Insulin pumps: Should you buy one? Part 1

For many diabetic individuals, monitoring blood sugar and taking diabetic medications or administering insulin every single day can be a chore. Now scientists have come up with an insulin pump.

The insulin pump delivers a constant amount (basal) rate of insulin 24 hours a day to control your blood sugar. One can program the pump to administer additional doses of insulin after a meal or to correct high levels of sugar.

The insulin pump is about the size of a thin wallet and can be carried on a belt underneath the clothing. A thin plastic tubing from this pump is then tunneled under the skin using a special needle. This tunneled site needs to be rotated every 2-3 days.

The insulin pump needs to be programmed for it to work.

Advantages of an insulin pump include the following:

- The pump controls your blood sugar levels without you having to worry about needles and syringes. Your basal rate is preprogrammed. If you do decide to eat an extra meal or have high sugar, all you have to do is press the button and a supplemental dose of insulin is delivered.

- Instead of giving insulin needle injections 2-6 times a day, you rotate the tubing site every 2-3 days.

- There is less time wastage and you do not need to carry a bunch of syringes and needles wherever you go

- In general, individuals who use the insulin pump have much better control of their blood sugars and hence fewer diabetic complications

- Individuals who use the insulin pump also have fewer incidences of hypoglycemia (low sugar).

How effective is Byetta for my diabetes?

In general, type 2 diabetes is treated with diet, exercise, and oral anti diabetic drugs. Now there is a new drug called Byetta (exenatide) to treat type 2 diabetes. The drug is administered as an injection but is not like insulin at all and not meant to treat type 1 diabetes. At present, Byetta is only approved for use in combination with special oral anti diabetic drugs. Incidentally, this drug was first discovered in the saliva of the Gila monster lizards.

Byetta works by mimicking the hormone incretin- this means it mimics incretin and increases insulin production when food is consumed. It also causes the liver to produce less sugar. Another benefit of the drug is that it reduces motility in the stomach, thus giving the patient a sensation of a full stomach. This leads to less food consumption and hence more weight loss. Several studies have shown that over 24-30 weeks, one can lose close to 2-3 kgs.

Byetta is available as an injection which can be given under the skin of abdomen, thighs, or upper arms. It is usually administered twice a day before the two heavy meals of the day. The meals should be at least six hours apart. To be effective Byetta must be injected within 60 minutes before the meals. It should not be injected once the meal has been consumed or more than 60 minutes before a meal is eaten.

Inhaled Insulin for Diabetes- Too much hype! Part 2

Exubera was ideal if you met the following criteria:

You only used short acting insulin to control your diabetes. Exubera was not available with longer acting insulin formulations

The inhaler was ideal for individuals who had never smoked. Smoking generally destroys the lung wall linings and there is no guarantee that that exact dose of insulin will be absorbed.

Individuals with asthma, COPD, emphysema or bronchitis generally were not good candidates for Exubera. These conditions are associated with lung damage which may prevent the insulin from getting absorbed into the blood stream.
You had no allergies to human insulin.

Most health care practitioners had to deal with lung function before prescribing the inhaled insulin and many individuals had to undergo lung functions testing- which only increased the costs.

Of the individuals who used Exubera, most remain satisfied. A number of studies showed that Exubera could control blood sugars but it still was not as good as the injectable insulin. Erratic absorption of inhaled insulin had been reported and a few individuals had developed either low or high sugars.

Exubera was only ideal for a diabetic who simply wanted to control his blood sugars after a meal. Exubera did not replace the standard long acting insulin and one still needed to get the blood sugar levels monitored on a regular basis.

As of Dec 2007, Exubera is no longer available in the USA.

Final point

The inhaling device for exubera was pretty large and cumbersome. Even though light weight it was about the size of a flashlight.

For more on diabetic supplies, please visit www.medexsupply.com

Inhaled Insulin for Diabetes- Too much hype! Part 1

Insulin has been the standard treatment of diabetes for the better part of the century. Unfortunately it can only be administered via an injection. The chief reason why insulin cannot be taken as a pill is because it is rapidly destroyed by acid in the stomach. Over the years, many types of insulin formulations have been developed, but so far none have worked and insulin injections remain the cornerstone of diabetes treatment.

In the last decade, however, insulin which could be inhaled did become available. Known as Exubera, this inhaled short acting insulin was used to treat both type 1 and 2 diabetes.

Exubera is powderized insulin and came in prepackaged formulations. The package containing the insulin is placed inside a specially designed inhaler. The inhaler is placed in the mouth and activated. The insulin which is inhaled as a fine powder usually starts to work within 10-15 minutes.

Exubera only contained the short acting insulin form. It worked anywhere from 3-6 hours. Most individuals used Exubera 10 minutes prior to a meal.

Inhaled insulin was not for everyone and each individual has to discuss the pros and cons with the physician.