| Abstract: |
Insulin pump therapy allows patients to manage their diabetes intensively by using a method that is pharmacologically superior to multiple daily injections (MDI). This chapter about insulin pump therapy is from a textbook that offers primary care physicians evidence-based guidelines for evaluating and treating all patients with diabetes. In this chapter, the author discusses the evolution of modern insulin pump technology, patient selection for pump therapy, improved overall glycemic control and reduced glycemic variability in patients using insulin pumps, talking about pump therapy with prospective patients, initiating pump therapy in the primary care setting, fine-tuning pump therapy, long-term follow-up of insulin pump patients, exercising with an insulin pump, and the use of insulin pump therapy in patients with type 2 diabetes. The author concludes that, compared with MDIs, insulin pump therapy has better insulin pharmacokinetics, less variability in insulin absorption, and decreased risk of hypoglycemia. Patients using insulin pumps enjoy greater lifestyle flexibility and often become more proactive in their approach to diabetes self-management. Although more expensive than MDIs, pump therapy offers patients a much more physiologic approach to controlling their diabetes. Careful evaluation of pump candidates, ongoing patient education, and timely follow-up visits are vital to the success of pump therapy. The chapter includes a list of “take-home points” that summarize the concepts discussed, as well as case reports that illustrate the topics covered. 3 appendices. 9 figures. 9 tables. 32 references. |