc. I think that sentence is misleading.

Reply: I rewrote, removing the long list of *things* you found incomplete.Mbbradford 08:10, 11 November 2006 (UTC)

Family doctors also do insulin pump starts and insulin adjustments...

It's true that an integrated meter saves the used from data entry, but not that it makes it easier to determine the bolus. Calculation of the bolus size is automated by the pump, and is not easier or more difficult with an integrated meter.

It's not true that folks using insulin pumps required more training in order to take advantage of the "additional flexibility of pumping insulin". Training on pump programming, set insertion, etc. is required, but anyone familiar with basal/bolus insulin regimes should be able to convert over quite easily.

Reply: reworded it for you. We had more training, and I'm glad we did. Everyone I know who is pumping received additional training. I suppose it is possible to use a pump like a pen, without training, but here are some things the pump does that you aren't taught when you learn to do injections with a pen or syringe: variable basal rates as a function of time of day to compensate for things such as the dawn effect and growth hormone at night; temporary basal rate reduction during and for a few hours after exercise; extended boluses for low carb high fat meals like eating steak; combination boluses for eating pizza and chocolate cake. Mbbradford 07:54, 11 November 2006 (UTC)

Infants (who may have total daily doses of < 3 units) are routinely put on insulin pumps without 6-12 months of diabetes experience. To say that "Often 6 months to one year..." is unnecessarily discouraging, and false.

True. Most pumpers are not infants, I was being general. I don't want to be discouraging. I'm glad to see infants pumping; it makes sense based on the very low doses, and it's hard to do that with a syringe. Perhaps it was just personal experience in our case that the endo and insurance company wanted us to wait for 6 months after T1 diagnostis before learning to pump.Mbbradford 08:25, 11 November 2006 (UTC)

Waterproof insulin pumps can be worn in water for up to 24 hours. The part about "sustained activities involving water" should be changed.

I edited the unnecessary words. But I disagree with your point. We have a waterproof pump (at least it was waterproof when it was new, and I hope it still is waterproof now in case it gets accidently dropped into the water someday). But it cost more than my car, and it will be a few more years before the insurance company will help me buy a new one. It is very important to us. Frankly, I want to test the waterproofness of the pump about as much as I want to test the airbags in my car. Mbbradford 07:54, 11 November 2006 (UTC)

"Attacks" of DKA is overly dramatic. I think the medically used word is "episode". Reply: done Mbbradford 07:54, 11 November 2006 (UTC)

"blind persons" should probably be changed to "people with visual impairments". Reply: done Mbbradford 07:54, 11 November 2006 (UTC)

That pump use is increasing because of improvements in glucose monitoring is an assumption (and probably untrue).

Reply: let's talk about this one. My son tests 10 times a day. It used to be 4 or 5 when he was using the pen. Pumping seems to demand more tests to keep basal rates updated. Testing more often is also wise because of the replacement of slow acting insulin with rapid. Kids expecially do not want to poke themselves more times a day when it hurts, expecially if the fingertips start to get sore. Even switching from the One Touch meter to the Freestyle (smaller drop of blood) made pumping more kid friendly. Why do you feel this is untypical? Mbbradford 07:06, 11 November 2006 (UTC)

The future developments section is outdated.

Reply: I agree. It seems to be ongoing, and under discussion. Mbbradford 07:06, 11 November 2006 (UTC)

Update: most of this section was summarized (edited thin), with the text moved to the discussion page of the artificial pancreas and where it is under discussion to be merged with that article.Mbbradford 06:01, 24 November 2006 (UTC)

Net, I think this article is poorly written and requires substantial update.

Reply: Please feel free to help. Go ahead and make edits, and we can discuss here when we disagree with an edit.Mbbradford 07:06, 11 November 2006 (UTC)

Even in the above comment... Minimed has A device called a QuickSerter, but it works only with QuickSets. There are other insertion devices for other types of sets. Infusion sets are only approved to be worn for 2-3 days -- not more than 2 days for steel needles, and not more than 3 for teflon cannulas. Some people (especially with children) prefer the butt for their sites. Others like the fat around their back, near the armpit...

Since the criticism in November, this article has been completely rewritten and no longer exists in its early form. mbbradford 05:14, 18 January 2007 (UTC)

bibliography

The books listed are links to Amazon.com rather than using the ISBN references. Regardless that some North Americans might use the link to shop, this is not the point. The links to Amazon allow the reader to see the cover of the book, read the table of contents, and independant review of the material. IMO this is a worthwhile feature.