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DOI: 10.2337/9781580404617
Library of Congress Cataloging-in-Publication Data Kaufman, Francine Ratner. Insulin pumps and continuous glucose monitoring / Francine R. Kaufman, with Emily Westfall. — 1st ed. p. cm. Includes bibliographical references and index. ISBN 978-1-58040-461-7 (alk. paper) 1. Insulin pumps. 2. Diabetes—Treatment. 3. Insulin—Therapeutic use. 4. Blood sugar monitoring. 5. Patient education. I. Westfall, Emily. II. American Diabetes Association. III. Title. RC661.I63K38 2012 616.4’62061—dc23 2011050394 eISBN: 978-1-58040-499-0
CONTENTS
Chapter 1: What You Need to Know about Diabetes
Chapter 2: An Overview of Insulin Pumps
Chapter 3: How Does My Pump Work?
Chapter 4: All about Basal Rates
Chapter 5: All about Boluses
Chapter 6: Understanding the Meal Plan
Chapter 7: Understanding the Impact of Physical Activity
Chapter 8: The Facts about Infusion Sets
Chapter 9: Special Circumstances: Sick Days, In-Hospital Use, Discontinuing Pump Therapy
Chapter 10: Travel with the Pump
Chapter 11: The Pump at School: From the Beginning through College
SECTION 3: ADJUSTING TO INSULIN PUMP THERAPY
Chapter 12: Capabilities by Age
Chapter 13: Attitudes about the Pump
SECTION 4: CONTINUOUS GLUCOSE MONITORING
Chapter 14: The Facts about Continuous Glucose Monitoring
Chapter 15: How to Use Continuous Glucose Monitors and Pumps
SECTION 5: A LOOK INTO THE FUTURE
Chapter 16: A Look into the Future
I would like to acknowledge the contribution that Dr. Harry Keen made to the field of insulin pump therapy. Harry gave birth to the notion and was visionary in realizing what it could do to improve the lives of those dependent on exogenous insulin treatment. I would also like to acknowledge all that Dr. John Pickup has done to help bring pump therapy to life.
I would like to thank Talia Rabb, who helped me conceive of how to frame this book. I would also like to thank Kelly Joy, Linda Burkett, Kathy Beaver, and Susan Bristol. Their advice and editing were invaluable.
I met Emily Westfall by serendipity on a plane. During that brief encounter, I was so impressed (and in need of help with organizing this book) that I asked her if she wanted to assist me. She was an amazing collaborator, and I am grateful she sat next to me and said yes to my request.
As always, my inspiration comes from my patients and their families, along with my husband, Neal Kaufman, MD, and my own children.
I remember the first insulin pump I used with my patients in the early 1980s. It was jokingly referred to as the “big blue brick,” and it weighed several pounds. The insulin-filled syringe was on the outside of the pump, the pump used a butterfly needle (the needle commonly used for intravenous delivery of medications) placed in the subcutaneous tissue, and, for the most part, it could only be used in the hospital setting. I remember feeling that this was a great advance for my patients, and I appreciated that they benefited from the continuous delivery of basal insulin and from the intermittent boluses that were given to match their food intake and to correct an abnormal blood glucose level when indicated. When I reflect back, I realize we have come a long way over the ensuing 30 years. We have witnessed incredible advances in the understanding of what happens to the cells of the body as the result of the diabetes process. We have seen tremendous breakthroughs in diabetes drug discovery, including the development of insulin analogs, and rapid advances in glucose monitoring technology. We have determined better ways to deliver diabetes education and support, and we continue to combat discrimination against people with diabetes. And most importantly for this book, today we have insulin pumps that