Story by: David Steen Martin on February 14, 2024
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If you have diabetes, new devices give you more options than ever to manage your glucose levels.
An insulin pump can deliver insulin throughout the day without the need for multiple daily injections. Thanks to advances in technology, insulin pumps are now able to link with continuous glucose monitors. This means the pump can vary the insulin dose in real time to help your glucose stay closer to a desired range without as much effort from you.
“We often recommend these pumps because they lessen the burden of diabetes management and improve control of glucose levels,” said Heather M. Rush, APRN, CDCES, pediatric nurse practitioner and certified diabetes care and education specialist with Wendy Novak Diabetes Institute, a part of Norton Children’s Endocrinology, affiliated with the UofL School of Medicine.
The pump and CGM together are called a hybrid system. You still need to input the number of carbohydrates you are eating, but you typically don’t need to enter glucose levels because the pump is able to adjust insulin to compensate.
“We see these pumps having an incredible impact on patients’ lives. Patients and their families don’t need to think about diabetes management all the time,” Heather said.
The pump does require a small tube to be inserted under the skin, but you are taught how to change this at home as it requires changing every few days. The device must be worn every day. The CGM is a small device attached to the body, with a small filament under the skin that communicates glucose levels to a receiver (which can be an app on your smartphone).
If you or a family member is interested in a pump, Wendy Novak Diabetes Institute offers an insulin pump class to show how it works, the pros and cons of using a pump, and realistic expectations for using a pump. Families or patients interested in these small, group classes should talk with their provider or educator and they will help with scheduling.
Insulin pens are devices that also have made diabetes management easier. The pens are pre-filled, and you need to dial the pen to the desired dose and inject with a pen needle. New “smart pens” can communicate with an app that helps calculate an insulin dose based on the current glucose level, carbohydrates consumed and insulin already given that is still working in the patient’s system.
Another recent development is an insulin inhaler, called Afrezza, where a person inhales insulin powder that could prevent the need for certain insulin injections. After you inhale the powder, it dissolves in the lungs and is absorbed into the bloodstream. Because it works much faster, Afrezza can be taken during a meal instead of ahead of time. Afrezza is not currently Food and Drug Administration- approved for pediatric use, but clinical trials are ongoing.
Other diabetes devices include a stand-alone continuous glucose monitor. This is a flexible sensor placed under the skin. The sensor can remain there for a week to 14 days and offers glucose readings every five minutes. A transmitter remains outside the skin and can send readings to a receiver or smartphone and can be shared among family members.
An insulin pump also can be used independently of a continuous glucose monitor. The pumps — either a patch pump or a tubed pump — give you insulin throughout the day as programmed into the settings. You will get basal insulin continuously throughout the day which replaces your long-acting insulin, and then bolus insulin will be delivered when you input your glucose level and the carbs that you eat into the pump.
At each visit to Wendy Novak Diabetes Institute, families are encouraged to bring their devices — glucose meters, continuous glucose monitors and insulin pumps. Data can be download and placed in your chart, giving providers the most up-to-date glucose readings to review.
Providers also discuss technological advances with patients frequently, as members of the team at Wendy Novak Diabetes Institute are also tasked with keeping up with the latest devices and technology. The provider team also tries out new technology, allowing members to be well-versed on any potential issues patients and families may experience.