An
insulin pump is a small computerized device designed to precisely deliver insulin to the body through a small tube inserted in the skin. This eliminates the need for individual insulin injections. It is still necessary to check your blood sugar often, and the infusion sets (the tubing plus the needle or cannula) must be changed every two or three days. Insulin pumps provide certain benefits
(see Insulin Pump Advantages),
but are not right for everyone
(see Insulin Pump Disadvantages). They can be a useful tool for controlling your blood sugar.
How Do Insulin Pumps Work?
There are several different
types of insulin pumps, but the basic operating principles behind all of them are basically the same
(see Comparing Insulin Pumps). An insulin pump is worn outside the body, often clipped to an item of clothing. The pump itself is fairly small (about the size of a deck of cards or smaller) and looks much like any portable electronic device. It contains insulin (usually rapid-acting or short-acting) and is connected to a small, replaceable tube. The tube can be connected to the body using various different types of systems. Some use a steel needle that remains in place the entire time; others use a steel needle only to insert the tiny plastic needle (known as a cannula), after which the needle is removed.
Insulin pumps are programmed to deliver tiny amounts of insulin continuously throughout the day (the basal rate) and can also provide additional doses as necessary (bolus doses). The basal rate can be variable. In other words, you can program it to deliver different basal rates throughout the day. For instance, you might need to have a high basal rate for early morning in order to counteract the increase in blood sugar that occurs in the early hours of the morning (the dawn phenomenon).
Many insulin pumps also store information about how much insulin was used and when. This information can be downloaded onto a computer for you or your healthcare provider to analyze.
Recently, real-time continuous glucose monitoring systems have become available. Some of these systems can be programmed to calculate an appropriate dose based on your blood sugar reading, and some can even wirelessly send a signal to the pump to deliver the calculated dose. Even some traditional-style blood glucose monitors can communicate wirelessly with some types of insulin pumps.
Your healthcare provider will help you get started with
insulin pump dosing. For most people, information about their current
insulin dosages (if they are already on insulin) will be used to determine a starting point for the initial dosing. Your healthcare provider will work with you intensively to help you get started, especially in the first few days.
Because insulin pumps provide insulin, they can cause any of the usual
insulin side effects. Possible side effects include but are not limited to:
- Low blood sugar levels (hypoglycemia)
- High blood sugar (hyperglycemia), especially if the tubing comes out and you do not realize it
- Infection or irritation at the needle or cannula site in the skin.
(Click Insulin Pump Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
What Should I Tell My Healthcare Provider Before Using an Insulin Pump?
Talk with your healthcare provider prior to using the device if you have:
- Liver disease, such as liver failure, cirrhosis, or hepatitis
- Kidney disease, such as kidney failure (renal failure)
- Vision problems that would prevent you from properly programming or using a pump
- Problems with manual dexterity that would prevent you from properly programming or using a pump
- Hearing problems that would prevent you from hearing the pump alarms
- An unwillingness to check your blood sugar often
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
- Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If My Insulin Pump Malfunctions?
It is possible for
insulin pumps to malfunction. There are several different ways this can happen. They can malfunction and provide too much insulin, which can be immediately life-threatening, or too little insulin, which could eventually become life-threatening. The alarms can malfunction, and the needles or cannulas can become blocked. However, taking good care of your pump, following all the instructions closely, and keeping an eye out for problems can help reduce the risk of pump malfunctions.
Is This Device Right for Me?
If you are not content with your current insulin therapy, you might want to consider an insulin pump. However, a pump might not be right for you if you:
- Are able to adequately control your blood sugar with insulin injections
- Are not willing to test your blood sugar often
- Are unable or unwilling to do carbohydrate counting (or some other similar method for determining bolus dosing)
- Have vision, hearing, or manual dexterity problems that limit your ability to properly use the pump
- Do not like the idea of having something continuously connected to your body
- Are not capable of learning how to operate and program the pump
- Do not have a good understanding of the basal/bolus method of insulin therapy.
Affording an Insulin Pump
Fortunately, many insurance companies now cover insulin pumps, the necessary supplies, and insulin. However, if you do not have insurance or Medicaid or Medicare, the cost of an insulin pump can be overwhelming. Be sure to check with your healthcare provider about any available programs that can help you afford an insulin pump. Many manufacturers have programs to help people who cannot afford one, and there are a few foundations that will help uninsured individuals afford
diabetes supplies. Your diabetes educator may be a great source of information about how to afford an insulin pump.
