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My Doctor Says I Need a Test
Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
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Bleeding in Pregnancy
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Getting a latch on breastfeeding
Group B Streptococcus
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Prenatal Classes
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Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
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Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
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When Baby Comes Home
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Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
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Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
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A Healthy Mouth
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Smiling through the Senior Years
Teeth for Life
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Wisdom Teeth
Your Healthy Smile
DIABETES
Full Listing with story descriptions
10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
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Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
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Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Check-Up
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Contact Lenses
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COPD
Cost of Doctor's Visit
Diabetes Management
Diarrhea
Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
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Family Doctor
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Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
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High Blood Pressure Risks
How to Talk to Your Doctor
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Medical Digital Technology
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Restore Your Core
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Stopping Stroke
Stroke
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Vaccination Controversies (ask the doctor)
Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
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Cuts and Scrapes
Emergency Care Guidelines
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
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Growing Older
Full Listing with story descriptions
Advance Care Plans
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Can I see Well Enough to Drive?
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Eating Well
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Get Active!
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Have Health, Will Travel
Health Tips for Seniors
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Living Longer With Diabetes
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Maintaining Quality of Life as You Age
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New Corneal Treatments
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Skin Over 50
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Travel Tips for Snowbirds
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Modern Living
Full Listing with story descriptions
Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
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Barbecue Basics
Bathtub Safety
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Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
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Diabetes Epidemic
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Downsizing
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Melamine in Food
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Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
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Safe Drinking Water
Schizophrenia
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Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
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Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
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Travel Comfort Tips
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Wind Chill Index
Workplace Drug Testing
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Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
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Vitamins and Minerals
Vegetarian Diet
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Weight Wise Tips
Pharmacy Care
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After a Heart Attack
Adverse Drug Reactions
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Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
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Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
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Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
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Kids and Cold Medications
Medication Questions?
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Natural Medicines
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Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Pain Relievers
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
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Research Studies
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Sports & Nutrition Supplements
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Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
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Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
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Caffeine
Cell Phones and Driving
Childhood Obesity
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Cold and Flu Season
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Foodborne Illness
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The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
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Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
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Low Birth Weight
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Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
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Teens, Drugs and Driving
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15 Great Reasons to Breastfeed
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Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
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Menopause - What Men Should Know
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Family Health Online / Pharmacy at Safeway
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Managing Diabetes Magazine - diabetes

Insulin Pumps
Different People, different needs... Get the pump best for you

You many be looking for greater flexibility in managing your diabetes. Consider the following scenarios. In each switching to insulin pump therapy could have an advantage.

An insulin pump is a small, battery-powered microcomputer. It looks like a pager and is usually worn in a pocket, or clipped to a belt or waistband. The pump holds a syringe filled with rapid-acting insulin (Humalog™ or NovoRapid™). The syringe is attached to an infusion set, which is a thin plastic tubing with a small needle at the end. The needle is inserted into the fatty tissue below the skin, and then removed. This leaves a tiny, flexible plastic tube in place which must be changed every two to three days. The pump is programmed to deliver insulin continuously through this tube. A small dressing holds the infusion set in place.

If you have discussed the option of an insulin pump with your diabetes specialist, you may be starting the search for the right pump. You, too, may be looking for greater flexibility in managing your diabetes. If so, you are likely asking yourself some questions. Which of the four pumps available in Canada should you buy? Which pump has the features you need and want?

Do your research. An insulin pump is a major investment that you will use constantly for the next few years. Think about similarities and differences between pumps, and what to consider in deciding.

How are insulin pumps similar?

How do they differ?

Pumps differ in how basic features appear and in the bells and whistles they offer.

Consider each one carefully.

Special features in pump brands

Animas IR 2020Animas™ IR – 2020

The Animas pump’s reservoir holds 180 units. It can program the smallest basal rate increment (0.025 unit/hour). The screen offers a contrast of yellow print against a dark background, making it easy to read, except in the sun. It is rated as waterproof to a depth of eight feet for half an hour, but some tests show 12 feet for up to 24 hours. It does not currently communicate with a blood glucose monitor.

