The insulin infusion pump is an electronic device about the size of a cell phone connected to the body through a catheter with a flexible needle at the tip. The needle is inserted into the subcutaneous region of the abdomen, arm or thigh, and must be replaced every two to three days.

HISTÓRY

In the early 1960s, Dr. Arnold Kadish developed the first continuous insulin infusion system (SICI), popularly known as an insulin pump. It consisted of a large, heavy and uncomfortable device, carried like a backpack. Despite its rudimentary appearance, it was effective in automatically administering insulin.1 It was only in the late 1970s that insulin pumps began to be commercialized, providing much enthusiasm in the medical field. In that same decade, they began to be used in studies such as the Diabetes ControlComplicationsTrial (DCCT),1,2 but the initial results were almost always disappointing, with pumps that were not discreet, difficult to use, and with constant errors in the functioning mechanisms. Therefore, its use was restricted to more complicated and difficult-to-control cases.1 The great advance occurred in the late 1980s, with the reduction in the size of insulin infusion systems, which became similar to the portable devices of the time. Thus, they began to be used in a greater number of patients as a resource for stricter control of glycemic levels.3

CHARACTERISTICS

The insulin pump is a mechanical device with electronic control, the size of a pager, weighing about 80 to 100 g. Placed outside the body, attached to the waist, hung inside clothing or around the neck, the infusion pump must be used 24 hours a day. In most insulin infusion systems, the pump is connected to a thin plastic tube that has a flexible Teflon cannula, which is inserted under the skin, usually in the abdomen, and through it sends insulin to the subcutaneous tissue of the patient continuously in microdoses, according to the dosage previously defined by the doctor. Other cannula application sites can be: lumbar region, thighs and even upper limbs (6). Insulin pumps are very accurate.

Insulin release during the 24 hours, which is automatic and done through a previous programming, can be constant or variable. Doses as small as 0.1 U/hour can be programmed, or no insulin at all, for a few hours, adapting to the different needs of each period of the day. As it is not waterproof, it must be disconnected from the cannula (for a maximum period of up to two hours) when the patient wants to swim or take a shower. The insulin infusion pump implements are: a) insulin reservoir; b) infusion set (catheter + cannula); c) batteries.

HOW IT WORKS

The pump acts similar to a normal pancreas, releasing insulin in low doses between meals and during sleep. The basal secretion rate is associated with the deposition of insulin in a bolus right after meals. The dose varies according to the food ingested or when there are higher blood glucose levels.8,10

For the implantation of the pump, the evaluation of a nutritionist is necessary, aiming to guide the patient about the diet and the count of ingested carbohydrates. It is from this count that the doctor will calculate the rate of insulin that should be administered in bolus.

INSULIN PUMP PROGRAM (ACCU-CHECK PARTNERSHIP – PANCREAS INSTITUTE)

The Insulin Pump Program was specially designed to optimize your metabolic control, your decision making and your treatment satisfaction, with education and management of Diabetes Mellitus.

With our team, you will have access to technologies and tools in the management of your health care.

The Pâncreas Institute has, in addition to the team of physicians, a multidisciplinary team of excellence specialized in insulin pumps. Book your appointment now.