Insulin Pump

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Category: Pt-Edu-Pub

Published on Tuesday, 08 July 2014 00:18

Written by Dr. Gururaja Rao

Insulin Pumps

Your way to flexible and better control of Diabetes

Insulin pump is a portable device that can help in delivering the right amount of insulin at the right time for a patient with diabetes requiring insulin therapy.

The aim of insulin pump is to help you achieve a better control of your diabetes while providing you with new found freedom and flexibility in your life style. This can free your life style from the shackles of diabetes.

Insulin Pump

• Can be worn like a pager or cellphone.
• Connected to a small plastic cannula underneath the skin by a tubing.
• Pumps insulin 24x7x365 as per the set program (instructions) personalised to your needs.

• Delivers small amounts of Insulin as programmed
• Alarm system helps you detect any malfunction / tube block.

• Basal Rate - Small amounts of insulin needed for the normal body functions (not food) 24x7.
• Bolus Dose: To match the food eaten.

• CGMS measures tissue glucose almost continuously.
• This reading is sent to the pump wirelessly.
• The reading is stored & displayed by the pump
• Pump may warn of low sugar and also stop insulin if needed.

Who can use Insulin pump therapy?

Insulin pump can be useful in patients with Type-1 or juvenile Diabetes as well as Type-2 Diabetes which is the most common type of Diabetes. It is commonly used among patients with Type-1 diabetes in the United States (20-30%) patients are on pump, but in India the usage is still less.

Who is a good candidate for insulin pump therapy?

If you are a patient requiring insulin for diabetes and:

• Want to have a better blood sugar control
• Want to avoid frequent or severe hypoglycemia
• Want flexibility in lifestyle and eating habits
• Wants to have varied sleep timings (e.g. sleep late)
• Wants to participate in sports or exercise without undue blood sugar variations (very low or very high).

These are mere general statements. It’s better to personally discuss with your doctor trained in diabetes pump or endocrinologist to see what insulin pump can offer you.

Who is not a candidate for Insulin pump therapy?

If you have unrealistic expectations from pump therapy – like:

• I expect it to be “fill it, fit it, and forget it!” (I don’t want to worry about diabetes).
• I want to never take insulin shots ever again.
• I don’t care what my sugars are.. (Not willing to check blood sugars)
• I don’t want to carry my diabetes supplies everywhere.
• Suffering from depression, psychosis or other serious mental illness.
• Are financially challenged.

Once again these are general statements and may not be applicable in your context. Best is to have a one to one conversation to see where you stand.

Can you give me a picture of how the insulin pump works?

Insulin pumps often are worn on a belt, similar to a pager or cell phone. It can also be placed in a pocket. It is made of resistant plastic. It contains a microcomputer which controls the pump pushing the insulin through a thin plastic cannula (tube) placed under the skin in the fatty tissue.

How is pump different from taking multiple daily injections of Insulin?

It’s vastly different. With pump you can set different basal rates of insulin depending upon the time of the day or night, activity level, menstrual cycle and so on. Similarly the meal time bolus dose of insulin can be adjusted to the amount of carbs (carbohydrates) consumed.

The rapid acting insulin used in the pumps has a more predictable absorption profile from day to day and this can minimize unexpected wild swings in blood sugar levels.

What are the types of pump available?

Miss Idaho 2014

• A US beauty queen who wore her insulin pump during contest.
• She was diagnosed with Type-1 Diabetes in 2012

• Won Miss America in 1999, wore her insulin pump during the competition.
• She serves on various health advisory committees with the American Diabetes Association & the Juvenile Diabetes Research Foundation.

• The olympian swimmer was diagnosed with Type-1 diabetes in 1999
• At the 2004 Athens Games, he became the oldest male in 80 years to win gold for the U.S. team by winning a both a gold and bronze medal, winning a total of 10 medals!

• A group with Medtronic Diabetes Australia showing their insulin pumps as part of the campaign.

