IS THE INSULIN PUMP FOR ME?

Insulin pumps deliver more than insulin. Many people who use them say that pumps also deliver more freedom.

An insulin pump is a miniature, computerized pump, about the size of a call-beeper, that you wear on your belt or in your pocket.

It provides you with a small amount of insulin throughout the day (the basal rate) to keep your blood glucose stable. When you eat, you simply press a button or two, and voila, you've given yourself a bolus, a dose of insulin to handle your food. With a pump, you're not tied to a rigid meal schedule, and you have more flexibility regarding your diet.

The pump can also help you achieve better control over your diabetes, which lowers your risk of developing complications and makes you feel better. Most people who use a pump say they love it.

However there are responsibilities that come with using an insulin pump. Knowing what they are ahead of time can help you make a smooth transition.

1. It requires training and education. The pump will be attached to your body through an infusion set. You'll need to learn how to change the infusion set, how to program the pump, and what to do if the infusion set gets clogged or knocked loose. You'll be taught the mechanics of the pump. Pump education programs are quite thorough and are designed to help you minimize the risk of such problems. At our center, we enroll pump patients in a five-session program that is designed to teach them all about the pump. Thorough and proper training is absolutely vital. But learning to use a pump is like learning to drive a car, or sail a boat. Once you understand and learn it, it becomes second nature, and is very easy.

2. You'll still need back-up equipment. The best laid plans can go awry, however, and pumps are not foolproof. Pump patients must be prepared to have quick access to extra supplies if the infusion set gets clogged, or the battery dies. If you are already using insulin injections daily, this isn't difficult. Just go back to your old insulin injections until the pump is sorted out.

3. You'll still have to check your blood glucose. If you're not willing to check your blood glucose at least four times a day, you probably shouldn't be considering the pump. Part of the beauty of the pump is that when your sugar is not on target, you can make little corrections to steer yourself back on course. The pump is not an artificial pancreas. It is not an automatic device, you need to tell it what to do.

4. It's not cheap. An insulin pump, depending on the model, may cost around $6000 to $7000, and pump supplies may cost about $350 to $400 every two months.

5. It takes patience at first. Even though you understand all the theory behind the pump, it really takes a few months to get used to using a pump. Most centers who run pump programs (ours included) require patients to keep close contact with their doctor and nurses when you start using a pump. This helps patients build confidence until they master the pump.

In summary, the benefits of using a pump are: (1) stable blood glucose readings, (2) improved HbA1c levels, (3) less hypoglycemia and swings in blood glucose, (4) increased energy, (5) greater flexibility in lifestyle. You can eat when you like and not be so tightly bound to a fixed timetable. You can be more adventurous in your food choices because the pump will take care of the “additional” calories! (6) no insulin injections on the tummy.