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[IP] PROTOCOLS for SELECTING and ASSESSING INSULIN PUMP USERS



http://www.diabetesincontrol.com/pumpprotocol.htm

PROTOCOLS for SELECTING and ASSESSING INSULIN PUMP USERS 
  
A process for selecting insulin pump users, using a list of indications
and contraindications for insulin pump therapy. 
Which patients are candidates for Insulin Pump Therapy? 
Such decisions will be based on objective and subjective criteria
evaluated by the health care team.  They will evaluate:  
X      The potential insulin pump users motivation  
X      Clinical indications  
X      Sociological indications  
X      Any contraindications  
  
This process will ensure that the therapy is safe and appropriate for
the individual.  
Insulin Pump User Selection 
___________________________________________ 
  
Policy on Indications  
There are several common indications for insulin pump therapy 
(Strowig, 1993, Farkas-Hirsch et al.. 1987, Farkas-Hirsch, 1992, 
Etkind, 1988, Forecast, 1982, DOCT, 1993, Marcus, 1992, Jornsay et al.,
1987, RodenstocketaL, 1985).   
When any of these indications are identified, you can consider insulin
pump therapy (listed in alphabetical order):   
Clinical Indications:  
X      Dawn Phenomenon 
X      hypoglycemic unawareness 
X      post renal transplant 
X      pregnancy, or planning for pregnancy 
X       retinopathy, nephropathy, or neuropathy 
X      too-frequent hypoglycemia or hyperglycemia 
X       unacceptable diabetes control  
  
Sociological Indications:   
X      desire to achieve near normal glycemia with a proven ability   
to implement intensive therapy 
X      financial resources to meet costs of intensive therapy 
X      insulin pump user preference 
X      realistic expectations of insulin pump therapy 
X      shift work, frequent or extensive travel, variable exercise
schedules, erratic lifestyle, variable meal schedules and unpredictable
food selection options 
X      sufficient intellectual capacity and technical ability, or close
support 
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