by Tom Rivera Ley
Have new designs made insulin pumps more accessible to those of us who cannot depend on our sight to read their small screens? The answer is a resounding no. Should blind and visually impaired diabetics avoid using pumps? Again: a resounding no.
The number of pump users has grown from around 10,000 in 1990 to an estimated 250,000 users worldwide in 2006. Competition in this exploding market has been good for consumers, sparking advances in pump technology and ease of use. Some are even kid friendly. Kid friendly, you ask? Yes. Many school-age children with type 1 diabetes now use insulin pumps by themselves. In an effort to target this life-long market, manufacturers have focused on smaller size and hip new colors and patterns. And pediatric endocrinologists are now prescribing pumps for parents to use with their diabetic children who are as young as two years old.
New features include:
• Lots of stylish colors
• Smaller size
• Wizards to assist in calculating the mealtime bolus
• Wizards to assist in calculating a high blood sugar correction bolus
• Added safety features, such as waterproofing
• Ease-of-use enhancements, such as menu-driven programming
But Voice of the Diabetic readers may recall numerous articles over the past decade outlining the inaccessible features of these devices. Unfortunately, even with all of these useful (or cosmetic) advances, pump manufacturers continue to ignore our voices pleading for an accessible pump.
Almost all pumps on the market today offer a way to administer a mealtime or correction bolus accurately without seeing the pump screen, but this is no advancement from a decade ago, as insulin pumps in the 1990’s also had this feature. What’s worse, nearly all of the new advances in convenience and safety, such as the bolus wizards, variable bolus deliveries and more powerful basal features are completely inaccessible without the ability to read the pump screen.
I am greatly disappointed as each new insulin pump comes to market without addressing the accessibility issue. But the good news is that the new models are no less accessible than the old. If you want to take advantage of the unique benefits of an insulin pump over a multiple daily injection (MDI) regimen, you can, with very little sighted help at first.
I am totally blind and have used an insulin pump successfully for nearly a decade. It offers greater control in preventing low blood sugar and added convenience when I’m on the go. Also, the pump is the only way I can match my basal insulin delivery to the peaks and valleys caused by the Prednisone I take daily. I do need sighted assistance to set the time/date, preferences and basal profiles. But once I have set those, I manage daily operation without assistance. This includes bolus administration, changing the batteries, and replacing insulin and infusion sets. I am very happy with my pump and plan to continue using it. I must assure you, however, that as soon as a manufacturer decides to make a truly accessible insulin pump, I will immediately change to that pump and will announce it boldly and loudly to all diabetics I know.
I am confident that sooner or later, and hopefully sooner, a company will produce an accessible insulin pump. It is the right thing to do, and it is the smart business thing to do as well. The National Eye Institute (NEI) states that 40 to 45 percent of diagnosed diabetics have some level of diabetic retinopathy. Furthermore, diabetics are living longer and healthier lives than ever. So even if diabetic retinopathy were not an issue, glaucoma, cataracts and age-related macular degeneration will be. And the fact is that nearly all pump users would benefit in some way from pumps that you don’t have to see to use. Turning on a light is not always convenient or desired, and poor lighting abounds. Pulling out your pump is not always physically or socially convenient. Many diabetics experience fluctuating vision: fine one day, relatively poor the next. Most pump users encounter one or more of these circumstances routinely, and all would benefit from an accessible pump.
So, which company will finally listen to our voices and make the smart business
decision? Who will create a fully accessible pump? Only time will tell, but
the first producer stands to reap rich harvests of loyal new customers, good
will, positive press, and competitive advantage. Until then, I will make do
with my semi-accessible model, which does allow for good self-management while