My insulin Log

Diabetic population in India is nearly 400 million, and considering an estimate of 14 percent patients on Insulin can be translated to 56 million Insulin treated patients in India. Out of these at least 10 percent that is 5.6 million patients most likely are having very high glucose levels and grossly uncontrolled Diabetes. Further at least 5 percent that is 2.3 million patients will not be in good control and are in search of options which can allow them to have a flexible life style and still good control.

These are patients who need a better Insulin treatment strategy. Such strategy is available in India since last 6 years. It is known as Insulin pump, which is a small pager sized device, and this device can replace Insulin like pancreas.

In last 6 years, number of Insulin pump users in India is estimated to be 1500 which is too small. Since pump is a costly therapy so a limited number is expected to use it but as compare to Insulin treated population, pump user population is too small indicating

According to endocrinologist Dr. Sunil M Jain, cost factor does play a role but additionally there are many other hurdles for pump therapy in India:

1. Lack of correct information among health care providers
2. Self testing of blood glucose is low
3. Myths about pump
4. Non availability of paramedics taking care of pump problemsConcept of health economics is missing
5. Many type 1 Diabetics are not aware about its availability

Many patients feel that pump requires a surgery. While pump is a device which can be carried in pocket and a tube is attached to skin and through this Insulin reaches in our body. Many doctors are not aware about pump menu, pump software and thus they try to avoid prescribing pumps. Even if a doctor is aware of pump and its use, often there is no time to explain and demonstrate it to patients. Thus in India there is a need to train doctors, as well as paramedical staff about pump use. Once doctors are trained and able to mange the device then only pump usage will raise. In developed countries, nurses often put patients on pump and do most of the management. But in India, patients are comfortable if initial management is done by doctor follow up management by assistant. Thus for India, there is need to train doctors as well as paramedical staff and diabetes educators. This may change the paradigm of management of Diabetes and there may be a major change in quality of life of all type 1 Diabetics and type 2 Diabetics on MSI regimen of Insulin.