Insulin Pump Therapy: Guidelines for Successful Outcomes
Release Date: March 27, 2009
Expiration Date: March 27, 2010
This activity is intended for nurses, dietitians, pharmacists, nurse practitioners, physician assistants, mental health professionals, physicians, and other clinical practitioners involved in the management of patients with diabetes mellitus.
Current forms of insulin delivery used in the treatment of diabetes mellitus (DM) include syringes, pens, and insulin pumps. Insulin pump therapy, or continuous subcutaneous insulin infusion (CSII), is considered the “gold standard” in insulin delivery for most, if not all, patients with type 1 DM (T1DM). Technical advantages of insulin pump therapy include precise insulin dosing and dose flexibility. In the context of intensive diabetes management, insulin pumps can facilitate improved long-term glycemic control and reduced risk for diabetes complications as well as increased lifestyle flexibility and convenience for patients and their families. Comprehensive patient education, carbohydrate counting, and frequent self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) are necessary components of successful insulin pump therapy.
Technological advances have increased the appeal of pump therapy to both patients and clinicians. Physically, insulin pumps have become sleek, discreet, ergonomic and more water resistant. Meanwhile, software revisions have yielded “smart pumps” with on-board features to support pump users in their daily diabetes management. Robust data analysis software packages allow patients and clinicians unprecedented insight into the quality of patients’ diabetes control. Furthermore, widespread insurance reimbursement for CSII has improved patients’ access to therapy. As the number of pump users and potential users expands, diabetes educators may face new challenges and opportunities to improve their 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 goals of this program are:
- To describe the principles of insulin pump therapy, review its potential advantages and disadvantages, and discuss strategies for appropriate patient selection, training, and ongoing management.
Upon completion of this activity, the participant should be able to:
- Describe the rationale for the use of insulin pump therapy and potential advantages and disadvantages of pump therapy
- Describe the basic components of CSII
- Identify appropriate candidates for pump therapy
- Apply principles, regimens and strategies for starting patients on pump therapy
- Articulate pump users' needs for ongoing support to achieve the goals of therapy
Robert J. Sobel, MD
Assistant Professor, Endocrinology
Feinberg School of Medicine
Daphne E. Smith, PharmD, CDE
Clinical Assistant Professor, Ambulatory Care/Diabetes Education
Clinical Pharmacist, Ambulatory Care
University of Illinois at Chicago
Gary Scheiner, MS, CDE
Integrated Diabetes Services
Anthony J. Pick, MD, CDE
Assistant Professor, Endocrinology
Feinberg School of Medicine
Davida Kruger, MSN, APRN-BC, BC-ADM
Certified Nurse Practitioner
Henry Ford Health System
Jacqueline King, MS, RD, FADA, CDE
Preceptor, University of Illinois
Karen Green, MSN, APN, CNP, BC-ADM, CDE
Diabetes Nurse Practitioner, Endocrinology
Dupage Medical Group
It is the policy of the American Association of Diabetes Educators to require that anyone who has an opportunity to affect continuing education activities content (e.g. authors, presenters and program planners) with products or services from a commercial interest with which s/he has financial relationships, discloses those financial relationship/s with commercial entities to participants.
Disclosure of a relationship is not intended to suggest or condone bias in any presentation, but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.
Relevant disclosures (or lack thereof) among educational activity planners and faculty are as follows:
- Gary Scheiner, MS, CDE, received consulting fees for serving as the certified diabetes educator (CDE) advisory panel coordinator for Unomedical and for serving on the Speakers’ Bureau and as a certified insulin pump trainer and certified continuous glucose monitoring trainer for Medtronic/MiniMed. He also received honoraria for serving on the Speakers’ Bureau and as a certified insulin pump trainer for Smiths Medical.
- Robert J. Sobel, MD, has no financial disclosures to declare.
- Daphne E. Smith, PharmD, CDE, has no financial disclosures to declare.
- Anthony J. Pick, MD, CDE, received honoraria for serving on the Speakers’ Bureaus for Sanofi-Aventis, Novo Nordisk, and Takeda.
- Davida Kruger, MSN, APRN-BC, BC-ADM, receives 50% of her salary and benefits from the National Institutes of Health (NIH). She is a stock shareholder for Amylin Pharmaceuticals, Inc; Dex Com; and Patton Medical Devices. She serves on the advisory boards for Novo Nordisk; Abbott; Council for Advancement of Diabetes Research and Education Seattle Medical; Home Diagnostics, Inc; Patton Medical Devices; AgaMatrix; Eli Lilly and Company; Amylin Pharmaceuticals, Inc; and Animas Corporation. She has received honoraria from Novo Nordisk, Takeda, Amylin Pharmaceuticals, Abbott, Home Diagnostics, Eli Lilly, AgaMatrix, Animas, and Seattle Medical. In addition, she serves on the Speakers’ Bureaus for Amylin, Lilly, Novo Nordisk, and the Amylin-Lilly Alliance and receives grants/research support from the NIH (2 research studies), Eli Lilly, and Amylin Pharmaceuticals.
- Jacqueline King, MS, RD, FADA, CDE, conducts continuing education for Bayer Corp.
- Karen Green, MSN, APN, CNP, BC-ADM, CDE, has no financial disclosures to declare.
The approval of this educational offering by the AADE does not imply endorsement of specific therapies, treatments, or products discussed in the presentations.
The authors wish to thank Melissa Ford for her contribution to the writing of the article.
CE Credit Information
To receive a Statement of Credit, you must:
- Review the full content of the program; and
- Successfully complete the post-test (70% or higher).
Note: You will have 2 opportunities to successfully complete the program.
Your statement of credit will be issued immediately upon successful completion of the test and submission of the evaluation form.
This program is organized by AADE and supported by an unrestricted educational grant from Medtronic, Inc. and LifeScan.
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