There is no right or wrong way to manage your diabetes. With that being said, there are a variety of options and devices that can be used for proper diabetes management. Many of my patients choose to use an insulin pump because they find that it provides better control over their blood glucose levels. While a pump can be effective in alleviating some of the challenges associated with diabetes, it is important to know the basics before you decide whether or not an insulin pump is the right fit for you and your diabetes.
The Basics of How an Insulin Pump Works
At its core, an insulin pump is a fancy syringe. Imagine a syringe with a very fine motor that pushes the plunger with great precision. In order for the pump to be effective, the motor pushing the plunger of the syringe has to be extremely reliable and accurate. In recent years, there have been several developments in pump technology, offering users better control of their pump both directly and remotely.
Throughout the day, the pump delivers insulin continuously. By doing this, the pump is attempting to mimic the normal pancreas’ release of insulin, but you must tell the pump how much insulin to inject. The pump delivers insulin in two ways: a basal rate, which is a continuous, small trickle of insulin that keeps blood glucose stable between meals and overnight; and a bolus rate, which is a much higher rate of insulin taken before eating to “cover” the food you plan to eat.
One factor to consider before choosing to use a pump is the differences between a pump and insulin injections. When using a pump, typically a needle is inserted under the skin in the abdomen, and the needle is connected to the syringe in the pump. The needle then stays in place for two to three days, and you simply program the pump to deliver insulin whenever you need it. With insulin injections, you use a syringe or insulin pen device, and you have to manually inject yourself every time you need insulin.
The Pros and Cons of Using an Insulin Pump
Even after discussing the logistics of an insulin pump with my patients, some are still unsure about committing to the device. In this case, I find it helpful to review the pros and cons.
There are several advantages of using a pump – the main one being that a pump is a more sophisticated way to deliver insulin that provides patients with the option of programming their pump with boluses that best match their meals and activity level. Programming the pump in this manner should lend itself to smoother and better control of your diabetes. The pump allows greater flexibility in lifestyle with respect to amount and timing of eating and physical activity.
While the pump does have many benefits, there are some drawbacks. Pump devices are currently worn externally, and so they are more conspicuous than an insulin syringe or pen. And contrary to popular belief, they are not autopilot glucose control devices. Thus, patients have to be committed to checking their blood sugar levels frequently so the pump can be regulated as needed.
Who Can Use an Insulin Pump?
Despite common misconceptions, an insulin pump can be used for both people with Type 1 and Type 2 diabetes. Initially, the pump was only recommended for people with Type 1 diabetes, but more recently, there is evidence that pumps may be useful for people with Type 2 diabetes who require insulin. Individuals with Type 1 diabetes tend to have more swings in blood sugars and also tend to be younger with more active lifestyles. Thus a pump offers them more flexibility with their insulin dosing. On the other hand, individuals with Type 2 diabetes tend to be older and generally have smoother sugar control and more predictable lifestyle patterns.
Research also shows that pumps may improve glucose control and cause less weight gain than the traditional insulin injections. It is possible that they experience less hypoglycemia while on the pump and thus eat less and gain less weight. Their total insulin dose via the pump may be less than the total insulin given in the usual two to three injections per day regimen.
Eventually, as insulin pumps get connected to reliable glucose sensors, it will make sense for most people using insulin to also use a pump.
The decision to use a pump or a device to manage your diabetes is ultimately up you as the patient, but I feel it’s important that all my patients have realistic expectations before choosing to use a pump. For people with diabetes who are motivated by the importance of blood glucose control and are willing to work hard, then the pump may be a good option and provide tighter control of your diabetes. If you are considering using a pump, make sure to research all your options and speak with your health care team before making any decisions.
This article first appeared on U.S. News and World Report’s For Better Blog on June 9, 2015.