Insulin Pump Information for The Practitioner’s Eyes:

Katie Neff, PharmD Candidate University of Florida College of Pharmacy

Insulin Pump Information for The Practitioner’s Eyes:
Katie Neff, PharmD Candidate University of Florida College of Pharmacy

Every Pump Company offers great software to use on your computer. But how often do our patients actually use the software? If the patient comes in the office how many clinicians can download the pump?  There are currently several choices of insulin pumps for patients to choose from. Tubing or no tubing, color screen or black & white, some pumps are even available in a variety of colors. The question is: what is the best pump in the eyes of a clinician? What one gives the most information that the clinician can use to make changes

As a doctor of pharmacy candidate on clinical rotations, I have had to contact patients to determine how well they are doing with their current pump settings and make necessary recommendations. I’ve had contact with patients using various insulin pump models, Medtronic MiniMed, Animas, and OmniPod. So based on that experience I have to say that as a clinician, I prefer the Medtronic MiniMed pump! Here’s why…

The Medtronic MiniMed insulin pump has one key component that really sets it apart from the competition; the ability to calculate averages. In just a few easy steps that take literally less than a minute, you can calculate an average based on however many days you choose and determine the average blood glucose, lowest & highest blood glucose reading, number of blood glucose readings, and even calculates percentage of insulin used for basal, bolus, food, correction, and any manual delivery right on the pump, no software needed. So, it’s very convenient to calculate the daily average over the last 7 days and know exactly how well your patient is doing.

As an example scenario, a patient calculated her daily average over 7 days and provided the following information:

• Average blood glucose: 217 mg/dL
• Low/High readings: 152/308 mg/dL
• Number of blood glucose readings: 1.3
• Basal %: 83%
• Bolus %: 17%
• Food %: 15%
• Correction %: 85%
• Manual %: 0%

Immediately I was able to see that this patient has been forgetting to bolus with meals, since the basal percentage is so high (83%). Also, the boluses the patient is giving are all correction and very few for meals. This then opens the door to determine why the patient is not giving any bolus doses.  In this particular case, the patient was forgetting to bolus because of a hectic schedule. She also was not testing her blood glucose that often less than twice a day. All these factors are part of the reason for her not being as well controlled as she could be. After some education about the importance of meal time boluses and blood glucose monitoring, the patient understood how she could take control of her diabetes and attain better results. Because of this feature the Medtronic MiniMed, gave all the information that was needed in a matter of minutes I was able to figure out what was wrong and fix it right over the phone.

With other insulin pumps, to obtain this information requires the patient to provide the last 7 individual days of total insulin used and state total units of insulin used for bolus and basal rates. That also doesn’t tell the practitioner how much bolus usage is being used for food versus correction. Also, if the practitioner wants to see average insulin used or figure out what percentage of total daily dose is being used as bolus or basal, you’ll have to determine that yourself.  This is much more tedious and time consuming.

In short, while the other insulin pumps have their perks (no tubing or color screens), the Medtronic MiniMed was a pleasure to deal with. The software features allows a practitioner to quickly determine the quality of care the patient is currently achieving and make needed adjustments. Hopefully, the competition will take note.