DIABETIC PUB
Type 1 Diabetes and Insulin Pumps 
 
Inevitably, for those with type 1 diabetes the question of getting an insulin pump arises along with many questions. Following are some answers to those questions. 
 
1. The simple answer is yes, get an insulin pump! 
 
Pumping has many advantages over injections with pens. Here are a number of them: 
 
* Continuous insulin delivery. With pens, you’ll be taking one or two injections of long-acting insulin every day along with meal-time boluses. Once that insulin is “on board” it’s there the rest of the day and if you start running low, you have to eat to compensate. Pumps deliver only short-acting insulin continuously 24-hours a day and the amount can be varied at different times based upon your actual needs. 
 
* Smaller boluses. With pumps, you can often deliver boluses in increments of as little as 0.5 units. With pens, you’re limited to 1.0 unit increments. While it seems a small thing, it can make a great difference in fine tuning insulin needs. 

* Convenience. While you quickly grow accustomed to injections by pen in public places, it can at times seem embarrassing. Pumps deliver boluses very discreetly by the push of a button. Additionally, most all have built-in meters that eliminate the need to carry another kit. 
 
* CGMs (Continuous Glucose Monitors). At least one manufacturer offers a pump with a built-in CGM that actually measures your glucose every few minutes. While these do not have the accuracy of a finger stick, they do make it easier to quickly check before you drive or while you’re out. 
 
* Service. These are serious medical devices that are heavily regulated. Most often, the manufacturers are very responsive to answering questions and responding to problems. 

* Record keeping. Pumps have associated software that allows you to download data and produce a variety of charts and graphs displaying trends. This becomes very useful in refining how much insulin your pump is delivering (the basal rate) during the course of the day. Additionally, your endocrinologist will be able to download that same data during your regular visits.

2. Which pump to get. 
 
There are a number of manufacturers and each has it’s share of positive virtues as well as drawbacks. Which you choose is quite personal, but there are many on-line resources to turn to for help in deciding which is right for you. Often your endocrinologist and/or their office can help you in making a determination.  
 
Here are the major manufacturers: 
 
- Animas 
- Asante 
- Insulet 
- Medtronics 
- Roche Insulin Delivery Systems 
- Sooll Development 
- Tandem Diabetes Care 
 
3. Cost. 
 
Much depends upon your medical insurance. Without insurance, the cost can be high, but insulin pens are not inexpensive either.  
 
There are additional items that need to be purchased regularly such as insertion sets that add to the cost. 
 
Obviously, it will be important to examine the cost and insurance coverage before you commit to the project.  

4. Learning. 
 
Many hesitate, thinking that pumps add another level of complexity to an already difficult problem.  
 
While it’s true that there will be new things to learn, there are also many resources for help. Endocrinology practices provide training in using pumps as do the manufacturers. 
 
You’ll find you quickly become very comfortable with your new technology. 
 
5. Improved glucose. 
 
Most importantly, you’ll find that you have much better control over your glucose and most of us experience improved A1Cs.  
 
6. Lifestyle. 
 
While your insulin pump is indeed a device you wear on your body (generally, your abdomen, thighs or the back of the arms), it is rarely a physical inconvenience. 
 
7. Maintenance. 
 
In one form or another pumps have an insulin reservoir containing about three days of insulin. At those regular intervals, fresh insulin must be introduced. That maintenance takes no more than ten minutes. 
 
8. Ease of use. 
 
Pumps require the insertion of a tiny cannula that delivers the insulin. The sensation is reminiscent of a finger stick.  
 
9. Problems? 
 
Once in a while, the pump will experience an error, generally an occlusion that causes it to stop delivering insulin. Built-in alarms alert you very audibly in such an event so that you can take action. If there has been a failure of the pump the manufacturers are responsive to help. 
 
Finally, go ahead and begin the process today. You’ll find your life much easier and your glucose much improved!