Type 1 diabetes is a condition where your body cannot produce insulin. Insulin is a hormone that promotes glucose uptake by your body’s cells to transform it into energy. If your body can’t produce insulin, the consequences can be dangerous.
If you have type 1 diabetes, you need insulin therapy. This is where the insulin pump comes in, providing a helpful and regular method of administering this essential hormone into your bloodstream. It ensures your blood glucose levels stay within a safe, healthy range.
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An insulin pump is a small computerized instrument attached to your body that delivers insulin as required, simulating a healthy pancreas. It’s a useful way of preventing hypoglycemia¹ (low blood sugar) while managing hyperglycemia (high blood sugar), which can result in potentially fatal convulsions and unconsciousness.
Insulin pumps were first commercialized in the 1970s and have advanced significantly since then.
An insulin pump can prevent many issues that result from imbalanced blood glucose levels. A pump reduces the risk of severe hypoglycemia and the associated worry. It also eliminates the need for ongoing injections.
Insulin pumps are an automated method of administering insulin so you can get on with your life. The pump is an alternative to other delivery methods, such as ongoing injections, which can be uncomfortable and impractical in some situations. Those methods are also time-consuming since you must measure your blood glucose levels before every dose.
Your body breaks carbohydrates down into glucose for energy. Your pancreas regularly produces insulin, a key hormone that allows blood glucose to enter many body cells. Some cells do not need insulin, such as neurons.
Maintaining your blood glucose levels in a normal range is crucial. In type 1 diabetes, your pancreas doesn’t produce insulin to regulate your blood sugar, so it accumulates in the bloodstream, causing hyperglycemia.
If you have type 1 diabetes, obtaining insulin from an external source is mandatory. This external source could be regular insulin injections or an insulin pump.
The insulin pump is suitable for people of any age with type 1 diabetes. However, determining who is eligible for insulin pump therapy requires careful evaluation.
You need to take responsibility for managing the pump. This includes operating the technology, measuring your carbohydrate levels, and understanding how to monitor your blood glucose.
Insulin pumps are ideal for people with poor glycemic control, even with several daily injections. Pump treatment is also common in women contemplating pregnancy so they can attain stricter glycemic targets.
If you travel frequently or engage in rigorous exercise, insulin pumps give you more flexibility.
An insulin pump is a mini, computerized device weighing approximately 100g. The pump provides exact amounts of insulin 24 hours a day to suit your specific requirements.
Basal delivers low insulin levels constantly to replicate the natural insulin production by the pancreas.
Bolus supplies extra insulin to match the food you’re about to consume or to manage excessive blood glucose levels. This method simulates the regular release of insulin by the body.
Insulin pumps have a display, an insulin storage component, and a pumping system. They’re controlled by a computer chip and are either battery-powered or rechargeable with a cable.
Although a pump may concern some people for practical or aesthetic reasons, the device is small, and you can wear it on a belt or place it in a pocket.
The insulin is pumped through a plastic tube called a catheter. The catheter ends with a thin needle called a cannula. You insert the cannula into your skin and use a piece of tape to hold it in place.
The insertion point should be an area with a lot of fatty tissue, usually in the belly.
The catheter and needle apparatus is called the infusion set, and you should change it every three days.
The great thing about the pump is that it isn’t a permanent fixture: You can remove it and put it back on at any time.
Insulin pumps generally require a prescription, and you should always consult your doctor before selecting a pump.
The type of pump you need depends on many factors. Insulin pumps are constantly evolving, so you must ensure your diabetes care team understands how to use and monitor your chosen pump. They will need to assist you if difficulties or malfunctions arise.
Two main types of insulin pumps are available:
You connect the pump to the cannula (the small tube which goes through the skin) using a length of thin tubing, and you carry the pump in your pocket or a bag, or you can hook it to a belt.
Some people get concerned about snagging and straining the connecting line between the cannula and the pump. The advantage of the tethered pump is that you can easily hide it from view.
A patch pump is commonly attached to the skin and has no tubing or a tiny tube. Because of this feature, the pump is smaller and lighter, which makes it significantly more comfortable. However, this type of pump is still visible under clothing.
Patch pumps are generally the preference for many people with type 1 diabetes.
Waterproof pumps such as the OmniPod pump work underwater up to 7.5 meters deep. This pump is fantastic if you’re involved in water sports like swimming or surfing. However, it’s not suitable for scuba diving since it can only be used for one hour in the water and is limited to relatively shallow depths.
Smart pumps can integrate with continuous glucose monitoring (CGM) systems to effectively sense glucose levels.
Pumps with automatic control functions can detect low glucose levels and immediately stop pumping insulin. This is especially useful if you’re at risk of hypoglycemia at night. An example of this type of pump is the Medtronic MiniMed 640G.
The insulin pump prevents complications when blood glucose levels go out of range.
If blood glucose levels are high, acute and chronic complications can occur, including:
Damaged blood vessels
Frequent urination from excess glucose in the blood
Diabetic ketoacidosis is when the body burns fat instead of glucose for energy
You may also notice dehydration, tiredness, and weight loss.
