The device is in the market since 1980. Over time it was evolving and today it has the size of a cell phone.This device avoids having to inequal daily.

Continuous insulin (ISCI) subcutaneous infusion devices, more commonly called insulin bomb, emerged as an effective and safe therapy for the management of people with type I diabetes and, very rarely, type II.While this device has been in the market since 1980, over time it has evolved until we know it today: a small and portable artifact with a size similar to that of a cell phone.This manages fast action insulin 24 hours a day through a small tube (catheter) and a cannula (called infusion equipment) that is implanted under the skin, usually in the abdomen area.

The amount of insulin administered can be adjusted to meet the needs of each patient, who must program the device daily so that it deposits insulin microgotes in your body.In any case, even if an insulin pump is used, it is still necessary to monitor blood glucose levels throughout the day, which will also establish insulin doses and allow to adjust food ingestion and the physical activities program.

The law and requirements

The two brands that arrive in Argentina of insulin bomb are ACCU-Chek and Medtronic.This device is leaving around 80,000 pesos, not counting the inputs that are needed monthly.This is why the apparatus is funded by the National Health System and, according to Law No. 23,753/89 and Decree No. 1,271/98, the patient treatment with type I and II diabetes is understood.

Therefore, the treatment with the continuous insulin infusion device is covered 100 % either by social works or prepaid medicine systems.“Although the granting of the apparatus to the patient must be evaluated and approved by the audit of the corresponding institution.And for that the patient's doctor should base and argue why it is necessary for the patient to have an insulin pump, ”said Tedesco.

In the event that the patient does not have money, the state health area through the different jurisdictions (national, provincial, municipal), will cover the demands corresponding to those who lacking resources and social medical coverage, according to thefollowing provisions: Let it be Argentine, do not have health coverage and that lacks resources or income that does not allow you to pay for medications and supplies.

“Generally deals with the process to request an insulin bomb.Although I have patients who have iOSper or PAMI and the procedure is quite fast, between three to six months it takes to get the device with the inputs.Although I have a patient who pays a prepaid medicine system and six months have passed since he requested insulinType I and Type II can request a continuous insulin subcutaneous infusion device."Not anyone can use an insulin pump, it can be said that there are certain requirements that the patient must meet," Tedesco said.

Some requirements for the patient to request an insulin pump are: have high levels of blood glycosylated hemoglobin not corrected with conventional insulin treatment methods;they suffer frequent and severe oscillations at their glucose levels (hypo and hyperglycemia);Repeat hypoglycemia at night or present hyperglycemia by getting up in the morning without eating food;dedicate yourself to activities of great physical resistance or sports of sportscompetition;inter alia.

Use the insulin pump

Each patient who decides, together with his doctor, stops injecting insulin to use the continuous insulin subcutaneous infusion device must participate in an educational process to know, understand and manage the device without inconvenience.One of the coast-ups is the Bachelor of Nutrition, Luisina Ricci, who is an insulin bomb educator ACCU-Chek Combo (one of the most used models currently) and technical advisor to the Carbohydrate count of the Roche Laboratory.

Ricci explained to one that patients who embark on the use of insulin pump are those who have a very varied glycemic activity.“They have many peaks, they go from having hyperglycemia hyperglycemia.That is why they are recommended to start using the pump to regulate their glycemia levels with daily insulin microgotes, "the nutritionist said and added that" once the insulin pump is placed the patient stabilizes at three months and decreases toless 30 percent the total insulin used before when injected. ”

“The first thing I teach them is the technical part of the device.To how they should program and administer the apparatus and daily dose of insulin, ”Ricci said and continued:" Once I taught them to use the pump technically, we go to the carbohydrate counting module. "

The Insulin Pump educator ACCU-Chek Combo said that “carbohydrates are those that increase the glycemia of the patient with diabetes.That is why it is important that the person knows the values ​​of the carbohydrates in order to correct, with insulin, the level of blood sugar and prevent blood glucose. ”

“So the first thing that is taught to the patient is to identify what foods have carbohydrates, which are the ones that will increase glycemia, and which foods do not have carbohydrates but they have to eat them moderately because they give them many fats and proteins.That is why it is necessary to internalize about food in order to prevent blood glucose to increase or fall. ”

Regarding the duration of the process to handle the insulin pump and know the carbohydrate count, Ricci said that they are generally two days, “the learning process depends a lot on the patient.Generally the biggest last three days and the little ones, who are bolder with technology, last a day. ”

in the first person

One consulted three young people, who suffer from type I diabetes and use the insulin bomb several months ago, about the device and they said that "they changed their lives for good and now regulate their illness without inconvenience."

Miguel Piccoli, 22, is from Paraná and in February 2010 he debuted from type I diabetes. “It was something sudden.I had been feeling bad, I was stressed and with many things, and from one day to another they told me that I had type I diabetes and had to inject insulin, ”said the young man and added that after two years he was injecting insulin, he was given the possibility of placing himselfThe insulin pump.“In May 2012, I started the procedures in my mother's social work, the Social Work Institute of the Army (iose), but as I delayed so much I did the procedures in my grandmother's social work, Pami, and in December of that year andI had the device and inputs. ”

Piccoli studied kinesiology in Santa Fe and said: “Having placed the insulin pump was a solution.Because I immediately regulated with the disease.The bomb really changed my life, now I don't have to walk injecting during the day as before and I don't have glycemia spikes. ”

To Miguel's sayings, Luciana Parellia, 23, added: “In November 2014 I put on the insulin bomb and I'm great.I really like it has as more freedom with insulin infusor.Before you had to be aware of injection, now it is not necessary. ”

Parellia is Federal and four years ago she lives in Paraná, where she studies special education teachers.When I was 11 years old, he debuted with type I diabetes, “it was in June 2004, I felt very bad, I was very thirsty and hungry, weight loss and I felt tired and sleepy.So I went to the doctor with my parents and detected a diabetes picture.I had to inject insulin for several years and now with the insulin bomb I should not do it, ”said the 23 -year -old and added that she has the social work iOSper and that, although she had to do many procedures and wait to getThe insulin bomb so far had no inconveniences.

Another young man who suffers from type I diabetes is 24 -year -old Tusolino dart.He is from Paraná and currently lives in Santa Fe where he studies medicine.When he was 3 years old, the disease was diagnosed, “it was in December.I was very small so I don't remember much.I have insulin -dependent diabetes so until November 2014 I was injecting insulin until the possibility of starting to use the insulin pump was given, "Dardo said and said it was a resounding change in his life:" It was a change for the better in my life.I regularized with blood glucose values ​​and I no longer have more peaks as before.I am very good and happy.In addition, my social work- for theper- gave me the insulin bomb and gives me all the inputs. ”

data

Tedesco reported that in 2010 he applied the first insulin bomb in Entre Ríos and who has patients from 18 years to 74. To which Ricci adhered: “I had to deal with patients with type I diabetes from 2 years toThe 70 ”.

In addition, the nutritionist explained that it generally places around eight insulin bombs per year in Entre Ríos and has done so in locations such as Concordia, Gualeguaychú, Colón and Paraná.