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Benefits and Drawbacks of an External Insulin Pump and a Case Study (Essay Sample)

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Essay on benefits and drawbacks of an external insulin pump and a case study.

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External insulin pump
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External insulin pump
Benefits and drawbacks of external insulin pump therapy
Patients are currently diagnosed with diabetes mellitus in the developed world at an increasing rate. It is, therefore, indispensable for health care providers, families, caregivers, and patients to maintain the newest evidence based knowledge of effective, efficient, reliable, and affordable strategic management of diabetes mellitus. External insulin pump therapy is one of the methods of controlling diabetes mellitus that has been associated with improved quality of life, prevention of acute complications of insulin therapy such as hypoglycaemia incidents, and avoiding chronic complications of diabetes mellitus such as retinopathy, nephropathy, angiopathy, and neuropathy due to a good control of blood glucose. (1) These reasons have resulted in extensive studies, to determine the contribution of external insulin pumps in managing diabetic patients, exploring its functions, reviewing its criteria for use, highlighting its advantages and disadvantages, and considering different aspects of nursing management with external insulin pump therapy. Meta-analysis of current and available literature comparing continuous insulin infusion with external insulin pump and daily multiple injections of insulin demonstrates significant benefits of external insulin pump in controlling diabetes mellitus and its complications. (2) Advantages of external insulin pump include improved percentages of glycated haemoglobin, glycemic control, flexibility, and to sustain positive outcome in managing complications of the disease or insulin therapy for as long as five years. (1,2,3) However, the use of external insulin pump has experienced drawbacks such as reluctance of some facilities in instituting training in pump initiation, lack of resources, interests, and skills, which anecdotally act as a rate limiting step in the use of external insulin pump. This paper critically analyzes and evaluates the current evidence based benefits and drawbacks of external insulin pump therapy, as well as a case study, with particular interest in avoiding hypoglycaemia and improving quality of life in adults with diabetes mellitus.
Benefits of external insulin pump
The new developed external insulin pumps in the form of mechanical devices have the benefit of functioning as the pancreas resulting in improved glucose control. The pumps have an insulin release system that is responsive to glucose levels; the set basal insulin release rate; and adjustable basal rate of insulin release. (4) These characteristics mimic the physiological secretion of insulin which has the benefit of preventing insulin therapy induced hypoglycaemia, and improving quality of life in diabetic patients for a longer time compared to multiple daily injections. A report on the external insulin pumps revealed that their insulin release resulted in almost equivalent average of blood glucose values without either gain in weight or incidents of clinical hypoglycaemia. The main benefit of these external insulin pumps is their continuous insulin delivery in the body, which ensure constant availability of insulin at acceptable levels. (5) The mechanism is similar to the normal physiology of the body which is beneficial in avoiding problems of accelerated atherosclerosis resulting from peripheral hyperinsulinaemia associated with injections. This advantage is attributed to improved quality of life and effective glucose control without hypoglycaemic events being experienced by diabetic patients.
External insulin pump improves quality of life significantly, considering that the patient is relieved from the agony of at least two insulin injections daily, external insulin pump is predictable, and easy to use. In addition, the external insulin pump uses one delivery needle for two to three days, as opposed to the multiple daily injections which uses at least two delivery needles per day. (6) The benefits have been augmented by the availability of different sizes of external insulin pump which fits individuals’ priority and preference. A systematic review of previous literature indicated that external insulin pump provides effective and safer management as evidenced by improved glycated haemoglobin, fewer episodes of hypoglycaemia compared to injections, dietary freedom, and independence for flexibility. (4) It provides psychological health because the patient feels some autonomy over the disease, and it is inter-related to physical well being. The findings indicated an improved quality of life through treatment satisfaction, emotional well being, and stable health status. External insulin pump offers recommendable glucose control; fewer variables to manipulate, and patient friendly meal times. (7) This ensures improved quality of life because the family caring for the patient has the freedom, flexibility, and can perform daily activities with spontaneity as compared to families taking care of a patient under multiple daily injections to control the disease. (5) It is evident that most patients prefer changing from multiple daily injections to an external insulin pump despite a few challenges encountered because of its perceived better health and management benefits.
Effective long-term management of diabetic patients is designed in regard of functional capacity as opposed to age, and this is achievable through the use of external insulin pump as the most beneficial treatment modality to improve the quality of life. (8) The functional capacity results from the ability of external insulin pump to control the glucose level while the patient performs daily activities without the risk of developing hypoglycaemia, undergoing the stressful life modification associated with intensive management, and complications of daily multiple injections. Despite some restrictions that the patient must sleep with the pump throughout the night, external insulin pumps have tubes of various lengths to make the patient comfortable while sleeping. (9) Health care providers are advised to initiate glucose management with the use of external insulin pump rather than other methods such as injections. (6) External insulin pump therapy has further qualitative benefits more than improvements in the glycaemic control and the associated reduction in the risk of hypoglycaemia for people suffering from diabetes. Over a longer duration, external insulin pump technology establishes a positive relationship between specialist healthcare provider and patient despite the short term challenges reported when switching from multiple daily injections to external insulin pump therapy. (10, 11,) These attributes of external insulin pump make it suitable for preventing hypoglycaemic incidents while improving the quality of life.
In a study to explore the benefits of external insulin pump, its role in association with continuous real time glucose monitoring system and perception of patients and caregivers on external insulin pump strategy, there were numerous benefits of external insulin pump identified. (12, 13) The findings of the research show that the prevention of hypoglycaemia incidents is the most perceived benefit, followed by the ability of the method to eliminate hypoglycaemia related anxiety, then the ease of managing patterns, improved control of diabetes mellitus, improved quality of life among patients and health care providers, and it makes care for diabetic patients easier than with other methods such as multiple daily injections which can precipitate hypoglycaemia. (9, 14) These benefits are common and act as the main driving force convincing diabetic patients, to indulge in the use of external insulin pump.
External insulin pump therapy is an attractive treatment modality for patients suffering from type 1 diabetes, particularly, in young adults resulting in patients opting for external insulin pump therapy instead of injection therapy. Although, previous studies have accounted for the views and experiences of patients with external insulin pump, very few focused on the benefits of this therapy which are evident in the current reviews. (10, 15) Patients learn the benefits or advantages of external insulin pump as well as its contribution in improving the quality of life formally from a healthcare professional, informally from the internet or friends, or through experience. These benefits have fuelled the wide global introduction of external insulin pump therapy, acted as a reason for the rapid transition, to pump therapy, and the general improvement in the context of social life for diabetic patients and their caregivers. Systematic review of the available literature on external insulin pump therapy shows that the main benefit of external insulin pump therapy is the achievement of the most pursued stable control of glucose levels and a comfortable lifestyle despite suffering from diabetes mellitus.(13, 16) The reviews highlight that external insulin pump has the advantage of enabling diabetic patients to control their ailments, achieve the best diabetic control, and the ability to socialize without the risk of hypoglycaemic complications. Improved control, flexible lifestyle, socialization, absence of dietary restrictions, and the ability of diabetic patients to carry out their daily functions when they use external insulin pump therapy proves the improved quality of life in diabetic patients. (17)
Drawbacks of external insulin pump
It is important to be aware of the drawbacks to external insulin pump therapy. One of the drawbacks of external insulin pump is under delivery of insulin dose due to precipitation within the pump. It is caused by precipitation in the external insulin pump which interrupts insulin infusion during therapy. This disadvantage makes the patient vulnerable to complicated hype...
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