PAINLESS INSULIN DELIVERY SYSTEM

Medicine aims to alleviate the pain and distress. Many diseases scourged mankind for ages. Marvellous inventions and discoveries have been made in the field of medicine right from the very early times. The significant ones that changed history as we know it today are

• Antiseptics
• Antibiotics
• Anaesthesia
• Anti-Rabies vaccination
• Insulin

Medicines which can be taken orally are well accepted by patients. Injections play a major role during Surgeries (Anaesthesia), acute emergencies and in cases of severe infections where we want the drug to take an immediate effect . One life saving medicine which doesn’t come under any of the above mentioned categories is Insulin. Many people have lost their lives to acute hyperglycemia (High Sugars). Those affected by the non insulin dependent type of Diabetes (Type2) suffered the long term complications of elevated blood sugars.

Paul Langerhans

Islets of Langerhans

It was the discovery of Insulin secreting cells in the pancreas by Langerhans which paved way for future research. Banting and Best provided us with a cure in a bottle – INSULIN. This saved millions of lives and continues to do so.

Porcine Insulin

Bovine Insulin

We have come a long way from crude Porcine, Bovine insulin to designer insulin. As the years passed safe insulin was developed. These were devoid of side-effects, much safer to use and more stable are various temperatures. So with this weapon we are ready to heal the world of Diabetes?? Oh No.... Wait.... There is one more problem....

Now the problem we face is with the route of administration. By nature insulin is a protein and has to be given via injections only. We are now at a juncture waiting and praying for the scientists to be successful in bringing out oral insulin. Few very promising compounds have been approved and some more are about to finish the necessary clinical trials...

All drugs undergo rigorous testing to make them absolutely safe for human consumption. The current scenario says we may have to wait few more years till safer oral insulin becomes extensively available.

One of the greatest technological marvels in the field of medicine has been the biomedical devices. Of great importance among them is the INSULIN PUMP. This device is useful in patients with Type 1 Diabetes, in those requiring very high doses of insulin, Type 2 patients requiring multiple insulin injections and for those who are afraid of taking injections.

So let’s have a bird’s eye view regarding INSULIN PUMP..

What is Insulin pump?

It is a small electronic device which delivers short acting insulin (Regular insulin) at a programmed rate via a small catheter placed in the abdominal wall.

Insulin doses are separated into:

• Basal rates
• Bolus doses to cover carbohydrate in meals
• Correction or supplemental doses

Basal insulin is delivered continuously over 24 hours to keep blood glucose levels in range between meals and overnight.

Bolus dose (additional insulin) can be given at the time of meals with a push of a button.

More dosage of insulin can be given if needed to cover the already elevated sugars or unplanned excess intake of carbohydrate.

Components of Insulin pump

How to place the Pump

The first question most of them ask when we mention insulin pump is “Where am I supposed to put it?”  An important question of course...  insulin pump is designed for our convenience so even the options how to wear it depends on patient convenience. You can buy a pump case or it can be attached to a waistband, pocket, bra, garter belt, sock, or underwear. You can also tuck any excess tubing into the waistband of your underwear or pants. When you sleep, you could try laying the pump next to you on the bed. You could even try wearing it on a waistband, armband, leg band, or clip it to the blanket, sheet, pajamas, stuffed toy, or pillow with a belt clip.

Showering and bathing are other instances when you should know where to put your insulin pump. Although insulin pumps are water resistant, they should not be set directly in the water. Instead, you can disconnect it. All insulin pumps have a disconnect port for activities, such as swimming, bathing, or showering. Some pumps can be placed on the side of the tub or in a soap tray. There are also special cases you can buy. You can hang these cases from your neck or from a shower curtain hook.

Advantages of Using an Insulin Pump

• Eliminates individual insulin injections
• Delivers insulin more accurately than injections
• Improves HbA1c
• Fewer large swings in your blood glucose levels
• Delivery of bolus insulin easier 
• Insulin pumps allow you to be flexible about when and what you eat
• Reduces chances of severe low blood glucose episodes
• Eliminates unpredictable effects of intermediate- or long-acting insulin
• Allows you to exercise without having to eat large amounts of carbohydrate

Disadvantages of Using an Insulin Pump

• Can cause weight gain
• Can cause diabetic ketoacidosis (DKA) if your catheter comes out and you don’t get insulin for hours
• Expensive
• Can be bothersome since you are attached to the pump most of the time
• Can require a hospital stay or maybe a full day in the outpatient center to be trained

(L) First insulin pump (R) Insulin Pump in Use

Like any other modalities of treatment INSULIN PUMP also has its own advantages and disadvantages. In practice we see that patients are more comfortable with the pump. The disadvantages are quickly forgotten. If you still don't like it... well there is always an option to go back to pen devices or to the conventional insulin delivery systems. Cost of operating the pump is the main disadvantage but , if you can afford it then insulin pump is the best choice available to get away from pricks...