Diabetes: Should I Get an Insulin Pump?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Diabetes: Should I Get an Insulin Pump?
Get the facts
- Get an insulin pump.
- Keep doing insulin injections.
Key points to remember
- An insulin pump can free you from a strict regimen of meals, sleep, and exercise, because you can program it to match your changing schedule.
- After you learn how to work with a pump, it can make living with diabetes easier. But it takes some time and effort to learn how to use the pump to keep it working properly and to control your diabetes.
- Using a pump includes checking your blood sugar many times a day and carefully counting the grams of carbohydrate that you eat.
- Using an insulin pump can keep your blood sugar at a more constant level so that you don't have as many big swings in your levels. People who use pumps have fewer problems with very low blood sugar.
- Many insurance companies cover the cost of insulin pumps, but they have strict guidelines that you will have to follow before they will pay.
An insulin pump constantly gives you a small amount of insulin, called a "basal rate," throughout the day and night to help control your blood sugar. When you need extra insulin to cover a meal or to correct high blood sugar, you tell the pump to give you a small dose of rapid-acting insulin.
A traditional insulin pump, which is about the size of a deck of cards, can be clipped to a belt or somewhere in your clothing. Plastic tubing connects the pump to a catheter just under your skin. The catheter is a tiny plastic tube that you insert into your skin using a special needle. You have to change the catheter every 2 or 3 days. You can disconnect the pump from the catheter site for brief periods when you want to go swimming or take a shower.
Some pumps attach directly to the body and do not need tubing. A remote device controls the pump.
Some pumps also work as a blood sugar meter or will communicate with your meter. Some pumps can suggest how much insulin you need based on the blood sugar reading.
- With a pump, you can plan your insulin around your life instead of planning your life around your insulin shots. Your basal rate is set and runs automatically. If you decide to stay out late, skip a meal, or work at a job with changing shifts, you can adjust your insulin at the push of a button.
- A pump can deliver an exact amount of insulin and in very small amounts.
- Instead of giving yourself shots several times a day, you only need to insert a catheter needle once every 2 or 3 days.
- With a pump, you don't have to stop what you're doing and pull out a syringe or an insulin pen to give yourself insulin. You just push a button to give yourself the right dose.
- A pump may help you keep your blood sugar in your target range. People who use a pump have fewer big swings in their blood sugar levels.
- Pumps work well for people who can't find an insulin dose that keeps blood sugar under control without also causing low blood sugar.
- You may have to stay in the hospital, or spend a whole day at a clinic, while you learn how to use your pump.
- Setting your basal rates for the first time may take a few days. You may have to skip a few meals and check your sugar levels extra often while you get used to the pump.
- People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. So you will need to check your blood sugar often. The number of times that you test may change every day, depending on when you eat, what you do, and how you feel. For example, you may need to test your blood sugar 5 times one day and 10 times the next day.
- If you are not good at counting your carbohydrate grams, an insulin pump may not help you control your diabetes.
- Infection at the area where the catheter goes into the skin is a common problem with insulin pumps. It is one of the most common reasons why people stop using pumps. So it's important to take good care of the site and change the catheter on schedule.
- The pump could stop working without your noticing. A pump has an alarm system to tell you when something is wrong with insulin delivery or if the pump's battery is getting low. But the alarm system will not tell you if the catheter is bent or has pulled out, so it's important to check the site often.
- Diabetic ketoacidosis (DKA), a life-threatening condition, may happen more often and more quickly with an insulin pump than with injections. Your blood sugar could get too high if something goes wrong with the catheter or pump without your noticing. Most studies show that this is usually not a problem with training and practice.
- Many insurance companies will pay for insulin pumps, but they have strict guidelines that you will have to follow before they will pay.
Your doctor might encourage you to get an insulin pump if:
- You have big swings in your blood sugar levels.
- You cannot find an insulin dose that keeps your blood sugar under control without also causing low blood sugar.
- Your lifestyle makes it hard to stop and give yourself insulin injections.
- Your eating and activity schedule changes often, so you need a more flexible insulin schedule.
- You need to inject yourself with insulin often.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- Instead of giving yourself insulin shots every day, you insert a catheter every few days.
- You test your blood sugar often, and you carefully count carbs so that you can program the pump.
- Infusion sites can get infected, so it's important to know how to place the catheter correctly and to keep the area clean.
- People who use pumps have fewer big swings in their blood sugar levels.
- People who use pumps have fewer problems with very low blood sugar.
- For some people, pumps improve hemoglobin A1c levels.
- Using a pump may not improve blood sugar control in people who are already giving themselves insulin shots 3 or more times a day.
- People who keep their sugar levels in a tight range—which a pump helps you to do—may be less able to sense when their blood sugar is low.
