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December 28, 2005

Insulin Pumps

Question from Russia:

I'm 21 years old and live in Russia. I have problems controlling my blood sugars, which I check four or five times a day. Recently, I learned about insulin pumps and have decided to buy one. I hope to buy one in the U.S. because I'm not sure that the price in Russia is the real price; I mean, it's higher. But, I cannot find prices of all pumps on the Internet and don't know which one is better. Here we have just only one by MiniMed.

Answer:

The insulin pump is an excellent way to controlled glucose, but you cannot use it by yourself without the assistance of a pump team – physician, nurse, dietician,etc. – who have experience with such pumps. It is also very expensive, about U.S.$6000, plus expensive supplies, catheters, etc. You should be able to get excellent control of your blood glucose levels with a multi dose insulin regimen using Lantus at bedtime and breakfast plus Humalog or NovoLog at meal and snack times, all based upon frequent blood glucose testing, carbohydrate counting, etc. Alternatively, overlapping doses of NPH Humulin or Novolin can also be used very successfully coupled with the multi-dose insulin (MDI) Humalog or NovoLog to do the same thing.

If you speak and read English, get Insulin-Dependent Diabetes in Children, Adolescents and Adults by Ragnar Hanas, M.D. and read it twice. It will explain these options in great detail and then you can go back and work with your diabetes team to improve your A1c levels. But, the key is learning about food and snack choices and coupling this with frequent blood glucose monitoring so that you can analyze your own results every week to make improvements.

SB