Diabetes Pharmacist : Diabetes Pharmacist Blog : Focus Express Mail Pharmacy : Insulin Pumps, Diabetes Supplies and Information

I just read that "cabin pressure changes during air flights may affect insulin pumps causing patients to receive too much or too little medication." Does anyone have any experience with this?

The article  continues :"Researchers at John Hunter Children’s Hospital in Newcastle, Australia investigated insulin pumps used by patients with type 1 diabetes to deliver insulin. The study, published in the journal Diabetes Care, found that when ten insulin pumps were flown on a commercial flight, they were affected by air pressure changes. Air pressure decreases during takeoff caused the pumps to deliver extra insulin, and air pressure increases during descent caused some insulin to be sucked back into the pumps, resulting in an insufficient amount of insulin being dispensed. The air pressure causes bubbles to form and expands existing bubbles, affecting the amount of insulin being given. Researchers advise diabetics to be aware of the effects of pressure changes, and possibly disconnect the pump before takeoff and landing."

I would think and hope that the pump manufacturers have taken flying into account. But, maybe I'm wrong. Can someone who wears an insulin pump and travels by jet frequently give us some insight?  Thanks!

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The staff at Focus Pharmacy speak to people with Diabetes all day. Lately, I hear, they've been getting a lot of "Where have you been all my life?" and "THANK YOU for being there for us"  from new customers. And some "We couldn't afford our medications and supplies if it wasn't for you, thanks!" from long time customers.  Just wanted to let those who don't know about Focus Pharmacy that:

• They stock all brands of insulin pump supplies including Medtronic,Omnipod, & Accu-Check
• They accept the insurance payment as payment in full (where allowed)
     so you have NO COPAYS To Pay
• Insurance claims and billings are handled by them - no paperwork for you.
• FREE overnight shipping of all your medications (they are a full service pharmacy too) and supplies.
• A live person will always answer your phone calls M-F, 9-5 ET 
• You can order your refills on-line anytime
• A pharmacist is available for emergencies 24 hours a day, 7 days a week
• They guarantee 100% satisfaction.
•  No Membership or Hidden Fees Ever
• If your insurance, qualifies, you get a $50 gift card with your first order!

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According to a recent study of people with Type 2 Diabetes, among high insulin users (using more than 150 units daily) insulin pump delivery  saved more than $12,000 over 4 years vs.Multiple Daily Injections (MDI) because basal rates dropped dramatically owing to better insulin absorption said certified diabetes educatorPhyllis Wolff-McDonagh, DNP, at the annual meeting of the American Association of Diabetes Educators.

 MDI were significantly more expensive than pump therapy for the high insulin user  patients: $41,100 vs. $28,826. With the potential cost savings from improved glycemic control factored in, insulin pumps could also prove cost savings even for the moderate-use group, Dr. Wolff-McDonagh pointed out. Cost calculations included both supplies (syringes or pen needles, pump plus pump supplies) and the insulin.

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Roche Insulin Delivery Systems has announced today that it has discontinued the ACCU-CHEK FlexLink Plus infusion sets as well as the ACCU-CHEK LinkAssist Plus insertion device. An alternative replacement is the ACCU-CHEK UltraFlex infusion sets and the ACCU-CHEK LinkAssist insertion device.

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Who should be on an Insulin Pump? How old do you have to be to be on an Insulin Pump? How will my life change if I get an Insulin Pump?

All of these questions, and others,  are answered by this excerpt from Dr. Steve Edelman, MD as well as a video from Focus Express Mail Pharmacy. Thank you both for your contribution.

Dr Edelman says the following,"In my opinion, you are an insulin pump candidate if you are a reliable person who tests your blood glucose values regularly. You do not have to be a rocket scientist or a doctor to achieve success with an insulin pump.

I recommend pump therapy to people who are consistently experiencing poor glucose control or frequent hypoglycemic episodes despite an appropriate insulin injection regimen. I also offer pump therapy to individuals who have adequate glucose control but are tethered to a rigid daily schedule that reduces their quality of life. I do not recommend starting pump therapy during pregnancy; it should be started before conception to allow for adjustment and blood glucose regulation.

Click here for more information about insulin pumps and pump supplies.

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We get asked all the time. "How Does an Insulin Pump Work?" So, rather than reinvent the wheel, here's a synopsis as found on the ADA (American Diabetes Association) website as well as a video from Focus Express Mail Pharmacy. Our thanks to them both!

