The use of insulin pumps has risen dramatically over the last 30 years to nearly a million people worldwide. The number of satisfied users continues to grow as pump technology and its benefits for control evolve.
Enthusiastic pump wearers of all ages propel this growth when they share their experiences with others. They see their pump as a turning point in diabetes care, saying “For the first time in years, I can eat when I want to,” or “I can really control my blood sugars now and I feel better, too.”
A Pump Really Helps Those Who:
- Want better control and more stable readings
- Need or desire a freer lifestyle
- Have an A1c over 7%
- Are very sensitive or very resistant to insulin
- Use less than 35 units a day
- Want to give insulin discreetly.
- Have problems with lows or are hypo unaware and can’t always tell when they are low
- Keep glucoses high because they fear lows
- Live alone
- Want to prevent long-term complications
- Experience insulin stacking
- Participate in intensive exercise
- Want to easily track data for optimal control
- Forget to take insulin
- Travel or do shift work
- Want peace of mind
One enthusiastic pumper who started at age 70 says, “My insecurity is gone. My A1c said my control was good on injections, but I couldn’t avoid overnight lows and that created stress day after day. On my pump, I feel positive and really in charge of my body.” An 11 year-old boy was happy to “eat just like my friends if I count my carbs and cover them with boluses” and added “Going on hikes this year at diabetes camp was easy.”
Pump benefits include fewer injections, the ability to give insulin easily for spontaneous events, with faster insulin adjustments for changes in eating, exercise, and activity. Unlike injections, a pump uses only a rapid-acting insulin. The large depot of long-acting insulin under the skin that is absorbed differently from day to day as temperature or activity changes is no longer needed. The infusion site stays in place for about three days rather than being injected into different locations with different absorption characteristics several times a day. Insulin stacking from previous boluses can be avoided for more consistent insulin activity.
A pump offers convenience, more consistent insulin action from day to day, easier problem solving, easier tracking of insulin use, less hypoglycemia, less risk of hypoglycemia unawareness, and fewer morning highs. A built-in bolus calculator (BC) uses personalized settings to make bolus doses more accurate and glucoses more stable. In the background, important insulin dosing and glucose history gets recorded to solve control issues.
An insulin pump may seem complicated, but wearers quickly become advocates when they can finally match their needs with the right amount of insulin at the right time. Powered by AAA, AA, or rechargeable batteries, pumps benefit people of all ages, from infants to those in their 80s and 90s.
People on multiple injections who have to eat meals on a rigid schedule, require a snack every night before bed, wake up at 3 a.m. sweating profusely, return to consciousness in an emergency room, face high morning readings that ruin the rest of the day, or want to sleep late on the weekend, find that changing to a pump offers a new confidence and a freer lifestyle.
Even the large pumps introduced as early as 1979 were well received. One study which reviewed 18 different research studies completed before 1991 found that 62.5% of the 520 participants who used both a pump and multiple daily injections (MDI) during crossover trials chose to remain on these early model pumps at the end of their study.
Today’s pumps offer many more useful features for convenience and safety as they perform the complicated math you need to calculate bolus doses.
Health Care Professionals Recommend Pumps For:
- Poor glycemic control
- Frequent or severe hypoglycemia
- Hypoglycemia unawareness
- Nighttime hypoglycemia
- “Brittle” diabetes or high glucose variability
- Post-meal hyperglycemia
- Dawn Phenomenon
- Frequent ketoacidosis
- Insulin requirement less than 35 units a day
- Frequent travel or a variable work schedule
- Intensive exercise or athletics
- Help in tracking insulin doses, carbs, glucose levels, and other information critical to control
- Reminders to bolus and test
- Pregnancy and preparing for conception
- Improved control during growth and puberty
- Managing gastroparesis
- Less insulin resistance in Type 2 diabetes
Pump features include:
- A bolus calculator with settings for a carb factor, correction factor, target glucose, and duration of insulin action
- An integrated glucose meter and often the display of CGM readings
- Carb counting aids
- Tracking of bolus on board (BOB) to reduce insulin stacking
- History to track insulin usage (basal/bolus balance, correction bolus percentage, etc.) and glucose values
- Helpful reminders and alerts
With training, support, and commitment, an insulin pump helps a person feel better, live more freely, and have fewer diabetes-related health problems, especially when its precise insulin delivery is combined with feedback from a continuous glucose monitor (CGM). A CGM helps change behavior as alarms warn of highs and lows. The results of under-counting carbs, late bolusing, over-treating lows, and being on too little or too much insulin are quickly seen in CGM trend lines. The reliability and accuracy of CGMs continue to improve and will eventually allow glucose readings to be directly entered into a pump bolus calculator (BC) for bolus calculations. Although integrating pumps and CGMs will take time, early features needed for automatic control when the glucose goes low, such as stopping basal insulin delivery for a period of time, are beginning to appear.
Diabetes devices continue to improve with better control procedures, CGM integration, smaller sizes, color screens, more infusion set choices, faster insulin analogs, and better trend analysis and pattern recognition. A pump helps manage the complex interactions between insulin levels, blood glucose and carbs with less effort. To get the most out of your pump and improve your glucose levels, you might want to learn and apply the principles in Pumping Insulin.