Mariana Londoño and her mini-computer go everywhere together: to school, home, out with friends, to the movies or to dinner. They even sleep together. And no, it’s not a tablet, videogame console or a music device. The 18-year-old student travels permanently with an insulin dispenser pump connected to her body that helps control her Type 1 diabetes.
“It doesn’t bother me at all; I take it to parties and everywhere. Nothing can keep me from living my life,” Londoño says. “When I don’t have it I feel differently, as if something is missing. The pump is already part of me.”
The insulin dispenser pump, which continuously monitors glucose levels, is part of the technological developments that help more than 23 million U.S. diabetes patients. Rigorous control of glucose is directly linked to the patient’s long-term life expectancy and diminishes the deterioration of the nervous system, the kidneys, the eyes, and the cardiac complications associated with the disease.
“Insulin was discovered in 1920 and before then diabetes was a lethal disease,” says Dr. Alejandro Díaz, an endocrinologist specializing in pediatrics at Miami Children’s Hospital.
But the handling of the disease changed significantly after the study “Diabetes Control and Complications Trial” was published in 1994. The study demonstrated that strict monitoring of glucose levels in the blood reduces the risk of eyesight disorders by 76 percent, kidney disorders by 50 percent and nervous system disorders by 60 percent.
“With these results we realized that we had to be much more aggressive in treating diabetes and we began to use methods of daily multiple-dose injections, because we know that an intensive control reduces complications significantly,” Díaz says.
The insulin dispenser pump incorporates developments of the last 30 years. The pump, a mini computer, connects to the patient’s body through a catheter, usually placed in the abdominal area, which has the dual task of constantly providing “basal” insulin and extra doses — called “boluses” — to process meals.
“The pancreas produces 40 percent of the insulin in basal form that is always present so that cells can consume glucose. The other 60 percent is produced when we eat, particularly carbohydrates,” says Díaz.
While the pump and insulin injections are similar, the pump has its advantages.
“With the insulin pump I can provide even smaller or more precise amounts than with the syringe,” Díaz says.
This is particularly important for small children, for whom injected doses can be very high. The pump runs continuously, avoiding the swings of blood sugar levels in the early morning or throughout the night.
The possibility of programming the insulin doses in accordance with the patient’s daily routine also allows the doctor to prescribe different amounts of basal insulin, depending on physical activity.
“For instance, if the patient is a boy who plays a lot at school between 1 and 3 in the afternoon, his sugar can be lowered by giving him the same dose as when he is resting,” Díaz says. “With the pump I can lower the dose specifically during those hours, something I can’t do with syringes.”