How can an insulin pump help manage diabetes?

An insulin pump is an insulin-delivering device about the size of a deck of cards that can be worn on a belt or kept in a pocket. An insulin pump connects to narrow, flexible plastic tubing that ends with a needle inserted just under the skin. Users set the pump to give a steady trickle or basal amount of insulin continuously throughout the day. Pumps release bolus doses of insulin (several units at a time) at meals and at times when blood glucose is too high, based on programming done by the user.

By using an insulin pump, you can match your insulin to your lifestyle rather than adjusting your lifestyle to your body's response to insulin injections. With help from your healthcare team, insulin pumps can help you keep your blood glucose levels within your target ranges both day and night. People of all ages with type 1 diabetes use insulin pumps, and people with type 2 diabetes have started to use them as well.

An insulin pump is not for everyone. If you have been unable to get your blood glucose levels into goal range, a pump may be a good choice for you. Using a pump requires motivation and a willingness to measure your blood glucose four or more times a day and to make decisions based on the results. A pump cannot "read" your blood glucose, so you have to do blood glucose tests regularly to tell the pump how much insulin you need.

An insulin pump is not for everyone. Talk to your healthcare team and insurance company about whether a pump would be a good idea for you.

Insulin pumps deliver a steady dose of insulin throughout the day, which may lead to better control of your blood sugar levels. Keeping your blood sugar under control may help you reduce your risk of diabetes complications. In one landmark study of more than 1,400 people with diabetes, doctors found that intensive insulin therapy with an insulin pump or three injections of insulin daily reduced the risks of diabetic retinopathy, neuropathy and nephropathy—eye problems, nerve problems and kidney problems. Frequent blood glucose level monitoring is recommended when using the pump. Consult your doctor to see if an insulin pump would be right for you.

Most insulin pump users are devoted to the idea that a pump is the only real way to treat type 1 diabetes properly. Certainly, in the days before the very-fast-acting and long-lasting insulin analogs were available it was nearly impossible to have the same control and flexibility with injections as with an insulin pump, but this is much less true with the newer insulins. At this stage, the choice between multiple daily injection therapy and an insulin pump is largely a matter of personal preference, and there are pros and cons to either approach. Pump treatment offers the greatest flexibility in insulin dosing, and the tools for deciding how much insulin to give are getting better and easier to use all the time.

A pump does become necessary if someone has lots of variability in his or her background insulin requirement. For example, for someone with a significant dawn phenomenon, it's usually impossible to get the fasting sugars under control with a once-daily long-acting insulin shot without causing hypoglycemia at other times of the day. On the other hand, a pump wearer can simply program the device to give a larger amount of basal insulin during the early-morning hours and correct the problem pretty easily.