Insulin Pumps: Pump Your Way to

Better Health John Gancarz

Alex GiannakosChris Reyes

Stephanie Steichen

Diabetes• Disease of the pancreas• Insulin deficiency• Affects glucose levels in blood • Three types: • Type 1 • Type 2 • Gestational

Adjusted percentage of diabetes sufferers, by state, in 1994 and

2008.

1994

2008

Effects of Diabetes • Twice the risk for heart disease

• Twice the risk of death

• High sugar levels in blood

• Weight gain

• Eye Damage

• Nerve Damage

• Gum Damage

• Kidney Damage

Timeline1st Century – Diabetes first recognized by Aretaeus1788 – Dr. Cawley discovered relationship of pancreas to diabetes1921 – Insulin discovered as being secreted by the pancreas1922 – First patient given insulin as a treatment for diabetes1930s – Insulin from pork and beef used 1935 – Difference between Type 1 and Type 2 recognized1952 – long-acting insulin created1961 – single use syringe invented1960s – idea of continuous insulin delivery emerged 1964 – Arnold Kadish designed first closed-loop insulin pump devised

1974 – Biostator, first computer-controlled closed-loop insulin pumpLate 1970s – Mill Hill Infuser - first portable and practical insulin pump 1978 – Autosyringe, “Big Blue Brick” - first insulin pump to go to market1983 – Today’s leader in insulin pump technology, Medtronic MiniMed, releases their first pump into the market1990s-2000s – Technologies continue to miniaturize and become more user-friendly, durable and accurate in insulin delivery2006 – Medtronic announces the release of the MiniMed Paradigm REAL-Time System

Traditional Diabetes Treatments

Multiple Daily Injections

• 3-5 injections per day

• Without insurance ~$150/month

• Mix of: • Long-acting insulin • Short-acting insulin

Insulin Pump• Continuous flow of insulin • Predictable short-acting insulin • Programmable bolus doses• Typically for Type 1 Diabetes • Better mimics pancreatic function

How do Insulin Pumps Work?

Infusion Set – Continuous Insulin DosingCannula – plastic needle into skin

Plastic Tubing – Insulin Delivery

Computer-Aided Dosing (Basal and Bolus)

Buttons for Bolus DosingUnit containing insulin

How do Insulin Pumps Work?

Insulin Pump Evolution

1964 1964 1978 2010

Insulin Pump Evolution

1970s- early 1980s 1980s 1990s – 2000s Present

Disadvantages• Expensive • $4000-$5000 for pump• $500 for monthly supplies • Versus $150/month for traditional

injections

•Possible weight gain

• Danger of catheter dislodgement

• Remove pump for bathing, swimming and physical activity

• Requires training to use correctly

Advantages•No individual injections

• Easier diabetes management

• More flexibility about when/what you eat

• Allows for physical activity without large carb consumption

• Fewer swings in blood glucose level

• Eliminates unpredictable effects of intermediate and long-acting insulin

Benefits of Insulin Pumps

Conceptual Framework• Relative Advantage

• Complexity

• Optional Innovation Decision

• Observability

• How-to knowledge

Finding Sources• In general, easy to find

• Sources included:

• Manufacturer’s websites • Medtronic

• Government institutions• Centers for Disease Control and Prevention • Food and Drug Administration

• Independent organizations • American Diabetes Association • Diabetes Health

• Scientific/Medical Journals

Credibility and Bias• Manufacturer’s Websites

• Government Institutions

• Independent Organizations

• Scientific/Medical Journals

Future Research• Quantitative and Qualitative Research

• Theoretical Framework

• Comparative Study

• Potential Problems

Discussion Questions1. If insulin pumps are covered in large part by insurance

(eliminating much resistance due to cost) why are only a quarter of type 1 diabetic patients using insulin pumps if they improve quality of life?

2. How might insulin pumps improve over the following years as technology and research continues to expand our understanding of diabetic issues?

3. What are the political and/or moral implications (if any) that may be associated with the diffusion and ultimate acceptance of the insulin pump?

4. Will the insulin pump dominate the market as a form in treatment for diabetes type 1 in the next 5-10 years?

5. If you were a type 1 diabetic, would you adopt the insulin pump based on the advantages and disadvantages?