Living with diabetes blog

Is insulin pump therapy for you?

By Peggy Moreland, R.N., C.D.E. August 20, 2016

An insulin pump is a small computerized device that delivers insulin in two ways:

  • It delivers insulin in a steady, measured and continuous dose. This is known as basal rate and replaces long-acting insulin and can deliver a very small amount — as low as 0.025 units per hour.
  • It can also deliver a bolus, or burst, of insulin to cover food. Before a meal, you enter the amount of carbohydrates and your blood glucose reading into the insulin pump. The pump will then calculate the amount of insulin required and deliver the precise dosage of bolus insulin — as low as 0.1 unit.

The insulin pump uses mainly rapid insulin such as aspart (NovoLog), lispro (Humalog) or glulisine (Apidra). In rare circumstances, regular insulin is used.

Many people want to have an insulin pump because "it does everything for you." While that option will be available in a few years, that is not true currently. Realistically, you still must test your blood glucose. You will still have blood glucose problems, but an insulin pump can improve blood glucose control by delivering individualized rates.

Being on an insulin pump does not mean that you can eat anything you want. Nobody can eat whatever they want. However, the pump does increase lifestyle flexibility because you do not need to inject insulin. But the pump is a tool and is only as effective as the person using it. It will take some time to learn and to adjust the settings on your pump.

Some things to consider for those thinking about insulin pump therapy:

  • Requirements:
    • Currently on an intensive insulin program requiring daily long-acting insulin and rapid-acting insulin with meals
    • Experience with carbohydrate counting
    • Able and willing to monitor your blood glucose at least 4 times a day
    • Able to understand and work with mechanical devices or computers
  • An insulin pump can increase the potential for ketoacidosis. Because only rapid-acting insulin is used in an insulin pump, if the pump fails your blood glucose will rise rapidly.
  • Insulin pumps cost approximately $7,000-$10,000 and approximately another $1,500 a year for pump supplies.
  • The pump weighs about 2.8-4.2 ounces and is attached to you 24 hours a day every day.

So, if you are interested in an insulin pump, you must be motivated, realistic in your expectations and willing to learn. You also need to have support from your family or significant other. It also helps to be able to afford the insulin pump and supplies.

Are you intellectually, physically, emotionally and technically able to run a pump? If so, check with your insurance carrier for coverage, as they may only cover a certain brand. Insulin pump companies are able to help you contact insurance and assist you in checking on specific coverage.

Have a great week!

Aug. 20, 2016