Ed Module - Initiating Pump Therapy

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Preparations for Initiating Pump Orders

  • Discuss therapy with patients who could benefit
  • Have Medtronic review payer considerations*
  • Draw labs needed for insurance approval
  • Write prescriptions
    • Pump
    • Initial pump settings
    • Vial(s) of rapid-acting insulin
    • Test strips/lancets
    • Glucagon™ Emergency Kit
    • Rx for BG meter and test strips
    • Ketone strips

*Payer considerations include A1C, blood glucose journals, and other labs (as needed)

Insurance Coverage for Insulin Pump Therapy Is Generally Quite Good*

For patients who qualify for insulin pumpt therapy for insulin pump therapy

  • Medtronic can assist with qualifying patients and verifying insurance coverage by:
    • Gathering information required for approval
    • Sending required information to insurance company
    • Supporting appeals process if necessary

*Insurance requirements may vary regarding coverage for pump therapy.

Patient Training and Education

Many resources are available for patient training, education and support

  • Educating / training a patient on insulin pump therapy is a key factor to their success
  • Patient training resources:
    • Printed education materials are shipped with every pump
    • Online e-learning modules are made available within 24 hours of the patient being entered into the system at www.medtronicdiabetes.com/customer-support/education
    • See Resources tab above for more information about patient training materials

Getting the Patient Started

A Medtronic educator is notified when the pump ships

Patient training:

  • Education materials are shipped with the pump or online
    (Patient reads materials/practices programming)
  • Pump training and start typically done in small groups
    (Can be at your office or another location)
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Summary

A successful start to insulin pump therapy requires collaborative teamwork

  • The initial insulin settings that will be programmed into the pump must be calculated and ordered by the prescriber
  • These settings include
    • Basal Rate (BR), Insulin-to-Carb Ratio (ICR), and Insulin Sensitivity Factor (ISF), which are all calculated using standard formulas
    • BG Target range and Active Insulin Time are based on patient history and your clinical judgment
  • Medtronic can assist with initiating pump orders and patient training
  • The patient needs to complete the necessary training and use the pump appropriately, so the prescriber can determine if any adjustments to the therapy need to be made

Let's take a look at adjusting insulin pump therapy and how the CareLink Pro reports provided by Medtronic can help determine whether any adjustments are needed…

  • Initial pump settings
  • Vial(s) of rapid-acting insulin
  • Test strips and lancets (8 to 10 BG checks/day)
  • Glucagon™ Emergency Kit
  • Glucose tablets
  • Ketone strips

References

  1. American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35(suppl 1):S11-S63.
  2. Hoogma RPLM, Hammond PJ, Gomist R, et al. Comparison of the effects of continuous subcutaneous insulin infusion (CSII) and NPH-based multiple daily insulin injections (MDI) on glycaemic control and quality of life: results of the 5-nations trial. Diabet Med. 2006;23(2):141-147.
  3. American Diabetes Association. Continuous subcutaneous insulin infusion. Diabetes Care. 2004;27(suppl 1):S110.
  4. Lepore M, Pampanelli S, Fanelli C, et al. Pharmacokinetics and pharmacodynamics of subcutaneous injection of long-acting human insulin analog glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro. Diabetes. 2000;49(12):2142-2148.
  5. Gross TM, Kayne D, King A, Rother C, Juth S. A bolus calculator is an effective means of controlling postprandial glycemia in patients on insulin pump therapy. Diabetes Technol Ther. 2003;5(3):365-369.
  6. Scheiner G, Boyer BA. Characteristics of basal insulin requirements by age and gender in type-1 diabetes patients using insulin pump therapy. Diabetes Res Clin Pract. 2005;69(1):14-21.
  7. Bode BW, Kyllo J, Kaufman FR. Pumping Protocol: A Guide to Insulin Pump Therapy Initiation. Northridge, CA: Medtronic, Inc; 2008.
References | 950M10996-012 20140701