Insulin Pump Centre
Insulin pumps. The sensible alternative to insulin injections.
An insulin pump is a device the size of a pager that contains a syringe reservoir filled with insulin. You wear the pump outside your body and a small, flexible tube connects the reservoir of insulin to a catheter that you insert under the skin of your abdomen.
An insulin pump delivers insulin in much the same way as your body does. Your physician helps you determine how much insulin you need, and then you program the insulin pump to release the desired amount of insulin into your body. The pump releases rapid-acting insulin and delivers the insulin in two ways: continuously (basal) and in bursts (bolus), to cover food eaten.
Insulin pumps deliver rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. Your insulin doses are separated into:
- Basal rates
- Bolus doses to cover carbohydrate
- Correction or supplemental doses
Basal insulin is delivered continuously over 24 hours, and keeps your blood glucose levels in range between meals and overnight. Often, you program different amounts of insulin at different times of the day and night to meet different needs.
When you eat, you use buttons on the insulin pump to give additional insulin, called a bolus. You take a bolus to cover the carbohydrate in each meal or snack. If you eat more than you planned, you can simply program a larger bolus of insulin to cover it.
You also take a bolus to treat high blood glucose levels. If you have high blood glucose levels before you eat, you give a correction or supplemental bolus of insulin to bring it back to your target range.
Some advantages of using an insulin pump injections are:
- Using an insulin pump means eliminating individual insulin injections
- Insulin pumps deliver insulin more accurately than injections
- Insulin pumps often improve A1C
- Using an insulin pump usually results in fewer large swings in your blood glucose
- Using an insulin pump makes delivery of bolus insulin easier
- Insulin pumps allow you to be flexible about when and what you eat
- Using an insulin pump reduces severe low blood glucose episodes
- Using an insulin pump eliminates unpredictable effects of intermediate- or long-acting insulin
- Insulin pumps allow you to exercise without having to eat large amounts of carbohydrate
- Can cause weight gain
- Can cause diabetic ketoacidosis (DKA) if your catheter comes out and you don’t get insulin hormone that helps the body use glucose for energy. The beta cells of the pancreas make insulin. When the body cannot make enough insulin, it is taken by injection or through use of an insulin pump.
- Can be expensive.
- Can be bothersome since you are attached to the pump most of the time.
- Usually require a half-day at the Diabetes centre for training on how to use the pump.
There are pluses and minuses to using a pump. Even though using an insulin pump has disadvantages, most pump users agree the advantages outweigh the disadvantages.
Pumps are not ‘for’ everyone. You have to be motivated enough to use this tool properly. That means:
- Mindfully managing your type 1 diabetes on a day-to-day basis
- Counting carbohydrates and adjusting insulin doses
- Checking blood glucose levels at least 4 times a day
- Checking that your basal rates are correct by occasionally missing meals
- Checking your insulin-to-carbohydrate ratios
If you are struggling with highs and lows despite your best efforts on multiple daily injections (MDI), or you have frequent hypos that need someone else’s help, then a pump may help you.
Discuss it with your diabetes care team. A GP cannot make a decision regarding a patient's suitability for an insulin pump. Ask your GP to refer you to a pump-friendly clinic or contact us at 011 660 8887 / 011 472 8443
Show that you have the commitment to use a pump safely by:
- Switching to multiple daily injections (MDI) (four or more injections a day)
- Performing four or more blood glucose readings a day and acting on the results
- Counting the carbohydrates you eat and adjusting your mealtime insulin doses
- Adjusting your insulin dose according to accommodate exercise, illness, stress etc
- Keeping good records and reviewing your results regularly to spot patterns that may be addressed by changing your insulin doses
If your consultant prescribes insulin pump therapy, he/she will arrange the funding and training. Discuss timelines with your diabetes care team for training.