Many diabetes patients, especially those with type 1 diabetes have to give themselves multiple injections of insulin every day. This can be uncomfortable and difficult to fit into their daily lives. Even with several daily injections and frequent blood sugar testing, some patients will still have difficulty controlling blood sugar.
For some patients, an insulin pump offers a better option to deliver insulin and can often provide better control of their diabetes.
The pump is a small device worn externally that can be attached to a belt or clothing. The user fills the disposable reservoir with insulin every few days and the insulin flows through a small tube inserted under the skin. The tubing should be changed every few days also. This system allows the patient to get a constant infusion of insulin, which mimics normal pancreatic function. The rate of infusion can be adjusted to customize the dose for each patient. It can also be programmed to deliver insulin at different rates during different times of day.
When the user is about to eat a meal, they program the pump to deliver an extra dose of insulin to control the after-meal blood sugar increase. This dose is determined by the carbohydrate content of the meal and the current blood sugar level.
Some insulin pumps are used in combination with a continuous glucose monitor and the devices can communicate with each other to regulate the insulin dose based on the patient’s blood sugar readings.
A patient with an insulin pump may still need to give themselves an insulin injection if the pump fails for some reason, or if they remove the pump, for example to go swimming.
An insulin pump is a good option for patients who have a high A1c level (average blood sugar) but also have frequent hypoglycemia, people with unpredictable fluctuations in blood sugars, and patients whose multiple daily injections interfere with their lifestyle and who feel a pump would be more desirable.
There are some drawbacks to using a pump also. Having a piece of hardware attached to the body is undesirable for many people. The pumps are expensive and may not be covered by insurance. People who have difficulty with technology may struggle with programming and using the pump properly.