Type 1 diabetes is much less common than type 2 diabetes, which differs from type 1 in that the pancreas produces insulin but does not use it properly.
Type 1 diabetes commonly starts during childhood or adolescence; that’s why people often call it juvenile diabetes. However, it can affect anyone at any age. Studies² point to genetic and environmental factors causing the autoimmune destruction of pancreatic cells.
Although insulin pumps appear to provide a solution for delivering appropriate insulin amounts, research still needs to establish their effectiveness compared to other delivery methods.
One study³ analyzed the effectiveness of pumps compared to insulin injections in younger patients. It linked pump use to decreased diabetic ketoacidosis and severe hypoglycemia. Pumps also provided greater glycemic control.
In contrast, another investigation⁴ found that pumps didn’t always result in better treatment outcomes, often due to pump failure. Injections were often just as effective at controlling blood glucose levels.
This led to a recommendation to consider pumps only if injections have failed to improve your hypoglycemia management. Nevertheless, people who used pumps in the study reported greater treatment satisfaction, more dietary independence, and fewer daily worries.
Ultimately, whether or not to use an insulin pump depends on you, your life situation, interests, preferences, and specific type 1 diabetes diagnosis.
Using an insulin pump brings many advantages, some of which include:
Consistent insulin dosing, which you can adjust when necessary
Delivery that mimics the natural functioning of the pancreas
Less reliance on insulin injections
Increased adaptability for sports: The pump allows you to adjust your basal insulin dose to reduce the risk of decreasing blood glucose levels.
More flexibility around eating patterns compared to injections
More accurate dosing of insulin compared to injections
Increased sense of privacy with a pump since you can hide it from view
Improved sleep as you don’t need to wake up during the night to inject insulin if levels are low
Although an insulin pump provides an automated method of receiving insulin, it doesn’t eliminate the need to check your blood glucose levels manually. This is the responsibility of you and your support system.
This ensures the pump is working correctly and pumping insulin. If the pump or the infusion set stops working, high blood glucose levels and even diabetic ketoacidosis can occur.
However, regularly monitoring your blood glucose levels ensures ketones don’t develop. You must be prepared to inject insulin whenever necessary if the pump somehow detaches or breaks.
Another disadvantage is that you must deal with wearing a device that’s attached to your body almost 24 hours a day.
Some pumps are difficult to hide, removing the privacy element.
Insulin pumps cost significantly more than injections: One analysis⁵ found that a pump costs an additional $20,500 per person over three years.
The pump can break if it comes loose, especially at the insertion site.
The reservoir of the pump can leak insulin if the seals get damaged.
If you don’t completely remove the air from the tubing while setting up the pump, bubbles can form, affecting insulin delivery.
If you’re considering managing type 1 diabetes with an insulin pump, you must consider some factors.
Insulin pumps aren’t cheap; they can cost anywhere from $4,995-$5,495.
Thankfully, many insurance firms cover the costs associated with insulin pumps, but you need to check your policy to determine which pumps are available.
You need to monitor your glucose levels carefully, and you still need injections as a backup if the pump fails or if you decide to stop insulin pump therapy.
You’ll require a professional diabetes team consisting of an endocrinologist, a diabetes nurse, and a dietician. Your general practitioner (GP) plays a critical role in this team, so your GP must be familiar with insulin pump terminology.
Medical treatments don’t come without risks, and the insulin pump is no exception. Although pumps are generally considered safe, they may not suit everyone.
However, understanding how to use an insulin pump may avoid typical problems and enhance results.
Doctors are an essential part of the care team for people with type 1 diabetes. You’ll need their assistance at many stages of your patient journey.
If you’re considering using a pump, a doctor will guide you in the right direction as to whether pump therapy suits you and which pump is a good choice.
Regular consultations are also helpful to monitor the correct use of the pump and check if you’re responding appropriately to the prescribed dosage.
If you suspect the pump may be leaking or broken, visit your doctor as soon as possible.
If the pump has been disconnected for more than 4–6 hours, you must self-inject insulin to avoid ketoacidosis. If this happens, seek medical help.
If you’re having technical difficulties with your pump, seek advice from your care team or doctor.
Occasionally, your doctor will be required to administer an appropriate insulin dose via injection to restore your blood glucose levels quickly.
Importantly, if your ketone levels are abnormally high or vomiting occurs, you should seek emergency medical care.
Insulin pumps are an excellent treatment option for type 1 diabetes because they reliably inject insulin and keep your blood glucose levels within a healthy range. One significant benefit of using an insulin pump is the flexibility permitted by the pump.
Many users prefer insulin pumps as they remove the requirement for strict daily routines of injections and provide more lifestyle flexibility. The technology of insulin pumps has improved dramatically.
If you opt for a pump, you and your medical professionals will need to keep up with the advancements to ensure you use your pump correctly.
Genetics of type 1 diabetes (2011)
Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: Cluster randomised trial (REPOSE) (2017)