"An insulin pump can help you manage your diabetes. By using an insulin pump, you can match your insulin to your lifestyle, rather than getting an insulin injection and matching your life to how the insulin is working. When you work closely with your diabetes care team, insulin pumps can help you keep your blood glucose levels within your target ranges.  People of all ages with type 1 diabetes use insulin pumps and people with type 2 diabetes have started to use them as well.
How do insulin pumps work?

Insulin pumps deliver rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. Your 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, and keeps your blood glucose levels in range between meals and overnight. Often, you program different amounts of insulin at different times of the day and night.

When you eat, you use buttons on the insulin pump to give additional insulin called a bolus. You take a bolus to cover the carbohydrate in each meal or snack. If you eat more than you planned, you can simply program a larger bolus of insulin to cover it.

You also take a bolus to treat high blood glucose levels. If you have high blood glucose levels before you eat, you give a correction or supplemental bolus of insulin to bring it back to your target range."

For more information  insulin pumps or insulin pump supplies, contact  Focus Express Mail Pharmacy.

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According to researcher Marie L. Misso, PhD, of the Australasian Cochrane Center at Monash University, Clayton, Australia, "good evidence is now available to support the use of continuous subcutaneous insulin infusion in the appropriate patient."

To assess and compare the effects of continuous subcutaneous insulin infusion with multiple insulin injections, researchers studied 23 randomized controlled trials which included a total of 973 patients who used one of the two interventions for their type 1 diabetes. Results showed that  the continuous subcutaneous insulin infusion users (users of insulin pumps)  had significantly lower HbA1c levels compared with multiple insulin injection users.

For more information about insulin pumps, click here!

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 Insulin pumps, used by people with diabetes, are medical devices that continuously deliver insulin under the skin through a catheter. Most often, a pump connects somewhere in the waist area. Many health providers recommend the insulin pump because its slow and steady release of insulin mimics a healthy pancreas.

 In recent years, insulin pump technology has made many new and important advances including improved screens with higher resolution, comfortable infusion sets, tactile bolusing and safety alarms. And now there's now a new generation of insulin pumps called patch pumps. Patch pumps adhere directly to the skin with no catheter tubing showing and insulin is infused directly under the skin. The Omnipod is the only patch pump on the market at the current time but there are many that are in the works.

Nancy J. Bohannon, MD, a physician at St. Luke's-Roosevelt Hospital Center in San Francisco, has reviewed the following patch pumps which are still being developed:

• Finesse (Calibra Medical): delivers bolus insulin or pramlitide.
• V-Go (Valeritas): is a once-daily disposable insulin delivery system for type 2 diabetes.
• Solo (Medingo): has a three-month life, electronically controlled.
• Freehand (MedSolve Technologies): is remote controlled, 80% smaller than OmniPod.
• Insulin NanoPump (ST Microelectronics and Debiotech): has large reservoir, miniaturized system.
• Altea Therapeutics: is developing a 12-hour and 24-hour patch.
• Medtronic: is developing a patch delivery system.

Most insurers will cover insulin pump therapy in situations where insulin pump therapy will significantly improve the level of diabetes care and control over and above multidose insulin (MDI) therapy. 
 

To see how easy it is for YOU to get an insulin pump or insulin pump supplies from Focus Express Mail Pharmacy, click here!

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Not able to compete with Medtronic-Minimed and J&J Animas, Smiths Medical announced today that it will stop selling the Deltec Cozmo^® insulin pump and gradually exit from the diabetes business.

What does this mean to you and me?

• When your pump approaches the end of its warranty period, you should consult with your physician to choose an insulin pump from another manufacturer.
• Smiths Medical will work with pump users to transfer purchases of cartridges and infusion sets to one of the many national and/or regional distributors that stock these items.

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Did you know that when you tie your shoes or when you get dressed or when you sleep, the different changes in the position of your insulin pump, relative to its infusion set, is significantly changing the expected rates of insulin being delivered to your body?

Researcher and lead investigator Howard Zisser, MD, Director of Clinical Research and Diabetes Technology at the Sansum Diabetes Research Institute in Santa Barbara, CA. found that raising or lowering a conventional insulin pump, to the full extent of its tubing, can significantly affect the accuracy of insulin delivery, especially at low basal infusion rates. "This is particularly important for children, for whom low basal rates are often used," Dr. Zisser noted.

He added, "Insulin pump therapy allows for precise control of insulin delivery for patients with type 1 diabetes. However, in this study, we saw that a conventional pump's insulin delivery rate can fluctuate significantly due to changes in the pump's height relative to its infusion set and the end of the tubing. This can increase blood glucose variability, which previous research has shown to be a risk factor for the progression of complications of diabetes,"

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