Treatment of type 1 diabetes has recently use of insulin pumps as well as introduction of some significant technologic advancements. Insulin therapy with “smart insulin pumps” renders treatment more physiological, whereas continuous blood glucose measurement systems are about to replace the conventional fingertip puncture. Not so long ago, these advancements have also enabled routine use of systems such as “artificial pancreas” and “bionic pancreas”, which allow automatic administration of insulin and blood glucose measurements. Insulin pump therapy and sensor products that are available in our country are utilized at our department. Currently, 20% of the children followed at Koç University Hospital with the diagnosis type 1 diabetes use insulin pumps, and 46% use continuous glucose monitoring systems.
As the Pediatric Diabetes team of Koç University, we do realize that insulin pump alone will not make a substantial contribution to treatment. That is why we concentrate on comprehensive diabetes training, primarily carbohydrate counting. Upon reaching a mutual agreement with diagnosed children/adolescents, parents and team members, we decide on fitting patients with pumps and make sure that they are trained in and follow training on carbohydrate counting/management. Insulin pump therapy consists of a 3-day process and consequent follow-ups.
Insulin Pump Therapy
· Consultation with dietitian and psychologist, determination of insulin/carbohydrate ratio and insulin sensitivity factor in the morning;
· Pump training, demo pump fitting with distilled water and treatment continued at home in the afternoon.
· Downloading GCMS data, if available, and glucometer;
· Training on pump functions;
· Training on hypoglycemia and hyperglycemia management;
· Team session, basal rate adjustments;
· Switch to insulin in the demo pump;
· Report compilation.
· Answering questions;
· Change of set;
· Training on exercise management;
· Management of disease conditions.
2 weeks later
· Pump and sensor download report;
· Review of settings;
· Introduction of models;
· Detailed sensor training, introduction of alarms.
1 month later
· Pump and sensor download report
· Review of settings.