With a new choice on the market, we look into what pharmacists need to know about insulin pumps for patients with diabetes
Since 1 July 2016, government-subsidised National Diabetes Services Scheme (NDSS) products became available only through community pharmacies that are NDSS Access Points.
Over 5,000 community pharmacies in Australia are now NDSS Access Points.
NDSS products include blood glucose test strips, urine test strips, insulin pen needles and syringes, and insulin pump consumables.
With the changes in the distribution arrangement for insulin pump consumables, pharmacists now have a more involved role in supporting people who use insulin pump therapy, in terms of providing advice and consumables.
The Pharmacy Guild of Australia recommends that pharmacists be able to:
- Identify the different components of an insulin pump and how they work
- Describe the clinical benefits of insulin pump therapy to people with diabetes
- Describe benefits of a pharmacy providing insulin pump therapy consumables
- Explain the recommended frequency of changing infusion sets and reservoirs
- Identify people that may benefit from referral to an endocrinologist or diabetes educator for an insulin pump
- Identify common problems experienced with insulin pumps and their consumables
An insulin pump is a small battery-operated electronic device that holds a reservoir of insulin, used by people with diabetes.
It is about the size of a mobile phone and is worn 24 hours a day, according to Diabetes Australia.
The pump, which is worn outside the body, is programmed to deliver insulin into the body through thin plastic tubing known as the infusion set or giving set.
The infusion set has a fine needle or flexible cannula that is inserted just below the skin where it stays in place for two to three days.
Whenever food is eaten the pump is programmed to deliver a surge of fast-acting insulin into the body similar to the way the pancreas does in people without diabetes.
An insulin pump delivers insulin in two ways: continuously (basal) and on demand (bolus).
Most pumps will calculate the insulin dose for each meal or snack based on the insulin-to-carbohydrate ratio programmed into the pump. This ratio is calculated with a diabetes educator or endocrinologist.
“Insulin delivery via a pump mimics a natural insulin profile with greater accuracy than other devices and this can lead to better glycaemic control and reduces the risk of hypoglycaemia, explains Matthew Tom, Consultant Pharmacist at Amcal+ Coffs Harbour, NSW.
“Operating an insulin pump effectively does require significant training and expertise, as well as being diligent with blood glucose monitoring. These factors mean insulin pump therapy isn’t for everybody.
“It is also important that your younger patients and their parents/carers are aware that there is a government program that subsidises the cost of insulin pump therapy to eligible Australians under the age of 18.”
Pharmacists need to understand the 3-4 different pumps available on the market so that they can provide information/advice to patients accordingly, says Ypsomed Australia, which has recently launched the new mylife YpsoPump system, its first insulin pump on the market.
The three other brands of insulin pumps in Australia are Medtronic, Animas and Roche Diagnostics.
Although the YpsoPump has only just launched, a number of people have been trialling it since April and the feedback to date has been extremely positive, says the organisation.
“Diabetes educators at most major centres have received certification in the new device and are ready to train new patients,” says Ypsomed.
“Pumps are now available to meet the demand of those eager to switch to the new technology.”
The main difference between the YpsoPump and the existing insulin pumps on the market is the touchscreen interface, which modernises the device and can make it more intuitive to use, says Mr Tom.
It is also smaller and lighter than some of the older insulin pumps currently on the market.
“The YpsoPump works with its own infusion set and reservoirs, and will require the user to purchase this new equipment. These items are now available at NDSS access points.
“There are slight differences in these consumables and their predecessors so close contact between patients and their Credentialled Diabetes Educator is recommended during a switchover period to ensure the effective insulin delivery.”
The Pharmacy Guild is offering a free course for pharmacists, which looks at the role of pharmacy in insulin pump therapy and the provision of insulin pump consumables.
Find out more about insulin pumps for people with Type 1 diabetes from Diabetes Victoria here.