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Home > Knowledge & support > Managing type 1 diabetes > Guide to type 1 diabetes technology > Insulin pumps
An insulin pump is a small wearable device that delivers short-acting insulin every few minutes in tiny amounts, 24 hours a day. At the touch of a button, it also delivers extra short-acting insulin when you eat or need to bring down high blood glucose levels.
Watch our short video or read below to find out how an insulin pump works.
Insulin pumps only use fast-acting insulin. If you inject insulin with a pen, you need to inject slow-acting insulin once a day, which usually lasts for about 24 hours. However, because insulin pumps deliver fast-acting insulin in tiny amounts all the time, there is no need for a separate slow-acting insulin to work in the background, because your pump is doing that job already.
This constant delivery is still known as basal even though it’s delivering fast-acting insulin. This is because it’s doing the same job as the slow-acting background insulin you use when you’re managing type 1 with multiple daily injections. You can also adjust how much is being delivered per hour, which gives you more flexibility.
There are two types of insulin pump:
You programme your pump to deliver basal insulin throughout the day and night. It can be slowed, stopped, or increased for a few minutes or hours as needed, for example when your glucose levels are going low.
You can also deliver insulin when you’ve eaten (known as bolus or mealtime insulin) or you need to bring down high blood glucose levels. When you need to, you can spread your bolus insulin over a period of time from 15 minutes to several hours, which gives you more flexibility on what you can eat and when.
When you start on a pump, you will be given training on how to attach the pump and how to use it. Insulin pumps aren’t permanent, you can disconnect them temporarily or take them off completely if you decide that using a pump isn’t for you. You will then be able to attach and change your pump and/or cannula yourself after training.
There are two kinds of insulin pumps, which you attach different ways:
Patch or micro insulin pumps are stuck directly onto the skin, often on the stomach. They have a short fine tube that goes from the patch into the skin. Patch pumps are disposable and need to be changed approximately every three days.
Tethered insulin pumps use a fine tube to connect a cannula under the skin to a pump which can be kept in your pocket, clipped to a belt, thigh belt or bra. The cannula needs to be changed every two to three days, and your diabetes healthcare team will teach you how to do this.
Tethered pumps attach to you through a tube, cannula and/or needle. These are known as infusion sets. There is usually a choice of infusion sets with tethered pumps, as well as in what type of pump works best for you. You can talk to your diabetes healthcare team or the pump manufacturers about what infusion sets are available and ask for samples to try. Some of the tethered pumps have more infusion set choices than others.
You can remove a tethered pump for about an hour if you need to, for example if you are swimming, active or taking a shower. With patch pumps you keep these on your body until you’re ready to change pumps, although you can suspend or adjust insulin delivery if you need to.
There are upsides and downsides to using insulin pumps and it’s important to consider both carefully.
Trying to keep blood glucose levels from going too high or too low is one of the major challenges of living with type 1 diabetes. A pump can help with this because it is so adaptable. For example, if you inject your long-acting basal insulin with an insulin pen, you cannot change anything once it is in your system. With a pump, you can turn off or slow down the insulin being delivered if you need to, whether it be for a few minutes or a few hours.
If you are having to deal with highs and lows despite your best efforts on multiple daily injections (MDI), or you have frequent hypos that affect your day-to-day life, then a pump may help you.
Pumps give you flexibility when you’re taking insulin to manage glucose levels after eating. It means you can be more flexible with what and when you eat. If you fancy that extra slice of pizza for your Friday night treat, you can adjust how to deliver your mealtime insulin, and spread it over several hours to cover that extra slice.
Pumps deliver insulin much more precisely than any available pen or syringe. The small amounts that are delivered throughout the day are adjustable down to lower than a tenth of a unit per hour, depending on the make of pump. This can be particularly good for children and their smaller bodies and for people who are more sensitive to insulin.
When you inject long-acting/background insulin with a pen, it can be absorbed differently every day. Sometimes it’s absorbed too quickly, sometimes too slowly, and sometimes only in part. With a pump delivering fast-acting insulin in tiny drops, absorption is much more reliable and makes your diabetes management more stable and predictable.
