New device popular with doctors who are diabetic, but patients stick with needle

SATURDAY, July 29 (HealthSCOUT) — Diabetics dependent on daily insulin could replace their syringes with a pump the size of a pager, but few patients do so, a new study found.

The device is most popular among diabetes specialists who have Type I diabetes, the study says. More than half use the insulin pump, compared with only about 10 percent of all U.S. Type I diabetes patients.

Why the wide discrepancy between specialists and diabetes patients as a whole?

The specialists, says the study, published in The Diabetes Educator, know what most patients don’t — that the pump provides more accurate, steady and precise insulin doses and is much easier to use.

The pump provides round-the-clock insulin by simulating the action of the pancreas to replace the insulin supply. Patients can swim, ride a bike, do other exercises and eat what they wish while using the pump.

The device comprises a reservoir filled with insulin, a small battery-operated pump and a computer chip that allows the user to control how much insulin the pump delivers. And it’s all in a plastic case about the size of a beeper. The reservoir delivers insulin to the body through a thin plastic tube painlessly inserted beneath the skin, typically in the abdomen, and the user changes the tube every two or three days.

The simplicity and reliability of the pump has won over many converts, says the study’s lead author, Marilyn R. Graff, a registered nurse and longtime diabetes educator who is now senior manager for professional education at MiniMed Inc., a California company that makes insulin pumps.

“People call and write and tell us, ‘Now that I’ve got my pump, I’ll never give it back,'” says Graff, former president of the 10,000-member American Association of Diabetes Education. “That’s the message we get from patients: ‘I’ve been trying all this time to take better care of myself and now I’m able to do it.'”

The pump costs about $5,500, she says, and most insurance companies will pick up 80 percent of the tab. The first insulin pump went to market in 1983 with a much bigger, bulkier monitor. MiniMed developed the pager-like device in 1997.

The study is based on survey responses from about 800 diabetics who also treat the disease. The specialists, the study said, not only used the pump more than their patients, but also almost universally maintained recommended “intensive treatment regimens,” consisting of three or more insulin shots a day or use of an insulin pump. By contrast, less than a quarter of American Type I diabetes patients follow the recommended regimens, the study says.

Dr. Michael Perley, an endocrinologist who uses the pump for his own Type I diabetes, says the study demonstrates “a huge disconnect” between specialists and their patients.

“This is a matter of education, and it’s also a matter of attitude,” he adds. Perley suggests specialists, including doctors and nurses, think the pump may be “overwhelming to the lay public.”

“But,” he adds, “these attitudes are being broken down. The pump after training is much easier” than daily shots, he says. “It provides a much more flexible lifestyle for the patient but, more important, it provides much better medical outcomes.”

About 1 million people in the United States have Type I diabetes and most them are diagnosed as children or young adults.

Lack of proper treatment can lead to serious complications including blindness, amputation, kidney disease and increased risk of heart and blood vessel diseases. Untreated, Type I diabetes can cause death.

What to Do: To read more about use of the insulin pump, visit the American Diabetes Association and Is The Pump Right For Your? @ MiniMed Inc..