Learning About Insulin Pumps

What is an insulin pump?

An insulin pump is a tiny computer that delivers insulin into your body. With a pump, you don't have to give yourself insulin shots throughout the day. You program the pump to do this. You can also give yourself an extra dose of insulin when you need it.

A pump may give you more freedom to eat, sleep, and exercise when you want.

How does it work?

The pump sends insulin through a narrow plastic tube (a catheter) that ends in a tiny needle. The needle goes into your skin. The tube and needle are called an infusion set. With most infusion sets, the needle pulls out, leaving a tiny flexible tube called a cannula under your skin.

Some pumps attach directly to the body and do not need tubing. With this type, a remote device controls the pump. And some pumps are disposable and do not use tubing or a remote control. A pump with no tubing is sometimes called a "pump patch."

An insulin pump gives you a constant trickle of insulin throughout the day and night. This is called your basal amount. You set this up to keep your blood sugar in your target range throughout the day.

You can use the pump to give yourself extra insulin when you eat a meal or a snack. You can give yourself less insulin when you are very active or exercising. You also can give yourself more insulin any time you feel you need more than your basal amount of insulin.

Why do some people prefer pumps?

An insulin pump can help you control your blood sugar.

• A pump may help you keep your blood sugar closer to normal. You may have fewer big swings in your blood sugar levels.
• A pump can deliver an exact amount of insulin and in very small amounts.
• The pump may help you keep your blood sugar under control without also causing low blood sugar.
• A pump may improve your hemoglobin A1c level.
• You don't have to give yourself shots several times a day.
• You don't have to plan your life around your insulin shots. You don't have to stop what you're doing and give yourself a shot.
• Some pumps also work as a blood sugar meter or they communicate with your meter. Some pumps continuously measure glucose. And some pumps can suggest how much insulin you need based on blood sugar readings.

What are the drawbacks?

Diabetes control

• A pump may not improve blood sugar control if you are already giving yourself insulin shots 3 or more times a day.
• If you keep your blood sugar levels in a tight range, it may be harder for you to sense when your blood sugar is low.
• If you are not good at counting your carbohydrate grams, the pump may not help you control your diabetes.

Safety

• Diabetic ketoacidosis (DKA) may happen more often and more quickly with an insulin pump than with shots. Your blood sugar could get too high if something goes wrong with the catheter or pump and you don't notice.
• You may get an infection where the catheter goes into the skin. You'll need to take good care of the site and change the catheter on schedule.

Effort

• It may take time to set up the pump. You may have to spend time at a clinic, skip a few meals, and check your blood sugar more often than usual.
• Many insurance companies have strict guidelines that you will have to follow or they will not pay.
• You may need to replace your infusion set every 2 or 3 days.
• You may have to learn new routines in how and when you test your blood sugar and when you travel, play sports, and eat.

How do you choose an insulin pump?

Some people say choosing which pump to use is harder than deciding to switch to a pump. There are a number of insulin pump companies, and each pump is slightly different.

Ask members of your diabetes team which pumps they recommend.

If you have insurance, find out which pump brands are covered. Then ask those companies to send you information or check their websites.

You should be able to try out a pump with saline solution. That way you can see how it works and feels.