There are several companies internationally. But while considering a given pump you need to discuss with your doctor the features that best suit your needs, e.g. real time glucose monitoring (CGMS) and so on. Also consider the kind of ongoing support available to you.

Can I try and see if an insulin pump suits me?

Yes, companies may offer “try before you buy” kind of schemes to let you have a first-hand experience and make sure that it fits your needs.

I have more queries…

Please contact us for more specific questions.

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Category: Pt-Edu-Pub

Published on Sunday, 02 February 2014 18:37

Written by Dr. Gururaja Rao

Caring your feet... Everyday!!

10 tips about care of feet for diabetes patients

They say "Prevention's better than cure",  but I would say prevention is the only cure for diabetic foot.

Control Blood Sugar

• Ask your doctor about your pre/post meal blood sugar targets.
• Adhere to diet, Excercise regularly.
• Take medicines on time.

• Tells you about long term control.
• Ask your doctor when to check.

Keeping sugars under control:

Caring for your feet begins with taking care of your diabetes. Talk to your doctor about your diabetes targets.

Proper blood sugar control means fewer chances of nerve damage and so less foot problems. Talk to your doctor about your targets.

Check your feet daily:

Checking your feet with mirror

• Use a mirror.
• Look for any wound, redness or infection.
• These may not be painful if you have nerve damage due to diabetes.

Seperate the toes and look for any fungus infection.

• Dry the feet thoroughly with a towel.
• Take special care to dry between your toes.

• Apply petroleum jelly or Vaseline if skin is dry or cracked.
• Don't apply between the toes..
• Don't use vegetable oil.

• Trim them straight across.
• Blunt them with a emery board.

• Walking on hot pavements can lead to blisters.
• You may not notice until it's too late due to lack of pain sensation.

You can detect any minor problems like redness, nail infections, injury by thorns etc. much before it escalates into a full blown problem. This is so because you may not feel any pain due to nerve damage caused by diabetes.

Protect your feet from hot and cold:

Wear shoes at the beach, on hot pavements etc. Avoid walking in hot sun in places like temples where you cannot use footwear. Don't put your feet into hot water. Test it before hand  just as you would before bathing a baby. Avoid hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it. Don't put your feet on the engine cover sitting at front seat of bus to avoid radiator burns.

Maintain blood flow to your legs:

Put your feet up when sitting. Move your toes and ankles periodically up and down. Don't cross your legs for long periods of time. Drink plenty of water when travelling. Avoid smoking / tobacco in any form.

Get your feet out of your shoes every hour or two so that your feet can breathe too:

Tight shoes suffocate and choke your legs by preventing flow of air and blood. The trapped moisture may also lead to fungal infections, maceration and peeling of skin.

Ask your doctor about need for special diabetic footwear:

Avoid Hawai Chappals

• They don't provide back support.
• Easily slip off the feet while walking
• Can lead to deformed feet in presence of nerve damage.

• They provide proper support while walking.
• Soft inner portion prevents foot injury.

Proper diabetic footwear can help prevent injuries to your feet, helps in healing any injuries that may have already occurred. They wear out instead of wearing out your precious feet.

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Diet for weight loss

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Category: Pt-Edu-Pub

Published on Monday, 16 June 2014 02:42

Written by Dr. Gururaja Rao

Eating Healthy

Healthy eating is the foundation to healthy weight. For most people, adopting healthy eating habits coupled with an exercise program can help attain healthy body weight and body fat. This balances the energy intake and expenditure.

To reduce weight you need to cut the calories and increase the amount and duration of exercise.
Dieting alone may not work. Even if you have genetic flaw in your body weight control system, or even if you are taking one of the newer drugs for weight reduction, still diet-exercise forms the sheet anchor of therapy.

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Category: Pt-Edu-Pub

Published on Sunday, 26 January 2014 09:35

Written by Dr. Gururaja Rao

Caring for your eyes

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