An insulin pump is a tiny computerized medical device used for the delivery of insulin in the treatment of diabetes mellitus. This method is also known as continuous subcutaneous insulin infusion therapy.
Insulin pump helps in effectively managing blood glucose levels
These pumps are small devices, which delivers insulin into the layer of fat, just below the skin. The pump can be programmed to deliver insulin every few minutes in small quantities. It can be programmed to either release small dose of insulin continuously or a bolus dose near mealtime to control the increase in blood sugar post meals.
This delivery system closely mimics the body’s normal release of insulin. The pump is programmed as per the requirements of the user. Only rapid-acting insulin is released into the body through a small, flexible tube.
These pumps reduce the requirement of multiple injections and user can make smaller and much accurate adjustments of insulin delivery. Blood sugar levels can be effectively managed with insulin pump. People suffering with diabetes can wear their insulin pump on their belt or can keep it in their pockets. Several people prefer using this continuous system of insulin delivery over multiple injections.
Components. A traditional pump includes:
- Pump (including controls, batteries and processing module)
- Controls are available to program the insulin and navigate through the menu.
- Screen to depict what your program.
- Battery compartment is there is hold the alkaline battery.
- Disposable reservoir for insulin – Has a cartridge that holds insulin. The reservoir is attached to a cannula at one end. Should be replaced every two to three days.
- Disposable infusion set with cannula and a tubing system to interface insulin reservoir to the cannula – Cannula is inserted with a needle, which is removed after it is placed. It is advisable to change the infusion set every two to three days. Wide range of infusion sets varying in cannula type and length are available. You can choose the set as per your comfort.
How do insulin pumps work?
Insulin pumps continuously transport short-acting or rapid-acting insulin into the body through a catheter, which is placed beneath the skin. Insulin pump sends insulin, stored in a reservoir within the pump, into the body through an infusion set. A tiny flexible thin tube known as cannula is inserted beneath the skin to deliver insulin to be absorbed gradually into the bloodstream.
Depending on the requirement of the patient, different types of insulin doses can be administered. Insulin doses are separated into:
- Basal Dose – Small amounts of insulin are programmed to deliver continuously mimicking the production of basal insulin by pancreas. Programmed rate is decided as per the requirement of the patient. This dose maintains the blood glucose levels within range between the meals and overnight. Different quantities of insulin can be programmed at different times of the day and night.
- Bolus Dose – To compensate for the food that you are going to eat or to rectify the elevated blood sugar levels; additional amounts of insulin can be delivered. The bolus calculators present in the insulin pump helps in calculating the bolus amount based on the requirement of the patient.
- Correction or supplemental Doses – If you have increased levels of blood glucose before eating then you can administer supplemental or correction bolus of insulin to normalize the blood glucose levels.
It is necessary to check your blood sugar levels minimum four times a day, if you use an insulin pump. This shall help you in setting your insulin dose based on your food and physical activity.
Advantages of using an insulin pump:
- Eliminating the need for multiple injections.
- Insulin can be delivered more accurately than injections.
- Delivery of bolus insulin is made easy.
- Provides better HbA1c control.
- Reduces severe attacks of hypoglycemia (low blood sugar).
- Absorption of insulin can be predicted more accurately.
- Permits you to exercise without the need to consume large quantities of carbohydrates.
- Offers ability to change the basal insulin when patient is ill.
- Eradicates erratic effects of long-acting or intermediate-acting insulin.
- Experiences fewer large fluctuations in your blood sugar levels.
- Achieves greater accuracy in reducing increased blood glucose levels.
- Provides better management of blood glucose levels when travelling across time zones.
Disadvantages of using insulin pumps:
- Can give rise to increase in weight.
- Risk of diabetic ketoacidosis due to absorption issues or from pump malfunction may occur.
- Can be cumbersome, as you shall always be attached to a pump.
- Patient may require a hospital stay to be trained in using the pump.
- Constant assessment of blood sugar levels shall be required, to determine the effectiveness of insulin delivery.
- Increased chances of risk of infections from cannula.
- Risk of infusion line getting blocked hence, constant change shall be required.
- Pumps may be quite costly.
- Scar tissues can result at the area around the inserted cannula.
- Allergic reactions and other skin irritations may arise from the adhesives.
How are Insulin pumps worn?
Insulin pumps are small medical device, which can be placed on the belt, waist of trousers or can be kept in the pockets. The pumps are connected to the body through infusion set. The cannula sits over the skin the entire day while the infusion set is placed in the same sites on the body, as are used for injections. It is essential to replace the infusion set once in two to three days. Using a Luer connector, the infusion set is connected to the pump. This is a standard locking mechanism, which securely attached the tube to the pump.
Selecting an Insulin pump
There are several options available when you have to make a choice of an insulin pump. The ‘ideal’ pump differs from person to person. Certain factors, which play a vital role in the selection of an insulin pump, are:
- Cannula insertion angles.
- Easy usage.
- Special features.
Factors concerning the patient related to the selection of infusion set includes:
- Age of the patient.
- Body characteristics.
- Immune system function.
- Physical activities and
- History of Diabetic Ketoacidosis.