The Cortisol Pump

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Glossary

We understand that there are terms about the Cortisol Pump that you might be unfamiliar with. This is why we have compiled a glossary. If you feel as if it is missing something, please contact us and we will look into it.

A

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B

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C

A small, single use, vessel that holds the medication inside of the infusion pump. The terms can be used interchangeably, but Medtronic exclusively uses the term “reservoir”. In tubed pumps, the cartridges come in individual packaging and will need to be filled and inserted into the pump. In the Omnipod system, the cartridge is built into the pod and the pod itself is loaded with Solu-Cortef.

An example Medtronic Cartridge / Reservoir. Photo taken from Medtronic’s Website.
An example OmniPod Cartridge. Photo taken from Omnipod Website.

The production of hormones and other biological processes that occur in a regular 24 hour pattern. In this guide we specifically focus of the circadian rhythm of cortisol.

Testing done to help determine the rate at which a particular medicine clears the body. It is a different value for each individual.

Also known as transcortin, CBG is the transport protein for glucocorticoids. Though cortisol bound to CBG is not biologically active like free cortisol, CBG plays an important role by storing and transporting cortisol when it is needed and where it is needed.

Short for Cushing’s Syndrome, which is the long term over exposure to cortisol. Cushing’s syndrome is usually caused by Cushing’s Disease, which is the body’s over production of cortisol.

In individuals with adrenal insufficiency, Cushing’s Syndrome is caused by glucocorticoid over replacement.

D

Multiple blood tests run throughout a single day in order to plot a curve of response.

E

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F

Free cortisol is unbound active cortisol. It is not bound to CBG. Ideally both FREE and TOTAL cortisol should be tested and endured they are in range when using the cortisol pump.

A prescription formulary is a list of medications covered by a specific insurance plan. Each plan may have a different formulary list.

G

Corticosteroids (e.g. hydrocortisone) which are involved in the metabolism of carbohydrates, proteins, and fats and have anti-inflammatory activity

H

Hair cortisol testing involves testing a very small sample of the hair. This type of testing looks at cortisol levels over a long amount if time. 1 cm of hair can give a month’s average of cortisol levels. Hair cortisol testing is best at finding long term over exposure to cortisol such as cases of Cushing’s disease. It is not at all helpful for checking or titrating pump rates.

I

Refers to the spot on the body the inset is placed and medication is being delivered.

Short for “infusion set”, which refers to the equipment that connects to the body to deliver medication. It consists of a very small tube called a cannula that is inserted under the skin. The cannula is held in place with an adhesive patch that is connected to the pump via tubing, or directly to the pod in Omnipod systems.

J

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K

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L

A legal document written by your doctor verifying why you need a specific medical treatment.

M

A corticosteroid, such as aldosterone, that is involved with maintaining the salt balance in the body. In individuals with forms of primary adrenal insufficiency Fludrocortisone is prescribed to replace aldosterone.

N

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O

“Off-label” means the medication is being used in a manner not specified in the FDA’s approved packaging label, or insert. The practice, called “off-label” prescribing, is entirely legal and very common. More than one in five outpatient prescriptions written in the U.S. are for off-label therapies.

P

“Personal Diabetes Manager.” This is another term for the remote that accompanies the OmniPod. A photo is provided below.

Photo taken from OmniPod’s website.

Testing that checks for genes that may alter the way a person responds to drugs. Learn more here.

This is only applicable to the Omnipod system. It is a usually rare occurrence when the pod is unable to communicate (relay signal) to the Omnipod PDM. When this happens, the PDM will attempt multiple times to establish communication with the pod, but if communication is not restored then the pod will need to be deactivated and replaced.

Q

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R

An enzyme secreted by and stored in the kidneys which promotes the production of angiotensin as part of the body’s renin–angiotensin–aldosterone system. Plasma renin level along with sodium level can be used to asses mineralcorticoid dose.

S

Measures free (unbound) cortisol. Saliva cortisol testing be useful if you know how to interpret the data. However, it is better suited for detecting over replacement than under. Results can also be contaminated by other substances in the saliva, such as things you have eaten. It best to conduct saliva testing along side blood (total) cortisol testing rather than a stand alone test.

Multiple cortisol tests conducted within the same 24 hour period. Samples can be taken as soften as every hour or a few as 4 per day. The more samples taken, the more data you will have available to use, and the more precise your rate adjustments will be. Ideally testing should include multiple blood cortisol tests (total cortisol), multiple saliva tests (free cortisol), and 24 hour urinary cortisol.

Stretch marks.

Situated or applied in the layer of fat under the skin.

T

Total cortisol is a measure of the amount of bound (free) cortisol as well as the cortisol bound to cortisol binding globulin.

U

A 24 hour collection of urine used to measure the amount of cortisol excreted in a day. This is useful for assessing the total hydrocortisone dosage, but not useful for adjusting individual rates. 24 hour urinary cortisol should be conducted along with blood cortisol testing.

V

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W

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X

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Y

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Z

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