If you have type 1 diabetes, your doctor may suggest using an insulin pump in addition to monitoring your blood glucose. An insulin pump delivers short-acting insulin continuously, allowing for better blood glucose control. Some advantages of using an insulin pump are:
- No need for individual insulin injections
- More accurate insulin delivery
- Ability to maintain more stable blood glucose levels
- Greater flexibility in what you can eat and when
- A reduction in severely low blood glucose episodes
How insulin pumps work
Insulin pumps deliver short-acting insulin continuously through a catheter inserted under the skin. When using a pump, insulin is delivered in three types of doses: basal, bolus, and correction/supplemental.
Basal – this is the insulin delivered continuously over time which keeps your blood glucose levels stable throughout the day. Many pumps allow you to program them to release varying amounts of insulin at different times.
Bolus – a bolus is an extra dose of insulin you normally take at mealtime to counteract the carbohydrates in the food you eat. In the event of consuming a larger meal, you can program your pump to deliver a larger bolus to cover it.
Correction/Supplemental – In the event of high blood glucose levels, you can use your pump to deliver correction/supplemental doses of insulin. This correction will bring your levels back into target range.
Incorporating a pump into your life
There are a variety of ways you can carry your pump with you. You can buy a pump case which you can wear like a waist or fanny pack. If you want to be accessory-free, you can clip the pump to your waistband, pocket, bra, underwear or sock. With the clipping method you may also need to control and tuck excess tubing into your waistband or underwear. Your doctor or Certified Diabetes Educator can give you helpful hints on securing and wearing your pump.
Sleep tight – Wearing your pump while you sleep may take some getting used to. Some methods to try are:
- Place the pump on the bed next to you
- Wear it on a waistband, armband, or legband
- Clip it to a blanket, sheet, your pajamas, a stuffed animal or pillow
Splish splash – Insulin pumps are water resistant but they should not be dunked under water or placed directly under the stream of a shower. Your pump will have a disconnect port which allows you to remove your pump to bathe, shower, or swim. During your activity, be sure to store your pump in a protective case or safe place so it doesn’t get wet. There are special waterproof cases you can use to store your pump to avoid getting it wet.
– Staying active is important for everyone and people who use insulin pumps can exercise, play sports, and participate in other strenuous activities. There are strong elastic wrist and arm bands that can hold your pump and case while you are active. Women can tape their pump to a sports bra. If you are participating in an activity where you may fall on your pump or it could be jostled or disturbed, you may be better off removing it for that activity to avoid injury.
Take it off – Your pump that is. Removing your pump is safe to do but when you do so you will not be receiving scheduled basal or bolus doses of insulin. If you remove your pump while it is delivering a bolus it will not resume the dose when you reconnect. Keep this in mind so you can program another dose when you reconnect. When you reconnect you will need to program a bolus that will also cover the basal doses you missed while disconnected. Even though disconnecting is safe, you should not go more than two hours without insulin. If you have a special situation where you would like to disconnect from your pump for a longer period of time, talk to your doctor or Certified Diabetes Educator.
Is it for me?
– Deciding to incorporate an insulin pump into your diabetes care routine is a personal decision. Weigh the pros and cons of the therapy with your doctor, family, and friends to determine if it’s right for you.
Getting started – Once you have decided to use an insulin pump, your healthcare team will help you get set up. During the set up process you will:
- Determine how much insulin to use in the pump
- Break down insulin into basal and bolus doses
- Come up with an hourly basal rate
- Make basal adjustments for high and low patterns (days when you are active and night when you are sleeping)
- Develop a carbohydrate dose (how many grams of carbohydrates covered by 1 unit of insulin)
- Determine a correction/supplemental insulin dose (how much 1 unit of insulin lowers your blood glucose)
– While you are getting set up with your pump and learning how everything works, don’t be afraid to take notes and ask questions. As time goes on, most of the activities associated with using and caring for your pump will become easier and you will find a routine. Try not to get frustrated in the beginning if things feel strange or foreign, that’s normal. Here are some tips and suggestions to help you with the adjustment period:
- Create a schedule so you are less likely to forget when to deliver a bolus dose of insulin.
- Get into the habit of keeping good records of your blood glucose levels, correction/supplemental doses, and anything out of the ordinary that occurs.
- Share your records with your healthcare team so they can help you make adjustments.
- Maintain a healthy diet and exercise program – don’t use your pump as an excuse to eat whatever you want whenever you want.
- When you disconnect or turn off your pump, develop a system to remind yourself to reconnect or turn it back on.
- When you are traveling or even just away from home for the day, bring extra supplies in case you are unable to use your pump.
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