Glossary/Lexicon

Dependence

Many people witrh diabetes reject the use of an insulin pump outright because they do not want to be dependent on it 24-hours a day and because they fear that the pump could be troublesome in their daily life.

The fact is: Those decide to use an insulin pump must accept it as a constant companion. However, nowadays insulin pumps are so small and light that it’s easy to forget that they are even there at all. They accompany you in all your day-to-day activities and they are durable and even shock-resistant.

It does not present a problem if you want to remove the insulin pump for certain situations, e.g., sports, when you are on the beach or during sex. An interruption of a couple of hours can be bridged with a small bolus, but if the interruption is longer, you’ll have to switch briefly to pen or injection therapy with which you are familiar.

By using the appropriate detachable infusion sets, it’s possible to take the pump off for the short term without having to insert a new infusion set.

Age

At what age should insulin pump therapy be started and when is it too late to start?

This is actually not a question of age, but of motivation.

In general the following applies: The earlier, the better – in order to prevent diabetes-related complications as early as possible. Nowadays this therapy is being recommended more and more frequently for children and young people and it is even being used during pregnancy.

Medical Care

If you decide to use insulin pump therapy, you’ll learn during the course of intensive training how to deal with everyday situations. Most of the time, these training sessions take place at so-called pump centers.

For further medical care you’ll then remain in contact with the pump center or your trusted physician. You’ll get immediate help from them over the telephone if temporary problems arise with the insulin pump.

Basal Rate

An insulin pump automatically dispenses the basic insulin requirement, the so-called basal rate, around the clock according to the programmed insulin requirement, thereby optimally supplying the body with insulin.

The basal rate profile is set on the basis of your individual daily profile. Disetronic insulin pumps offer 24-hour variable basal rates and therefore can be adjusted optimally to the biorhythm of you own individual insulin requirement.

Ability to Withstand Stress

Are you stressed in your day-to-day life, in your job or with your children? Do you do shift work? With an insulin pump you will quickly notice that you are again much more able to withstand stress.

You’ll automatically be supplied with your basic insulin requirement, you’ll be able to spontaneously adjust the basal rate and through pump therapy you’ll achieve a level of flexibility in your day-today life (e.g., various bolus deliveries possible) that only this form of therapy makes possible.

And you won’t have to inject intermediate- or long-acting insulin at specific times in the morning and evening.

CSII makes it possible to achieve better metabolic control and greater quality of life.

Bolus

The bolus is used to compensate for the food-related insulin requirement and, if necessary, to correct a blood sugar reading that is too high. It is dispensed using the same infusion set and from the same insulin cartridge as the basal rate.

Eating

Insulin pump therapy allows you to enjoy the greatest possible freedom in terms of eating.

Consuming meals with a high fat content can be regulated without a problem since when using an Accu-Chek D-TRONplus insulin pump an extended bolus is possible or an extra bolus can be administered with an evening meal.

In case of doubt you can check afterwards to see if you acted correctly or whether another correction is required. Without any injections, simply with the press of a button.

Hyperglycemia

Because only short-acting insulin is in the body, an interruption of the insulin supply, e.g., due to a needle that has come out or a leak in the system, produces a relatively rapid increase in the blood sugar level.

As a result, regular blood sugar self-monitoring plays a very important role in insulin pump therapy. 

You’ll learn what you yourself can do to avoid ketoacidosis and how you should react in case of emergency in the course of a training session.

Hypoglycemia

One of the disadvantages of intensive insulin therapy is that good metabolic control comes at the expense of an increased risk of low blood sugar/hypoglycemia, particularly at night when the blood sugar drops significantly in some circumstances.

Insulin pump therapy is the right solution in this case. Due to the individualized supply of the basic insulin requirement hypoglycemia is avoided to greatest possible extent.

Prefilled insulin cartridges can be used in all insulin pumps made by Accu-Chek/Disetronic:

For the Disetronic H-TRONplus: Insuman® Infusat from Aventis Pharma.

Insuman® Infusat cartridge

For the Accu-Chek D-TRONplus: 3-ml pen cartridges with Humalog® insulin from Lilly.

Humalog® cartridge

Other types of insulin can also be filled into empty cartridges.

Infusion Set

An infusion set is a thin tube with a fine needle at the end, which connects the insulin pump to the body. Insulin flows through it constantly. It is usually inserted in the abdominal region.

Infusion sets are only used once and should be changed daily or every other day in order to avoid infusion set blockages and hardening of the skin or even inflammation.

Reimbursement of Costs

The costs of the insulin pump and accessories like infusion sets, batteries, carrying cases, etc. as well as blood glucose test strips will normally be paid by your medical insurance.

At the beginning of therapy your physician will recommend the necessity of insulin pump therapy and your medical insurance will prepare a one-time declaration indicating that they will assume the costs.

This is the basis for additional prescriptions from your physician.

Sleep

Sleeping late in the morning is not a problem because the basic insulin requirement is being constantly supplied.

Most people with diabetes let their insulin pump lie loosely next them when sleeping or fasten it loosely to the body with an appropriate belt.

Now a word about sex: Whether you want to take the insulin pump off or leave it on is a matter of personal experience.

You are not dependent on the pump, you can take off quickly if need be and compensate for a longer interruption with a small bolus.

Pregnancy

Optimum blood sugar values are important even before pregnancy. Many women decide to use an insulin pump even when they are planning to get pregnant.

As a result, the initial phases of nausea and vomiting can be tolerated more easily without the fear of hypoglycemia since the insulin supply can be adjusted in the short term.

Training

Once you have made a decision to use an insulin pump, you will undergo an intensive training lasting one to two weeks, as an inpatient or outpatient in a pump center.

During this period you’ll learn all about your insulin pump as well as learn the right way to react to various possible situations.

You’ll monitor your metabolic stability by checking your blood sugar.

This training is very intensive and will prepare you in a comprehensive way for day-to-day life with your pump.

If any questions arise later on, you can contact the pump center or your physician at any time.

Sports

Insulin pump therapy doesn’t just offer you the greatest possible freedom if you like to engage in sports.

Even if you like to engage in other physical activities like taking long walks, working in the garden or doing strenuous housework, an insulin pump is an ideal way of reacting flexibly to changes in your demand for insulin.

Only the insulin pumps made by Accu-Chek/Disetronic allow you to increase and decrease the basal rate proportional at the push of a button without having to change the programming.

Wearing an Insulin Pump

The insulin pump can be worn in an appropriate carrying case on your belt, in your pants pocket or in a shirt pocket.