It’s a pager sized device that holds insulin. A small tube runs from the device into your body delivering insulin continuously (this constant delivery is known as “basal” insulin). When you eat , you push a sequence of buttons to deliver a lump sum of insulin to cover the carbohydrate content of the meal (this is called a “bolus”). You may also bolus just to correct for high blood sugars.
Does a needle stay in me all the time?
The small tube in your body is placed with an “introducer needle”. The needle is then withdrawn leaving a soft, flexible cannula (tube) under the skin (this is your “infusion site”). Most people don’t even feel the cannula once it’s in place. You also have the option to use an infusion set where the needle stays in.
Is the cannula something the Doctor puts in?
No. You will insert your own infusion sets at home. It’s similar to giving an injection. You’ll need to do this at every two to three days.
What kind of insulin do pumps use?
Pumps are filled with only rapid acting insulin (Humalog, Novolog or Apidra). You will no longer be using any long acting insulin. The pump most closely replicates the body’s output of insulin by giving little bits of rapid acting insulin continuously.
Do I have to wear my pump all the time?
You can be disconnected from most pumps up to 2 hours. You will not be able to disconnect from “patch pumps” like the Omnipod. Remember, you have no long acting insulin in your body and the fast acting wears off in 2-4 hours. Without insulin, you will produce ketones (a potentially dangerous situation) within hours. Occasionally people take “pump vacations”. This involves coming off of your pump and going back onto shots (both long and short acting insulins) for a time.
Will it give me perfect blood sugars?
No. You’ll still have highs and lows but hopefully fewer than what you have now. The pump’s just a tool. Your wise use of it is what can make it a success.
Does it test my blood sugars and give me insulin automatically?
No. You still have to test. In fact, testing 4 times daily minimum (breakfast, lunch, dinner, bedtime) is a prerequisite for going on the pump (most “pumpers” test 6 to 8 times a day). Then you have to push the buttons to deliver insulin in response to the numbers you get.
Do pumps ever accidentally deliver the wrong dose?
Pumps all have safety systems in them that keep them from delivering any insulin other than what you request.
There will be times when the pump is unable to deliver insulin (ex. out of insulin, dead battery, kinked tubing, pump malfunction). This requires an injection of insulin with a standard syringe to prevent ketones from developing.
How much do they cost?
Pumps cost between $3000 and $6500. The supplies to operate them are another $200 - $400 a month. Most of these expenses are covered by insurance under your Durable Medical Equipment benefits. It’s important to check with your insurance provider about coverage.
Where can I learn more about pumps?
The book, “Understanding Insulin Pumps and Continuous Glucose Monitors” by H. Peter Chase, MD is a great resource. It’s available online at www.Children’sDiabetesFdn.org or it can be purchased at the front desk of The Barbara Davis Center for $15. Chapter 26 in the “Understanding Diabetes” (Pink Panther) book is a nice introduction to “pumping”. It’s also available at the website or at our front desk for $25. In addition, there are many websites such as childrenwithdiabetes.com or the pump company sites that have lots of useful information.
What do I have to do to get one?
First, you need to discuss with your doctor if a pump is right for you. You’ll need to be testing a minimum of 4 times daily and dosing your rapid acting insulin using carb to insulin ratios. Then, you’ll need to choose a pump. Your Doctor may recommend a specific brand. You can also research them yourself. Following are the 3 pumps we use (because they’re all reliable and downloadable):