Deltec Cozmo
Deltec Cozmo™

The Cozmo pump holds 300 units. It comes with a thin glucose monitor that attaches to the back of the pump and communicates with it. You do not have to carry a separate monitor, but must still carry strips and a lancing device. The Cozmo pump has an IPX8 rating – waterproof to a depth of eight feet for 30 minutes. It also has added ‘alert’ features that reminds you when it is time to change your infusion set or if you have missed your meal bolus.

Accu-Chek SpiritDisetronic Accu-Chek™ Spirit

This pump holds 315 units. Basal increments are set in 0.1 units. The type size on the pump screen is quite large, making it easy to read. The display orientation can be flipped 180 degrees to help view it from any angle. It is waterproof for up to one hour at eight feet.

The pump comes with a second back-up pump that will run up to six months. It can be used in case the main pump fails. (Other pump companies replace a failed pump quickly.) The second pump can be handy when travelling far from home. However, other pump companies offer a travel loaner pump at little or no cost. Ask about this if you like to travel.

The Accu-Chek pump will work for 2200 days (six years), then must be replaced with a new version. Check on what would happen if the pump were to fail after four years, but before six years are up. Get any agreement in writing with a signature.

Another unique feature of this pump is the pocket device, somewhat like a palm pilot, that comes with the system. The device stores information, such as insulin to carbohydrate ratios, correction factors, and carbohydrate lists so that you can calculate boluses. It includes an Accu-Chek meter that sends blood glucose readings to the pocket device. However, the device does not communicate with the pump. If you lose the handheld device, the pump does not have a built-in calculator like other pump models.

Paradigm 522 or 722Medtronic Minimed Paradigm™ 522 or 722

The 522 and 722 models differ only in reservoir size. The 522 model holds 180 units, while the 722 model holds 300 units.

Unique to the 522/722 pump is the ability to communicate with another separately purchased device called a continuous glucose monitor. This allows you to check glucose level readings continuously through a sensor inserted under the skin. The sensor is attached to a transmitter about the size of a quarter. Glucose readings are sent wirelessly to the pump every five minutes and can be viewed on the pump screen. However, treatment of high or low readings must be based on finger poke tests. The sensor readings may not match these tests, as the sensor does not sit in blood but in a body fluid called interstitial fluid. Information about trends and the direction your blood glucose is moving (high or low) can be used to adjust your insulin. The sensor requires calibration with finger poke tests, twice daily. The sensors are also purchased separately and changed every three to six days. Some insurance plans do not cover this cost. To save on costs, the sensor can be worn only periodically. It is possible that a similar feature may be offered with other pumps in the near future.

Medtronic also sells other pumps (models 515/715) which are the same as the 522/722, but not capable of communicating with the continuous blood glucose monitoring system.

Resource list

Animas: www.animas.ca and animascorp.com
Contact information:
www.animas.ca/contact.aspx

Cozmo: www.cozmore.com

Contact information: www.autocontrol.com/contact.html (In Canada, Cozmo is distributed through AutoControl Medical.)

Disetronic/Roche: Accu-Chek Spirit pump: www.disetronic-ca.com
Contact information:
www.disetronic-ca.com/dstrnc_ca
(click ‘contact us’)

Medtronic Minimed Paradigm pumps:
www.minimed.com and www.minimed.ca
Contact information: www.minimed.ca/ContactUs.aspx

General pump information:
www.diabetesnet.com

Finding out more

Each pump company offers a web site. This is a good place to start your research (see resource list above). A good comparison chart of insulin pumps can be found at www.diabetesnet.com (type ‘compare insulin pumps’ into the info box). If you access this site, remember that only the four pumps discussed in this article are available in Canada.

Call your local diabetes education centre or endocrinologist’s office to learn if they offer information classes or materials on pumps. They can advise on which reservoir size and basal/bolus increments would work best for you. As well, they can give you contact information for local pump company representatives. Take the time to meet representatives to get hands-on exposure to the pumps. Some offer group information classes and others meet with you one on one.

Shopping for an insulin pump is both exciting and overwhelming. Choices, choices! No matter what you decide, be assured that each pump is a good product. However, the homework pays off when you choose a pump that suits your needs and lifestyle. Research is key! Make an informed decision about this important long-term commitment. The right choice will make using the pump even more rewarding for you.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
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