Insulin pumps: No scarier than riding a bike

Insulin pumps, How insulin pumps work

Doctablet Diabetes, Everything About Insulin

Diabetes pumps are as simple as riding a bike.

Your doctor might have suggested that you need an insulin pump to manage your diabetes better. Or maybe someone mentioned an insulin pump to you in passing and you do not know much about it! Perhaps you have a relative or friend that uses one and you are wondering if it might work for you. Either way, the idea of having a pump connected to you can sound super scary. Truthfully, using an insulin pump is much more complicated than the machine itself. Although a lot of patients worry about having “something” connected to them all the time, people who use insulin pumps to manage their diabetes almost never complain about being connected. In fact, most people report that they would never go back to insulin injections once they receive their pump. Trust us, the insulin pump does not perform some kind of magical mind control. In fact it is the opposite. The patient runs the show, even when the pump is connected. Let us cover a little bit more about insulin pumps for diabetes before we review who is a good candidate for an insulin pump.


How insulin pump works

An insulin pump is simply a device used to deliver insulin continuously, 24 hours per day, 7 days per week. If this sounds too sci-fi for you, let’s break it down to basics. An insulin pump is like a bicycle. You, the patient, are the operator. For most of the day and night, the bicycle (or pump) is headed down hill, meaning the bicycle driver (or patient) performs very little effort. The pump coasts by itself and delivers small amounts of insulin all day and all night. Doctors refer to this coasting function as “basal”, or, background insulin. The “basal” function of the pump requires such little effort from the patient because the pump is programmed to flow automatically. But, like any bike ride, things aren’t always downhill. When the patient eats, or checks their blood sugar, the pump operation gets a little bit harder. Using the analogy of the bicycle, meal time would be like going up a small hill on your bike. There is a little more effort required, but with enough riding, those small hills become very easy.

Carb counting is part of using a diabetes pump

When a patient on an insulin pump eats any type of food, they have to enter the number of carbohydrates (sugars), they plan to eat into the pump. This is often called carbohydrate counting. The pump will then calculate the insulin dose necessary to cover the food about to be eaten. Similarly, when a patient checks their blood sugar, this is also entered into the pump so the pump can help determine the amount of insulin needed to bring the sugar to a normal level. The insulin used to cover food and high blood sugar is called “bolus” insulin.

So, a pump is like a bicycle. That kind of makes sense, but that does not explain how insulin gets from the pump into the patient’s body! Insulin flows from the part of the pump called a reservoir. It travels down a skinny tube that connects the insulin pump to the patient’s body. Doctors call the part of the tube that stays out of sight under the skin the cannula. This small bendable plastic part of the pump is how insulin enters the body. The cannula is almost like a super, super tiny IV that stays in place under the skin. Patients DO NOT feel this piece of plastic. It is recommended to change the location of the cannula every 3 days. Most people prefer this to having 4 to 5 insulin injections per day.

We do not mean to make insulin pumps sound too easy. The fact is they do require work. They might “coast” along for most of the day, but they still need someone to ride the bike, to be an operator. To put it simply, the pump is not entirely automatic. This is a common mistake people make when they think about pumps. The pump still requires someone to steer and pedal.

Diabetes pump parts and setup

Who is a good candidate for an insulin pump?

Good candidates for insulin pumps take at least 3 insulin shots daily, check their sugar at least 3 or 4 times per day, make regular appointments with their diabetes doctor, and can safely recognize high blood sugar levels. For the right patient, using an insulin pump can be a life changing therapy. Insulin pumps can be used for patients with ANY type of diabetes.

About the Author

Chris Palmeiro D.O. M.Sc.


Dr. Palmeiro is Chairman of Endocrinology at the HealthAlliance of the Hudson Valley, he also serves patients with intellectual and developmental disabilities at the Westchester Institute of Human Development in Valhalla, New York. He has a Masters of Science degree in clinical nutrition and is a diplomate of the American Board of Internal Medicine. His interests within the realm of endocrinology include nutrition support, obesity counseling and the progressive management of diabetes.

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Last Modified: Sep 17, 2018 @ 5:57 pm

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