You can also set temporary increases or decreases in your basal insulin if you’re ill, having your period or going through a stressful time. If you’re looking after a child with type 1 this can also help when your child is going through growth spurts.
With an insulin pump, you only need to use one needle every two or three days, instead of multiple injections every day. This is good news for anyone who struggles with needles!
We all know life is rarely straight-forward. Whether it’s work stress or fun with family and friends, unexpected things happen all the time. Pumps can help you manage this because it’s much easier to adjust your insulin intake around things you haven’t planned for, like doing an extra shift at work or joining in that spontaneous game of football.
Pumps can also help at different life stages. You can make adjustments if you’re looking after a toddler with type 1 diabetes who may not want to eat everything on their plate, or you’re a teenager going through growth spurts and hormonal changes.
Getting used to an insulin pump and learning how to use it takes time and effort. You will need to have training on how to use it correctly and work with your diabetes team to get it working well. Although there are many advantages to using a pump, not everyone gets on well with the technology in the long run.
Insulin pumps may mean that you can spend less time thinking about your type 1 diabetes, but you will still have to mindfully manage your type 1 every day. You will still need to count carbs and know your insulin-to-carbohydrate ratios, check your glucose levels at least four times a day and check that your background rates are correct by occasionally delaying meals.
Using an insulin pump can increase the risk of diabetic ketoacidosis (DKA), which is when the glucose levels in the blood go too high and can become life-threatening. This is because you are solely relying on the pump to deliver fast-acting insulin all the time, and there is no long-acting insulin in your body. If something goes wrong with the pump or it becomes blocked or unattached, there is no insulin working to bring blood glucose levels down.
Your Diabetes Healthcare Team will fully train and support you to make sure you can manage this risk. There is no reason you won’t become as knowledgeable and comfortable in managing this as you are with making sure you don’t inject too much insulin.
There is a small risk of getting an infection around the cannula. These are rare and can usually be avoided by changing the cannula as recommended (every two to three days) and following the proper guidance.
There are many makes of insulin pumps available. Take a look through the list below to find out more about each device:
In terms of managing your type 1, there is no evidence to suggest that one make of insulin pump works better than another. That means that when choosing an insulin pump, the important things to consider is what you will be most comfortable with. You’ll also need to find out what is available at your clinic. Find out more about insulin pump choice.
Insulin pumps cost £2,000 – £3,000 and usually last between four and five years. Remember though that there may be additional costs for other components such as infusion sets and batteries.
You can get an insulin pump on the NHS if you meet certain criteria. Find out more about the criteria and process involved in getting a insulin pump on the NHS.
Some pumps can interact with continuous glucose monitors (CGM) and adjust insulin delivery based on your glucose readings. Medtronic’s Minimed 780G works with Guardian 4 CGM, the Tandem t:slim x2 works with Dexcom G6 and Ypsopump (or Dana I) works with Dexcom G6 using the CamDiab algorithm. Find out more about hybrid closed loop technology (also known as the artificial pancreas).
Insulin pumps are not compatible with flash glucose monitoring.
“The daily demands on my time are very different and it’s quite difficult to establish routine, so to have the flexibility of the pump is fantastic.”
“Daisy started wearing an insulin pump which cut out all injections (unless there is an emergency). The pump is changed every three days and will be on either her arm, leg or tummy. Since wearing the pump, it has meant Daisy can have snacks between meals or have an ice cream on a hot day without an extra injection.”
“Now I have the Dexcom G6 and the Omnipod and I love both of them, they’re amazing… The Dexcom can send my parents my blood readings at all times, and they can text me and tell me like you need to sort this out, if I’m not aware of it. It’s so much easier for doing sports and all.”
“Dancing makes me really happy. My friends and coaches all think my pump is very cool, they are all very supportive.”
In England, Wales and Northern Ireland, providing you meet certain criteria, the answer is yes!
Our views on pump choice, what pump users would like to see in the future development of pumps, and insulin pump user reviews.
Information about insurance for pump, CGM and Flash technologies.
A smart insulin pen is a reusable self-injection pen, which records information about how much insulin you inject and the timing of it.
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