Some goals of pump therapy are to allow people with diabetes to delay a meal without going low, sleep in without worry, and exercise at will—instead of on a rigid schedule. Insulin pumps are pager-sized devices that continually deliver insulin via an infusion set: flexible, plastic tubing that connects to an under-the-skin cannula (a short tube). Since the infusion set is worn for two to three days at a time, you’ll stick yourself with a needle much less often than if you do multiple daily injections.
There are two ways in which a pump keeps blood glucose levels stable. First, it delivers a continuous dose of rapid-acting insulin all day long. This is known as your “basal rate,” and it’s how your glucose levels will stay steady overnight or between meals. Second, when you’re about to eat or if your blood glucose is too high, you can deliver a short burst of insulin—called a “bolus”—with the press of a button. If you’re fuzzy on the math, your pump’s bolus calculator will compute a suggested bolus based on your current blood glucose level, the amount of insulin in your system, and how many grams of carbohydrates you plan to eat. Each pump on the market gives you the option of delivering your bolus all at once, over an hour or two, or in a combination.
No two pumps are alike (click here for product listings), so it’s important to learn what elements suit the way you live.
Using an insulin pump can make diabetes management easier, but the ease comes with practice. All newbie pumpers should take a training course with a diabetes educator to learn how to wear the pump and to perform basic functions. It may be overwhelming at first, but with time you’ll learn to tweak treatment to suit your diabetes and lifestyle goals.
Before purchasing a pump, however, there are four main points that you should ponder:
1. Does the pump easily deliver your insulin dosage?
All pumps deliver about the same amount of insulin, but if you are very insulin sensitive or are choosing a device for a child who requires tiny doses, consider the pump’s basal and bolus ranges. Some can deliver as little as 0.025 units of insulin at a time. Those who require a lot of insulin may want to pick a pump with a larger reservoir size (they hold from 176 to 315
units of insulin).
2. If the pump is for a child, does it have kid-friendly features?
Regardless of the pump you pick, you’ll have a key lock option so your child (or you) won’t accidentally deliver a bolus at the wrong time. Some pumps are programmable from a remote, which may make it easier to change settings or administer insulin to children who won’t sit still. If disconnecting from the pump before bathing is a hassle for your child or you, look for one that’s waterproof.
3. Can you use the pump’s data management software on your computer?
Reviewing blood glucose and insulin data is an important part of your treatment, so pay attention to a pump’s data management tools. Pumps don’t just store data in their memory; all pumps but one offer software for downloading information, tracking trends, and creating graphs and tables that you can review with your doctor. It’s essential to note whether a pump’s software is compatible with your computer’s operating system. Some don’t work on Macs or with Windows 7.
4. Can you get an upgrade?
If you’re a veteran pumper using an old model, don’t assume your insurance company will fund an upgrade. You can ask for one, but you may have to hold out until your four-year pump warranty is up and you become eligible. (Always check with your insurer to be sure.) Certain companies offer upgrades for people wanting to try a newer model or switch to a different brand,
so ask customer service if you’re eligible.