[acb-diabetics] Insulin Pump: To do or not to do…

[Chanelle Allen]

Dear Nefertiti and list,
Many people who are blind have successfully used insulin pumps. 
Unfortunately, most features are inaccessible, but it is possible to perform 
basic functions without the aid of sighted assistance. It takes some time to 
be trained in how to fill reservoirs, change infusion sets, and learn button 
pushing sequences. I have used the Minimed Paradigm pumps, so I can only 
speak from my experience with Minimed. The pump has three horizontal buttons 
and two vertical buttons which are the up and down arrows. My pump is set to 
beep for each press of the up arrow so long as I am in the main screen. This 
is called easy bolus, and for me, one beep equals 0.1 units of insulin. 
Everyone has their pumps customized differently (1 beep = 0.5 or 1 units of 
insulin etc.). The pump will beep back to me again (10 beeps = 1 unit of 
insulin) to confirm that I want the insulin. The maximum amount of insulin 
that can be given at one time is ten units. The key closest to the arrow 
keys is the activate button, which also goes into menus. The button in the 
middle is the escape key, and I am not quite sure what the other button 
does. Priming the pump is simply a matter of pressing the activate button 
and down arrow a few times activate, and down arrow again. When the 
reservoir and infusion set are inserted, continually holding down the 
activate button until you feel wetness lets you know that the insulin is 
going through the tubing properly. After inserting some infusion sets, the 
pump must be primed again; since that feature is inaccessible however, I 
just press escape and activate several times until I come back to the main 
menu indicated by three beeps and give 0.4 units of insulin (about the 
amount given when going into the menus to prime the pump). The Minimed pumps 
have something called a bolus wizard where users may input their blood 
glucose level along with the amount of carbohydrates eaten and the pump will 
calculate the amount of insulin needed. Unfortunately, this is inaccessible. 
The pump gives a certain amount of insulin each hour called the basal rate. 
Doctors may from time to time want to change the basal rate, and since there 
is no audio feedback to do this, I have needed assistance. The button 
pushing sequence is simple enough to set a temporary basal rate. The pump 
emits a sequence of three beeps, which could mean several things: the 
battery is low, the reservoir only has a certain amount of units left, the 
pump is not connected or able to give insulin, and many others. Usually, I 
am able to take a guess as to what the pump wants. For example, after three 
days, it probably wants more insulin; after two or three weeks, it wants a 
new battery; after an infusion set is inserted, their may be a problem with 
the cannula being bent, etc. Doctors are able to download settings and 
history from the pump on to a computer in order to analyze trends. Minimed 
produces a meter that works with the pump in transferring readings 
wirelessly; however, this is inaccessible. At one time, the software for a 
pump user to view settings and history was accessible, but I don't know what 
the case may be now. Overall, being on a pump is better than having to give 
injections several times a day. It is best to try to be patient with the 
process as many adjustments to basal rates and boluses will need to be made 
in the first several weeks. There are several different types of infusion 
sets from which to use, so you will need to find the one that works best for 
you. Usually, pump users are first trained in filling the reservoir with 
saline, inserting the infusion set and wearing the pump for a few times.
I hope that I am not overwhelming you with too much information and that 
this explanation helps. Please feel free to ask more questions.

Chanelle

-----Original Message----- 
From: Nef
Sent: Thursday, November 10, 2011 4:43 PM
To: acb-diabetics at acb.org
Subject: [acb-diabetics] Insulin Pump: To do or not to do…

Hi everyone,
My doctor and I began discussing the possibility of putting me on an
Insulin pump during my last visit. Both she and I are ignorant as to
the accessibility challenges one might face as a visually-impaired
individual. In hopes of remedying this, we agreed to do our due
diligence by way of research, and reconvening in 2 weeks time.
So far, the information I have read online is grossly out of date, and
this has hampered any true progress on my part.
Recently, I read a message posted to this list by a lady (Patricia?)
who mentioned her pump use.
Are there any other users here? Would any of you be willing to share
your experiences and/or advice? Perhaps there are resources I’ve yet
to tap into that someone might be kind enough to impart?
Hoping all are well,
Nefertiti
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