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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.read biographyclose window
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.
Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.
Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Insulin pumps: Explore the pros and cons
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Are you considering the use of an insulin pump? More and more people with type 1 diabetes and insulin-dependent type 2 diabetes are wearing insulin pumps. Insulin pumps deliver rapid-acting insulin 24 hours a day.
Insulin pumps deliver insulin in three ways:
- Basal rate. The insulin pump delivers small hourly increments of rapid- or short-acting insulin over a 24-hour period. The basal rate replaces a long-acting insulin injection and accounts for approximately 50 percent of a person's total daily insulin requirement.
- Boluses. These insulin injections are required to cover carbohydrates eaten at meals.
- Correction. A correction is used to adjust the pre-meal insulin bolus for glucose values outside of the blood glucose target range.
Benefits of insulin pumps
Insulin pumps can:
- Improve blood glucose control by delivering individualized basal rates
- Eliminate inconvenience of multiple daily injections
- Increase lifestyle conveniences — you have more flexibility about when and what you eat
- Offer precise dosage delivery in basal rates as low as 0.025 units per hour and bolus rates of 0.1 unit doses
- Allow temporary basal rates
- Deliver a special meal bolus to match the delays in the absorption of certain foods
- Usually result in fewer large swings in your blood glucose levels
- Reduce frequency of hypoglycemia
Disadvantages of insulin pumps
On the flip side, an insulin pump:
- Can malfunction, delivering too much or too little insulin
- Increases risk of diabetes ketoacidosis — the pump uses only rapid-acting insulin, and if insulin delivery is disrupted for any reason, your blood glucose will rise rapidly putting you at risk of ketoacidosis
- May be expensive — costing around $7000 for the pump itself, with supplies costing about $1500 a year
- Is attached to you all day every day
- Won't take care of all your blood glucose problems — you'll still need to test your blood sugar before meals and at bedtime, and the person using the insulin pump will continue to give a bolus before meals
Most insulin pump users would agree that the advantages far outweigh the disadvantages. My two sons with diabetes both use insulin pumps and wouldn't have it any other way. If you're considering an insulin pump, you must currently be on a multiple daily insulin dose program, be experienced in carbohydrate counting, and test your blood sugar at least four times a day. A good candidate for an insulin pump must also be able to understand and work with mechanical devices or computers. Please discuss with your diabetes care team if insulin pumps interest you.