The untethered regimen is a technique combining the use of insulin pumps with slow-acting insulin analogues such as Lantus or Levemir. This allows a person who is dependent on insulin to break the pump when desired while maintaining the flexible benefits that an insulin pump can provide.
This term was coined by Dr. Steve Edelman, a type 1 diabetic, insulin pump, and endocrinologist, who want to see the diabetes regimen tailored to everyone's needs so that excellent results from diabetes care and a happy lifestyle can be achieved simultaneously. Edelman himself developed a desire to release his insulin pump for a long time to swim and exercise, often a full weekend. He developed this technique to get the freedom from tether to the pump all the time.
Video Untethered regimen
Eliminate pump
Sports and training
Depending on the intensity and duration of exercise, insulin pump users typically use interim basal rates to reduce the amount of insulin being sent to adjust to the reduced need for insulin as a result of exercise. The reduction is determined by trial and error by monitoring blood glucose. Some users suspend the base rate completely or decide to exercise.
In some cases, insulin pumper may wish to use the pump during exercise to be able to increase and decrease insulin delivery as needed. This is when the basal level of the pump is reduced.
In other cases, the user of the pump may prefer to release the pump together: This is when the combination of slow working insulin and the basal level of the pump work just as well. Pumps can be removed before any planned activity (anything from soccer practice to water skiing to dancing), and pump users continue with reduced basal insulin from the injected Lantus or Levemir. After the activity is complete, the pump returns to life.
Water activities
While most insulin pumps are waterproof (at least when they are new), the high cost of the pump often causes caution on the part of the user, which often moves the pump when it plans to get wet. In addition, most pump manufacturers recommend that the pump be released even if waterproof because waterproofing is only guaranteed ideally and can not be taken into account. However a waterproof pump case for water sports is available.
The pump can be disconnected for a short time to take a shower with a little problem. However, for a party in the hot tub or for a day on the beach, removing the pump and "going without a rope" can be a fun holiday.
Different water sports place different demands on the patient. Sailing may be considered a long dry period of sitting - distracted by an unexpected wet period. Swimming laps are a great aerobic activity. But a toddler in a pond partly filled with water may get the most powerful exercise of anything. Each situation requires that the user of the pump adjust the basal level. If some of the basal insulin is combined with long-acting insulin, there will be more trial-and-error. This allows the pump to be removed for longer periods and blood glucose control is maintained adequately.
To enjoy their favorite water sports regularly, each pump user will work with their diabetes care team to develop the best plan for them.
Pump vacation
Edelman first developed his untethered regimen because he wanted to release the pump for the weekend. He prefers to use his insulin pump on weekdays to benefit from his flexibility, in which case he gives doses for three quarters of his total basal insulin requirement and uses the pump to deliver the remaining quarter. In this way, the basal pump rate can be adjusted temporarily and downward as needed. Then on Friday night when he usually gives Lantus a shot every day, he will give 100% doses of his basal needs and take the pump for the weekend. He then used the insulin pen required for food bolus and correction. Alternatively, the insulin pump can be reconnected to the site disconnect rapidly on the infusion set when necessary. On Sunday night at the time of Lantus's injection, Edelman dosed three quarters of his basic needs with Lantus and reconnected the pump.
Sometimes, the insulin pump needs to be repaired. Pump manufacturers offer fast turnaround times, and replacement pumps are delivered quickly. This may be the time when a person who is dependent on insulin should be pump-free for several days. It is good to get to know this technique.
Maps Untethered regimen
Insurance against ketoacidosis
All people who depend on insulin will become very ill with diabetic ketoacidosis if it is rejected insulin for a sustained period. Periods vary with each person and their situation. Insulin pump problems during the night (such as running out of insulin, dead batteries, or leaking infusion tubes) that can not be detected cause ketoacidosis before morning. Slow-acting insulin such as Lantus or Levemir can be used for most basal insulin requirements, and basal pump level programs can be used to fill the remaining needs. Lantus injected once a day is a reserve for pump users, but it can be a real benefit for some insulin pumpers that are likely to develop ketoacidosis quickly.
References
Source of the article : Wikipedia
0 Comments