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At a Glance

For people with type 1 diabetes and for some with type 2 diabetes who take insulin, the management of your diabetes with multiple injections of insulin can sometimes seem to get in the way of how you'd like to live your life. If you find yourself looking for a better way to control your blood glucose and have more freedom, maybe the insulin pump is a good choice for you.

What is an insulin pump?

It is a device which delivers a continuous dose of insulin through a small soft plastic tube inserted under your skin. The pump can be connected and disconnected for bathing and other activities; it is not "permanently attached." Most pumps are small, about the size of a cell phone or pager, and are worn outside of the body, often attached to a belt or placed in a pocket. The pump gives you a small continuous amount of insulin 24 hours a day; this is called the basal dose. The pump simulates the working of an effectively functioning pancreas. Since your blood glucose rises after eating, you need an additional amount of insulin to help control the blood glucose when you eat. You will use the pump to deliver extra doses of insulin at mealtimes in order to keep your blood glucose from going too high. This is called a bolus dose. There are special features in the insulin pump that can be activated for special circumstances such as doing exercise, when you may need less insulin, or eating a prolonged meal. You still get to make the decisions about how much insulin is delivered by the pump and you will have to check your blood glucose several times a day.

What are the benefits of using an insulin pump?

Insulin pump therapy can offer you a more flexible lifestyle. A study called the Diabetes Control and Complications Trial showed that in those people with diabetes who were able to keep their blood glucose at near-normal levels with intensive therapy, the risk of developing some of the complications of diabetes was greatly decreased. The A1C levels of those who used the insulin pump in the last year of that trial decreased. The insulin pump is a tool which can help you to keep your blood glucose in good control and avoid some of the health issues that may come with diabetes over time. According to a follow-up study, good blood glucose control can not only increase the quality but also the length of your life. With the use of an insulin pump, you avoid the multiple injections needed when you are on a basal-bolus routine with insulin by injection. Since you are in control of the amount of insulin that you get through your pump, you are able to make adjustments when your need for insulin may be increased or decreased such as eating more or less food, illness, and engaging in various levels of activity. The use of an insulin pump has been shown to decrease the risk of low blood glucose at night or when you are engaging in physical activity or exercise. Using an insulin pump can offer you improved blood glucose control, more freedom, more convenience, more control and a better quality of life.

Are there disadvantages to using an insulin pump?

• Insulin pump therapy takes commitment on your part; it is not just a "put it on and go" deal. You will need to learn how pump therapy works and in particular, how the pump that you choose functions. There are still steps that you will need to take on a regular basis to ensure that your blood glucose stays in target range and that your pump is working appropriately. You will need to check your blood glucose a minimum of 4 times a day and enter data into the pump in order to ensure the correct insulin dose.
• Having an insulin pump can be expensive even if you are covered by insurance. Each plan is different and you may be responsible for certain expenses associated with pump use.
• You may notice some weight gain when you start to use an insulin pump. At first this may be due to better blood glucose control but remember that with insulin pump therapy comes more freedom with eating. You may be able to eat more, especially carbohydrates, and still keep your blood glucose in target. Extra calories, if not balanced with extra activity, will cause weight gain.
• There are some complications that can occur including a serious condition called diabetic ketoacidosis if your pump becomes disconnected and you don't receive insulin for several hours.