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Let's Talk About Pumps

May 26, 2015

I work with a largely older Mexican-American adult population and have not had much success with starting patients on insulin pumps because they don't meet the qualification criteria or they lack the literacy skills to manage one.

Carbohydrate counting and physical limitations such as poor manual dexterity or impaired vision have been barriers to successful pump training in my patient population. As a result, I have lost my skills in pump management and have not kept up with the latest trends. Recently I had a patient who was requesting an insulin pump and I realized I have not worked with pumps for over three years and I could not remember the labs needed. What I do remember is that patients on pumps need a lot of invested time and I am ambivalent about starting patients on pumps.

In general, I wonder what percentage of patients with diabetes currently uses an insulin pump. I found a website listing common insulin pumps currently available on the market.

A lot of questions and discussion regarding pumps currently has been ongoing on the specialty groups on MyAADENetwork and I am rethinking my strategy for getting more patients interested on initiating use of insulin pumps.

Are you a pump expert? What tips do you have for me or others who have lost our skills or want to get back into pump training?

4 comments

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  1. Mar 14, 2011

    I would recommend getting with one of the pump company reps. and start there, with the most common pump that you see in your area or that would be most useful for your patient population. They can get you trained and certified so you will be confident when you start a pump pt. The reps we work with are great resources if we run across a difficult situation etc. Good luck! There is one book called "Pumping Insulin" by John Walsh, PA, CDE and Ruth Roberts, MA that I have used alot since getting started into pump training. It may help refresh things for you!
  2. Mar 04, 2011

    Hi, We are beginning pump training at a small outpatient clinic. A representative from the company that sells the pump is coming to our facility to train several MDs, nurse practioners and myself. She stated we can wear a pump (saline). We all have never done pumps so hopefully we will learn from start to finish It is my understanding that for patients on Medicaid in New York state, however, they must see an endocrinlogist for a pump. Good luck with it.
  3. Mar 02, 2011

    Iris: We do about 6-8 pumps per year and it's hard to keep up-to-date with that many as well. I would suggest connecting with one or several of your pump company clinical reps to see if you can 'tag-along' on pump trainings or ask to do/be observed on a few trainings. I find that the best way to stay abreast of the skill is to do it or observe it. Good Luck! Laurie
  4. Feb 26, 2011

    I wish to start a discussion about CDE licensure. Most CDE's have a license RN's, RD's MD's, RPh 's does that make them prepared for DSMT ? I will speak to my profession, nursing . There are few nurses that could pass the CDE exam without a complete study of diabetes and adult , child education techniques . Why bother getting certified if everyone with a license could do your job . In my opinion it's like allowing an MD could do brain sugery without further training and passing exams. If anyone with a license is prepared for DSMT why bother to test and retest to hold the CDE credential. A CDE is a trained specialist that deserves to be set apart like in my profession a pediatric, CCU - ICU nurse and receiving monetary reward for the extra effort added to our training .

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