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Insulin Pumps—Pros and Cons

Updated on September 29, 2017
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Stephanie Hicks has been a Type 1 diabetic for 15 years. She manages the disease with an insulin pump, doctor visits, diet, and exercise.

Pump or Needle? Choices for Insulin-Dependent Diabetics

Insulin Pump Therapy vs. Manual Insulin Shots
Insulin Pump Therapy vs. Manual Insulin Shots | Source

What Is an Insulin Pump and Why Is it Used?

Some people have the impression that an insulin pump fixes everything for those of us that are insulin dependent. Someday, we hope that will be true, but primarily an insulin pump is most useful for allowing Type 1 and some Type 2 diabetics to minimize the use of needles for shots.

Insulin is a hormone produced in the beta cells of the pancreas. It acts as a "key" in unlocking cells so that they can use the energy from items we consume. After digestion, carbohydrates are converted into blood glucose, also known as blood sugar. Our muscles and organs use the blood glucose for energy.

Whether due to an auto-immune disorder (type 1 diabetes) or due to genetics, a poor diet and lack of exercise, or simply age (general factors in developing type 2 diabetes), the patient's pancreas is unable to make sufficient—or any—insulin. As a result, blood glucose levels rise and complications may develop. This is why all type 1 and some type 2 diabetics need to take external insulin to survive.

An insulin pump is a medical device and mini computer that is used to calculate a bolus (otherwise known as a "shot" of insulin) for meals and is also used to provide a baseline rate of insulin over a 24-hour period. Insulin pumps calculate the amount of "insulin on board," which prevents low blood sugar, also known as hypoglycemia, from occurring when a patient does not take into consideration the insulin that has already been administered when they use the pump to give more insulin in response to another meal or snack.

Patients can input personalized information into the pump so that calculations can be made efficiently and more precisely than manual insulin shots. This information includes an insulin sensitivity factor—for example, 1 unit of insulin for every 15 grams of carbohydrates consumed. Some people are less insulin sensitive, so they might need 1 unit for every 5 grams of carbohydrates. An endocrinologist (medical specialist used to treat diabetics) should help a patient new to insulin pump therapy develop individualized settings.

Significant Differences Between Insulin Pump Therapy and Manual Insulin Shots

 
Insulin Pumps
Manual Insulin Shots
Able to eat or drink immediately
x
x
Operates over a 24-hour period for baseline insulin
x
*must take separate long-acting insulin
Need to use more than one type of insulin
 
x
Calculates and accounts for insulin previously administered
x
 
Calculates amount of insulin to administer with input from patient
x
 
Able to administer tenths of insulin units
x
 
Software that allows medical team to monitor and detect blood glucose trends
X
 
Waterproof
No
N/A
Requires batteries
X
 
Cost/insurance coverage
Usually thousands of USD - insurance companies may or may not cover
Relatively inexpensive - need prescription for two types of insulin and needles
Reliability
Patients using insulin pumps generally have far greater control over their A1C which is a measure of blood glucose over a 3-month period
Patients using manual insulin shot therapy generally have greater difficulty with tight A1C control and may experience more frequent episodes of hyperglycemia and/or hypoglycemia

How do Insulin Pumps Work?

Basic Components of an Insulin Pump

Many of today's insulin pumps are relatively small—about the size of a credit card, but thicker. They can be easily worn in a pocket or clipped to a belt. Other versions of insulin pumps are worn directly on the insulin site, like the OmnipodTM discussed in the next section below. Regardless of the type of pump, it must be worn 24 hours a day because only fast-acting insulin is used in the device.

The basic components of an insulin pump include: (1) a reservoir for insulin, on which to draw, (2) a battery, (3) mini-computer—programmable with individualized patient settings, as well as month, date, time; and (4) tubing or other method by which insulin is transferred from the reservoir to the patient. The patient connects him or herself to the pump for delivery of insulin via a catheter that is inserted with a needle, after which the needle is withdrawn and the catheter remains. See the photo immediately below for an example of an "insulin site" that I inserted for use with my pump.

The reason why insulin pumps must be worn 24-7 is because the liver stores blood glucose and emits it to allow a person to draw on energy even when they are not consuming food or drink. This is why people who are insulin-dependent and who are not on the pump need to use both short-acting and long-acting insulin. Long-acting insulin smooths out the long-term highs and lows that might happen for those not on insulin between meals.

Some insulin pumps require the use of batteries that must be replaced. Other pumps have batteries that can be recharged like a mobile phone.

Tubing and Insulin Site: Stays in Place Up to 3 Days

Insulin Site: Where insulin goes into the body from an insulin pump
Insulin Site: Where insulin goes into the body from an insulin pump | Source

Insulin Pumps vs. Insulin Shots

Insulin Pump Manufacturers Providing Devices Available in the United States

In the United States, insulin pumps must be approved by the federal Food and Drug Administration (FDA) before they can be prescribed for patients. And yes, you will need a prescription from a doctor before you can begin insulin pump therapy.

A patient should meet with his or her doctor and discuss the various pros and cons of the use of insulin pumps before making a decision for themselves or a loved one. Most, if not all, companies that manufacture insulin pumps have professionals that will come to you to go over the use of the pump and answer any questions.

This article does not contain any affiliate links for pump manufacturers, nor is it to be considered a recommendation for or against any individual insulin pump.

  • Tandem
  • Medtronic
  • Roche
  • Insulet Omnipod
  • Animus Vibe

For me personally, my change between Medtronic and Tandem was because I could use a touchscreen with my Tandem and because I could charge my Tandem with a phone charger, rather than replace the AAA batteries.

Insulin Pump from Medtronic: MiniMed Paradigm

One Type of Insulin Pump
One Type of Insulin Pump | Source

Misconceptions Concerning Insulin Pump Therapy

Some of the most common misconceptions people have about insulin pump therapy for diabetics are summarized:

  1. It cures diabetes. Unfortunately, a pump does not constitute a "cure" but is simply another method by which the disease can be managed effectively.
  2. The diabetic patient no longer has to test blood glucose. If only this were true! Diabetics must still poke their fingers, usually multiple times a day, to gauge blood sugar levels so that they can input the information into the pump before consuming food or drink. Unless the patient uses a continuous glucose monitor, use of a glucose meter is also required to determine hypo- or hyperglycemia before treating such conditions.
  3. The patient can eat whatever and whenever they desire. Again, this is a pipe dream! A diabetic patient must be ever vigilant to make decisions that the rest of the population with functioning pancreases takes for granted.

A Blood Glucose Monitor Must Still Be Used With an Insulin Pump

Blood glucose monitor... finger poking required!
Blood glucose monitor... finger poking required! | Source

© 2017 Stephanie Hicks

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    • stephhicks68 profile image
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      Stephanie Hicks 2 weeks ago from Bend, Oregon

      Thanks Dianna! Hope a cure for diabetes is found soon. When I was diagnosed 15 years ago, and to this day, they promise they are close to a cure. For now, insulin pumps appear to be the best method of managing the disease!

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      Dianna Mendez 2 weeks ago

      Wish it was possible to cure this disease with a pump. Thanks for sharing this important product information. I am sure it will help many.