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The Diabetes Educator
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FEATURES

Insulin Pump Therapy

Guidelines for Successful Outcomes

Gary Scheiner, MS, CDE, Robert J. Sobel, MD, Daphne E. Smith, PharmD, CDE, Anthony J. Pick, MD, CDE, Davida Kruger, MSN, APRN-BC, BC-ADM, Jacqueline King, MS, RD, FADA, CDE and Karen Green, MSN, APN, CNP, BC-ADM, CDE

From the Integrated Diabetes Services, Wynnewood, Pennsylvania (Mr Scheiner); Feinberg School of Medicine, Northwestern University, Chicago, Illinois (Dr Sobel, Dr Pick); University of Illinois at Chicago (Dr Smith, Ms King); Henry Ford Health System, Detroit, Michigan (Ms Kruger); Private Practice, Glenview, Illinois (Ms King); and Dupage Medical Group, Geneva, Illinois (Ms Green).

Correspondence to Gary Scheiner, MS, CDE, 300 E. Lancaster Avenue, Suite 111, Wynnewood, PA 19096 (garyscheiner{at}prodigy.net).

Purpose

Current forms of insulin delivery used in the treatment of diabetes mellitus (diabetes) include syringes, pens, and insulin pumps. Technical advantages of insulin pump therapy, or continuous subcutaneous insulin delivery (CSII), include precise and flexible insulin dosing. In the context of intensive diabetes management, insulin pumps can facilitate improved long-term glycemic control and reduce the risk for diabetes complications, with improved lifestyle flexibility for patients and their families. Comprehensive patient education, carbohydrate counting, and frequent self-monitoring of blood glucose or continuous glucose monitoring are necessary components of successful insulin pump therapy. Technological advances have increased the appeal of pump therapy to patients and clinicians. Physically, current insulin pumps are discreet, ergonomic, and water resistant. Meanwhile, software improvements have yielded smart pumps with features that support pump users in their daily diabetes management. Robust data analysis software packages allow patients and clinicians unprecedented insight into the quality of diabetes control. Furthermore, widespread insurance reimbursement for CSII has expanded access to therapy.

Conclusions

As the number of pump users and potential users expands, diabetes educators face new challenges and opportunities to improve patients' lives with diabetes. This activity describes the rationale for insulin pump therapy, its potential advantages and disadvantages, and strategies regarding patient selection and education.

The Diabetes Educator, Vol. 35, No. 2 Suppl, 29S-41S (2009)
DOI: 10.1177/0145721709333493
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