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Quinte Insulin Pumpers- Minutes of the group meeting, November 19, 2003 |
Quinte Insulin Pumpers- Minutes of the group meeting, November 19, 2003
On Wednesday, November 19, 2003, approximately 30 people who use insulin pumps,who are considering the use of insulin pumps or who are family members and
friends of those who have an interest in this therapy, gathered for an exchange
of information. Two special guests were journalism students associated with the
Loyalist College Pioneer newspaper. New members were encouraged to leave their
e-mail addresses with Louise Marinier and other contact information with Nancy.
FUNDING
Chair Nancy Stafford confirmed that under the Ontario Disability Support Program
(ODSP), there is public funding for insulin pump therapy supplies including
batteries.
To have provincial funding extended especially to include the purchase of pumps
themselves, we should write to the new minister, Honourable George
Smitherman, Minister of Health and Long-Term Care, 10th Floor, Hepburn
Block, 80 Grosvenor Street, Toronto M7A 2C4. and to our riding member in the
provincial legislature (Ernie Parsons in Hastings-Prince Edward).
Public (government) funding for insulin pump therapy is available in the United
States, England, France and other European countries.
Some financial assistance for the purchase of a pump by members may be available
through Quinte Insulin Pumpers and those concerned should contact Nancy.
NEW GUIDELINES
Debbie Moffat reported on the recent Canadian Diabetes Association Conference in
Ottawa. New guidelines for recommended blood sugar levels are expected to be
released within the next two months. Some expressed concern that having a goal
below 6.0 will lead to an increased risk of hypoglycaemia. Otherwise, most
sessions were related to Type II diabetes issues.
NEW PRODUCTS
Jill Milliken, Diabetes Nurse Specialist, had attended a Diabetes Technology
Conference in San Francisco. Highlights included presentations on inhaled
insulin, the implantable pancreas, the use of alganate in placing
insulin-producing cells on a pancreas, and the glucose watch with associated
issues.
Medtronic has released a new infusion set called the "Quick Set Plus" which has
a new rotating connection but still fits into the usual quick serter.
Auto Control Medical has released a 1.2 cm. length cannula "comfort" infusion
set. This is 5 mm shorter in length than the standard comfort set.
The Medtronic MiniMed 712 Paradigm Insulin Pump holds 300 units of insulin.
This month's issue of Popular Science magazine lists the continuous glucose
monitoring system (CGMS) whereby the meter "talks" to the pump among its top 100
products for the year. An example was circulated among the members.
INSULIN PUMP THERAPY
Jill explained that the medical benefits of insulin pump therapy being greater
than those of injection therapy have been demonstrated by 52 studies involving
Type 1 diabetics (1600 patients) Medical analyses have demonstrated that pump
therapy improves A1C readings because there are fewer highs and lows, and
diabetes complications are reduced or delayed through better control of blood
sugars..Weight gain is reduced, and the quality of life improves.
Independence is another major benefit of insulin pump therapy. A member
commented that before getting her pump, she could never be alone; her husband
had to check her every 2 hours. Now she has recovered her personal awareness of
highs and lows.
Convenience? For some diabetics, insulin pump therapy is more convenient than
multiple injections (attending business meetings, locating clean washrooms, etc.
), for others pumping is more complicated than the routine of injections. It is
possible to remove the pump for up to two hours if necessary.
Testing and recording blood sugar levels is important. If you don't test, you
won't know if you have a problem. Testing before a meal enables you to
calculate the size of the bolus required to compensate for the carbohydrates
consumed and the amount of exercise you have planned. Looking over your
records, you will be able to detect patterns in your highs and lows.
A basal rate is what you need for non-food activities. The basal rate holds the
blood sugar level flat without eating. With an insulin pump, a little bit drips
in all the time.
Set your night basal rate first because if you don't start your day right, you
can't really adjust it.
A bolus is a correction for the food eaten. It is also used to correct a high
blood sugar reading.
A "square wave bolus" is useful after eating such high-fat meals as pizza,
Chinese food, cheesecake, or a buffet dinner. This extends the bolus over the
time needed during digestion.
With multiple injection therapy a person can be on a rollercoaster of highs and
lows. The sugar level is low so a person eats to compensate. Then the sugar
level swings high so the person takes more insulin. Then it drops, and the
person eats again. This can lead to weight gain.
When beginning on an insulin pump, it is important to have the support of a
family member who will help to establish a consistent daily routine. The first
week is stressful. Try to have a quiet routine.
To calculate the carbohydrate content of your meals, see the Contents label on
the packages, refer to a carbohydrate counter booklet, and select recipes from
magazines and cookbooks that list the number of carbohydrates per serving. Note
the size of the "servings." A dietician can help.
Treat a hypo promptly: take 15 grams of carbohydrates, wait 15 minutes and test
again.
Use a Chapstick to get rid of the adhesive guck after a site change.
BOOKS
Jill recommended a new reference paperback released in 2003: Using Insulin-
Everything You Need for Success by John Walsh, Ruth Roberts, Chandraeskhar
Vainer and Timothy Bailey, ISBN 1-884804-85-3 Torrey Pines Press, San Diego
California. Reading it would be an excellent preparation to understand insulin
pump therapy; it is less technical than the book, Insulin Pumping, also
available through our group.
Also available on the group library are Teens Pumping it Up, Insulin Therapy
Guide for Adolescents by Elizabeth Boland 1998, and Easy as ABC What You Need
to Know About Children Using Insulin Pumps in School by Deborah F. Tappen
2000.