- Continuous subcutaneous insulin infusion is administered by an externally worn device that contains a syringe attached to a long, thin, narrow-lumen tube with a needle or Teflon catheter attached to the end.
- The client inserts the needle or Teflon catheter into the subcutaneous tissue (usually on the abdomen) and secures it with tape or a transparent dressing; the pump is worn on a belt or in a pocket; the needle or Teflon catheter is changed at least every 2 to 3 days.
- A continuous basal rate of insulin infuses; in addition, based on the blood glucose level, the anticipated food intake, and the activity level, the client delivers a bolus of insulin before each meal.
- Both rapid-acting and regular insulin (buffered to prevent the precipitation of insulin crystals within the catheter) are appropriate for use in these pumps.
Insulin pump and skin sensor
- A skin sensor device that monitors the client’s blood glucose continuously; the information is transmitted to the pump, determines the need for insulin, and then the insulin is injected.
- The pump holds up to a 3-day supply of insulin and can be easily disconnected for activities such as bathing.
- A jet injector is a needleless device that delivers insulin through the skin under pressure in an extremely fine stream.
- Insulin administered by this device usually absorbs faster.
- The injector can cause bruising at the site of insulin delivery.
- The goal of pancreatic transplantation is to halt or reverse the complications of diabetes mellitus.
- Transplantations are performed on a limited number of clients (generally, these are clients who are undergoing kidney transplantation simultaneously).
- Immunosuppressive therapy is prescribed to prevent and treat rejection.
Self-monitoring of blood glucose level
- Self-monitoring provides the client with the current blood glucose level and information to maintain good glycemic control.
- Monitoring requires a finger prick to obtain a drop of blood for testing.
- Alternative site testing (obtaining blood from the forearm, upper arm, abdomen, thigh, or calf) is nowavailable using specific measurement devices.
- Tests must be used with caution in clients with diabetic neuropathy.
- Client instructions
- Urine testing for glucose is not a reliable indicator of the blood glucose level and is not used for monitoring purposes.
- Instruct the client in the procedure for testing for urine ketones.