Why use an insulin pump?
For people with type 1 diabetes, keeping blood glucose levels in normal range is the best way to prevent or delay complications of type 1 diabetes, but tight control can increase the risk of hypoglycaemia.
If a pump is used well it can help keep tight control without increasing the risk of hypos because it is so adaptable. Once long-acting insulin has been injected you cannot turn it off or slow it down,but basal insulin delivered by a pump can be slowed, stopped or increased for a few minutes or a few hours.
The tiny doses of insulin are more easily absorbed than larger amounts from injections, so blood glucose levels are more stable and predictable.
What are the advantages?
Insulin pump users like managing their type 1 diabetes this way for lots of different reasons. Some of the most common reasons are:
- Feeling like you are more in control
- Having the flexibility to have a lazy morning, skip a meal or eat late
- Managing the dawn phenomenon
- Only needing one needle every 2 or 3 days (other than finger pricks)
Insulin pump users may also find the following things easier:
- Managing blood glucose levels around planned or spontaneous exercise
- Treating hypers with precise correction doses (from 0.05 unit upwards)
- Treating hypos with just fast-acting carbohydrate
- Keeping good control during illness
- Managing changing shift work patterns
- Managing toddlers’ meal-time battles
- Keeping good control through growth spurts and hormonal changes in adolescents
What are the disadvantages?
There are some disadvantages and things that can put people off pump use:
- Being attached to something 24/7 (but you can take it off for up to an hour for showers, sports, etc)
- Increased risk of DKA (that’s why you need to test blood glucose levels at least four times a day)
- Risk of site infections (especially if you leave the cannula in longer than the recommended number of days)
Is it right for me?
Pumps are not ‘for’ everyone. You have to be motivated enough to use this tool properly. That means:
- Mindfully managing your type 1 diabetes on a day to day basis
- Counting carbohydrates and adjusting insulin doses
- Checking blood glucose levels at least four times a day
- Checking that your basal rates are correct by occasionally missing meals
- Checking your insulin-to-carbohydrate ratios
If you are struggling with highs and lows despite your best efforts on multiple daily injections (MDI), or you have frequent hypos that need someone else’s help, then a pump may help you.