- The pump could stop working without your noticing.
- You keep giving yourself daily insulin shots to control your blood sugar.
- For some people, daily shots work well to control blood sugar.
- Daily shots may not control your blood sugar as well as a pump would.
- People who use daily shots have more problems with very low blood sugar.
Personal stories about insulin pumps
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I got my insulin pump 3 years ago. I was pretty nervous about how well I'd be able to program my pump and take care of it. There was so much to learn! But I had a great team of people helping me, including my doctor, my dietitian, and even the manufacturer of my pump. Still, I almost gave up after 3 months. It was always there to remind me that I had diabetes, you know? But my doctor talked me into sticking with it a little longer. Now I would not want to go back. Before the pump, diabetes controlled my life. With the pump, I feel like I am now in control of my diabetes—and my life.
Sally, age 50
I was on an insulin pump for more than 2 years, and then I quit. For me, the hassle of constantly taking my blood sugar and figuring out how to program my doses wasn't worth it. Plus, I got a lot of infections at the catheter site. I went back to injections and feel happier with my life now.
Abner, age 35
I got my pump as a teenager, and I love it. I'm a police officer now, and having a pump makes it much easier to do my job.
Jake, age 22
I have several reasons for not wanting an insulin pump. I'm a pretty private person and I wouldn't want people to notice that I'm wearing a pump. Also, I play football and basketball almost year-round, and it's a big part of my life. I know you can safely disconnect the pump for an hour or so, but my games last longer than that. I just don't like the idea of a pump.
Xiang, age 29
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to get an insulin pump
Reasons not to get an insulin pump
I wish I didn't have to give myself insulin shots every day.
I am comfortable giving myself injections.
I feel ready to take on the responsibilities involved in using an insulin pump.
Using and caring for an insulin pump seems too complicated for me.
I want a more flexible lifestyle than my current insulin shot schedule allows.
My schedule is the same every day, so it's not hard to schedule my shots.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Getting an insulin pump
NOT getting an insulin pump
What else do you need to make your decision?
Check the facts
How can an insulin pump help me manage diabetes?
- It will get rid of my need for insulin.No, that's not right. Your body will always need insulin, no matter how well you control your diabetes. An insulin pump may help you keep your blood sugar in your target range, which is the most important part of managing diabetes.
- It can help me keep my blood sugar in my target range.You're right. The most important part of managing diabetes is keeping your blood sugar in your target range. A pump may help you do that.
- It can cure my diabetes.No, that's not right. Unfortunately, there is no cure for diabetes. But you can live a long and healthy life by managing your diabetes and keeping your blood sugar in your target range. A pump may help you do that.
- I'm not sure.It may help to go back and read "Get the Facts." A pump can help you manage diabetes by helping to keep your blood sugar in your target range.
How hard will it be to learn to use an insulin pump?
- It will be very easy.No, that's not right. It would be nice if it were easy, but learning how to use an insulin pump can take some time and effort. Most people find that it's worth it.
- It will take some time and effort.Correct! Learning how to use and program your insulin pump takes time and effort, but most people find that it's worth it.
- It will take a lot of training, and it will probably be too hard for me.No, it doesn't require a lot of training. Although it takes some time and effort to learn how to use and program a pump, most people can do it.
- I'm not sure.You may want to go back and read "Get the Facts." Although it takes some time and effort to learn how to use a pump, most people can do it.
How will a pump affect keeping track of my blood sugar?
- I won't have to worry about keeping track of my blood sugar anymore.No, that's not right. People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. So you'll need to check your blood sugar often when you use an insulin pump.
- I will only have to prick my finger once a day to check my blood sugar.No, that's not right. People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. So you'll need to check your blood sugar often when you use an insulin pump.
- I will have to prick my finger often to check my blood sugar.That's right. People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. You will need to check your blood sugar often when you use an insulin pump.
- I'm not sure.It may help to go back and read "Get the Facts." With a pump, you will need to check your blood sugar often.
How will a pump affect counting carbohydrate grams?
- I will still have to count my carbs every time I eat.Yes, it's true. You'll need to count your carbs every time you eat so you can tell the pump what to do at every meal and sometimes in between.
- An insulin pump can count my carbs for me.No, that's not right. The pump can't count your carbs for you. You'll need to count carbs every time you eat so you can tell the pump what to do at every meal and sometimes in between.
- A pump makes counting my carbs unnecessary.No, that's not right. Counting carbs is still very important. You will tell your pump what to do every time you eat, based on how many carbs you have eaten.
- I'm not sure.It may help to go back and read "Get the Facts." Counting carbs is still very important when you use an insulin pump.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism|
Last Updated:January 23, 2013