An insulin pump is a device the size of a pager. It contains a syringe or reservoir filled with a fast-acting insulin, a battery-powered syringe plunger, and a small computer to control the insulin delivery. The syringe is attached to tubing, which in turn is attached to a small plastic tube (cannula) inserted under the skin (see Figure 6-1). The pump can be programmed to put tiny drops of insulin into the subcutane-
Figure 6-1 Insulin Pump
Buttons to give boluses
Buttons to give boluses
ous tissues every three to ten minutes day and night—this is the basal insulin. When you eat, you can program the pump to give a bolus of insulin for the food. Thus, when you are on the pump, you use only a fast-acting insulin to provide both your basal and bolus needs.
Often, people with type 1 diabetes will decide to go on an insulin pump for their diabetes control. The pump does not check glucose levels, nor does it decide how much insulin to give. It does allow you to tailor your basal insulin to your needs. With a pump, you are better able to reduce your insulin levels for exercise. A major advantage is that the pump reduces the number of insulin injections—essentially, you are doing one injection every three days.
There is a fair amount of work involved in using an insulin pump, and you will have to be proactive in terms of managing the diabetes and feel comfortable taking the initiative and adjusting your insulin dose for food and activity. You will need to check your blood glucose as many times or more often than when you were on injections. You also have to set basal rates and make decisions on how much bolus insulin you should give. Table 6-10 summarizes the advantages and disadvantages of insulin pumps.
Table 6-10 Advantages and Disadvantages of Insulin Pump Therapy
(Also Known as CSII—Continuous Subcutaneous Insulin Infusion)
Advantages of Pumps
Disadvantages of Pumps
One injection every three days
More precise basal insulin levels—especially overnight and first thing in the morning
Adjust basal insulin levels for exercise
More precise boluses—adjust by 0.05-unit increments
Insulin on board feature—which reminds user that previous insulin bolus is still active-helps avoid stacking of insulin boluses
Being attached to a machine
No significant subcutaneous insulin reservoir—if the pump fails or infusion set kinks and you are not aware, you can go into ketoacidosis
Increased risk of skin abscess
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