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. 2019 Aug;32(3):194–204. doi: 10.2337/ds18-0091

TABLE 2.

Clinical Considerations and Ideal Attributes for Insulin Pump Therapy

Clinical Considerations for Insulin Pump Therapies
• Not meeting glycemic targets • Gastroparesis
• Frequent and/or nocturnal hypoglycemia • Desire more flexibility in diabetes management
• Hypoglycemia unawareness • Desire fewer injections
• Dawn phenomenon • Unpredictable eating habits
• Pregnancy • Variable schedules or work shifts
• Require small doses of insulin (i.e., pediatric patients)
Ideal Attributes for Insulin Pump Candidates
• Willing to wear device on body and able to tolerate adhesive on skin
• Motivated to complete education and frequent follow-up with health care team
• Views insulin pump as a tool to improve care but not as a “cure” for diabetes
• Adequate insurance coverage for the device and ongoing supplies or ability to pay out of pocket
• Sufficient dexterity and vision to operate insulin pump or has a care partner willing to operate the pump
• Willing and able to check blood glucose four to six times daily
• Willing and able to bolus for meals and high blood glucose correction, as needed
• Willing and able to count carbohydrates*
• Willing and able to use the bolus calculator*
Additional attributes for SAP technologies
• Willing to wear a sensor and infusion set on body
• Willing to check blood glucose as needed and when prompted for CGM calibration
• Able to manage additional information from CGM
• Willing to respond to alerts from CGM and work with provider to personalize alert settings based on goals
Additional attributes for hypoglycemia suspend technologies
• Comfortable with pump suspending automatically, potentially without user knowledge
• Understanding that, if hypoglycemia does occur, system has likely already suspended insulin delivery; therefore, may require treatment with fewer grams of carbohydrates (i.e., 5–10 g) to prevent rebound hyperglycemia
Additional attributes for HCL systems
• Willing to respond to additional alerts related to HCL functionality
• Willing to bolus for all meals and snacks
• Comfortable with relinquishing some control of insulin dosing to the device (i.e., user cannot influence basal insulin dosing in HCL systems)
*

For individuals with type 1 diabetes only; individuals with type 2 diabetes may not require advanced pump features or carbohydrate counting while on pump therapy.