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Insulin Pump Fatigue by Amy Rich

By Megan Watts posted 21 days ago

  

Over the last year, I have had some patients express frustration with their insulin pumps (along with the many other challenges that they have faced with the recent pandemic).  The many complaints include the typical battles with hyperglycemia following cannulas kinking, adhesive problems, and overnight pump malfunctions which lead many of them to have sleepless nights. I have recently taken a few patients off their insulin pumps and started them on multiple daily injections.

Surprisingly, some of these patients have been on pump therapy so long that they have never utilized pre-filled insulin pens.  Training patients on their new insulin programs has provided the opportunity for diabetes education including meal planning/lifestyle modifications, site rotation, and hypoglycemia treatment and prevention protocols.  I see these patients as a nurse practitioner every 3-4 months and rarely have time to review these “diabetes basics” during our quick visits.

Partnering with my patients to find the best treatment solutions is important to me. I strive to make sure my patients feel supported in their disease management.  Giving them the tools to take a “pump vacation” has sparked a lot of interest.  Patients are returning for follow-up visits with improved blood glucose management.  I am an advocate for diabetes technology and have many patients on the “latest and greatest”, but I am very eager to see if absence makes the heart grow fonder. I wonder if these “pump vacations” will bring patients back to their pumps with a greater understanding of their insulin requirements or if they will continue with multiple daily injections.   

 

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Amy Rich, DNP, CRNP, CDE

Doctor of Family Nurse Practitioner

Certified Diabetes Educator

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We see these pump vacations usually in the summer. Any change in the treatment plan is an opportunity for education! I recently trained a pump user on pen injections as a back up plan for times the pump is not available. Pens were not available when she started on the pump therapy decades ago, so she was surprised at the pharmacy when her endocrinologist ordered her pens!

20 days ago

I have also experienced several patients taking a break from insulin pumps and CGM.  A lot of them never return to their pumps, but usually return to CGM.  All  the advancements in technology puts people with diabetes into overload sometimes. I agree with you in letting patients take the lead on what works for them.

20 days ago

Thanks for taking the time to share your experience with "pump vacations." Although NOT a new concept, pump vacations are no longer the only wearable technology in town.  Guessing we may also begin to see patients seeking "CGM vacations"--not sure, but you never know. 

It is so important to consider what is important to the patient as you said.  And, if  it means a break from technology, then a break it is.  Working together--so important.