Читать книгу Transitions in Care - Howard A. Wolpert - Страница 18

Some individuals will need a different insulin program for each phase of their life. For example, during the school years, when taking a lunchtime injection in the cafeteria can be impractical, the NPH-based insulin program may work best. Later during the college years, the extra flexibility provided by the basal/bolus program may be a real advantage. There are a couple of considerations in weighing the decision about whether to use injections or a pump for basal/bolus insulin replacement. Some find that it can be a hassle to take an extra injection every time they want to snack or have eaten more than planned, and with a pump, it is easy to take a bolus of insulin whenever there is a need. However, before you decide on the pump, there are two key questions you should ask yourself. First, “How comfortable will I be with wearing a pump and having an outward sign of diabetes?” and second, “Do I have enough time to attend to the extra demands of using a pump?” The early adult and college years are often a time when serious relationships (both romantic and platonic) outside of the family first develop, and some people will find the pump a bit too obvious and public. The added responsibility of starting pump therapy can be too much to handle if you have a lot of other commitments in your life. Some find it’s better to deal with the demands of getting settled into a new job or college before trying the pump. Because it is you who lives with and manages your diabetes day-to-day, only you will really know which type of insulin program will suit you best. The decision should be yours—made in consultation with your health care provider.

FIGURE 3 Schematic showing basal insulin (glargine or determir) and mealtime rapid-acting insulin such as aspart, lispro, and glulisine.