Insulin Pumps

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Alternative Devices for Taking Insulin
Many people who take insulin to manage their diabetes inject the insulin with a needle and syringe that delivers insulin just under the skin. Several other devices for taking insulin are available, and new approaches are under development.

Injection aids are devices that help users give injections with needles and syringes through the use of spring-loaded syringe holders or stabilizing guides. Many of these aids use push-button systems to administer the injection.

Insulin pens can be helpful if you want the convenience of carrying insulin with you in a discreet way. An insulin pen looks like a pen with a cartridge. Some of these devices use replaceable cartridges of insulin; other pen models are totally disposable. A short, fine needle, similar to the needle on an insulin syringe, is on the tip of the pen. Users turn a dial to select the desired dose of insulin and press a plunger on the end to deliver the insulin just under the skin.

Insulin jet injectors send a fine spray of insulin through the skin by a high-pressure air mechanism instead of needles.

An inhaled insulin delivery system provides rapid-acting insulin as a dry powder that is inhaled through the mouth into the lungs. The insulin then passes into the bloodstream. The United States Food and Drug Administration (FDA) approved inhaled insulin on January 27, 2006, for adults with type 1 or type 2 diabetes. The manufacturer predicts that inhaled insulin will be available by mid-2006.

Subcutaneous infusion sets, also called insulin infusers, provide an alternative to injections. A catheter (a flexible hollow tube) is inserted into the tissue just beneath the skin and remains in place for several days. Insulin is then injected into the infuser instead of through the skin.

External insulin pumps are devices that deliver insulin through narrow, flexible plastic tubing that ends with a needle inserted just under the skin near the abdomen. The insulin pump is about the size of a deck of cards, weighs about 3 ounces, and can be worn on a belt or carried in a pocket. Users set the pump to give a steady trickle or "basal" amount of insulin continuously throughout the day. Pumps release "bolus" doses of insulin (several units at a time) at meals and at times when blood glucose is too high based on the programming set entered by the user. They also can be programmed to release smaller amounts of insulin throughout the day. Frequent blood glucose monitoring is essential to determine insulin dosages and to ensure that insulin is delivered.

Approaches Under Development
Implantable insulin pumps are surgically implanted under the skin of the abdomen. The pump delivers small amounts of insulin throughout the day and extra amounts before meals or snacks. Users can control doses with a remote control unit that prompts the pump to give the specified amount of insulin. The pump is refilled with insulin every 2 to 3 months.

The insulin patch, placed on the skin, provides a continuous low dose of insulin. Because it's difficult to overcome the skin's barriers, delivery of insulin through the skin is aided with sound waves or an electrical current.

Insulin pills provide insulin in tablet form. Researchers are working on ways to get the insulin into the bloodstream before it is changed by normal digestive processes.

Researchers are investigating delivering insulin as a spray. A buccal spray delivers liquid insulin into the mouth. Insulin is then absorbed through the tongue, throat, and inside of the cheeks. An intranasal spray delivers insulin as a nose spray.

An artificial pancreas, a surgically implanted device, imitates the action of the pancreas by sensing blood glucose levels and secreting insulin in response. The user also can release insulin using a remote control.
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