Insulin Pump

What is an insulin pump?

Insulin pump therapy is an alternative to injecting insulin. Some people who cannot achieve adequate glucose control by conventional (or jet) injection are able to do so with the appropriate pump. An insulin pump is a small device (about the size of a pack of playing cards) that holds insulin.

The pump is attached to you by a long piece of thin tubing, with a needle at the end, which is inserted under your skin, where there is a temporarily implanted catheter or cannula. Most people insert the needle into their stomach but you could also insert it into your hip, thigh, buttock or arm.

The pump allows insulin to flow into your bloodstream at a rate that you control. This means that you no longer need to give yourself injections, although you will need to monitor your blood glucose levels very closely to ensure that you are receiving the right amount of insulin.

Insulin pump therapy can be used by adults, teenagers and children (with adult supervision) who have type 2 diabetes. However, it may not be suitable for everyone. Your diabetes care team may suggest pump therapy if you often have hypoglycaemia (low blood glucose), or if you can manage your own day-to-day diabetes treatment and look after your health carefully.

What are the pros and cons of an insulin pump?

Insulin pumps are a reasonable solution for some. Advantages include better control over background or basal insulin dosage, bolus doses calculated to fractions of a unit, and calculators in the pump that help with determining bolus infusion dosages. The limitations are cost, the potential for hypoglycemic and hyperglycemic episodes (excessively low or high blood sugar), catheter problems, and no means of easily controlling insulin delivery based on current blood sugar levels.

Potential Side Effects

As with injections, if too much insulin is delivered or the patient eats less than he or she is dosed for, hypoglycemia (low blood sugar) can result. On the other hand, if too little insulin is delivered, hyperglycemia (high blood sugar) can result. Hypoglycemia can be especially life-threatening. In addition, indwelling catheters pose the risk of infection and ulceration. Some people may also develop lipodystrophy, which is a change in fat metabolism, due to the infusion sets. These risks can be minimized by keeping infusion sites clean. Insulin pumps require care and effort to use correctly. However, some people with diabetes are capable of keeping their glucose in reasonable control using only an insulin pump.