Insulin Pump for Diabetics: Treating Diabetes Made Easier

Do you or a loved one have diabetes? Did the doctor prescribe insulin to help lower blood sugar levels?

Diabetes is on the rise and many people are diagnosed with the disease each day. There are two variations, which present in a similar manner but arise from different causes. Type 2 diabetes is the most prevalent. Generally speaking, a person's body does not make sufficient insulin, which is a hormone that "unlocks" cells so that glucose in the bloodstream can be used for energy. Extra blood sugar builds up, and the patient loses weight as the energy from food they have eaten is flushed from the body. This is why diabetics feel so thirsty! There are many reasons the disease may develop, including heredity, smoking and carrying extra weight.

With Type 1 diabetes, an auto-immune reaction kills the cells in the pancreas that produce insulin. The symptoms of diabetes are the same, but the cause is very different. Unlike Type 2 diabetics, those with Type 1 have not made lifestyle choices that increase the risk of the disease. Type 1 diabetics are insulin-dependent, meaning they must take insulin for the rest of their lives in order to survive, or until a diabetes cure is found.

In either event, when insulin is required to treat diabetes, it used to mean needles, syringes and shots. Today, an insulin pump for diabetics can significantly reduce the pain of living with diabetes and make it more convenient to eat and drink without having to pull out a needle every time.

Insulin is a powerful hormone. Anyone taking it must be very careful to avoid "over-medicating" which can result in seriously low blood sugar (hypoglycemia). Using an insulin pump is a much more precise method of administering the medication.

I have been living with Type 1 diabetes for almost 9 years. When I was first diagnosed, my doctor prescribed two types of insulin - long-acting and fast-acting. Long-acting insulin covers a person's basal, or baseline needs. Throughout the day, our pancreas and liver secrete stored blood sugar for energy during the times we are not eating. Insulin is required so that we can tap into that energy, and to avoid rising blood sugar levels. The amount of long-acting insulin you need is generally the same from day to day, but may be increase during illness or decrease during extended periods of physical activity.

Fast-acting insulin covers the food and drink that we ingest. Diabetics have to count grams of carbohydrates (not just sugar) and use an insulin ratio at mealtime. My ratio is 1 unit of insulin for 15 grams of carbohydrates.

Using an insulin pump provides more precise control of diabetes for several reasons. First, the pump can be turned off when basal insulin is not required, like when I go running. Second, you can take increments of units of insulin in tenths. So, when I eat something with 24 grams of carbs, I can give myself a bolus (or shot) of exactly 1.5 units, rather than eyeballing the lines on a syringe, wondering if I have enough or too much.

Insulin pumps resemble and act like mini computers. They store information on the last time you took a bolus, and the amount of insulin. Daily insulin totals are also stored. Because basal insulin requirements can change over 24 hours, you can program rates to go up or down at certain times of the day.

My Medtronic Minimed insulin pump has a wireless transmittal feature, as well. When I test my blood sugar with my meter, the information is wirelessly transmitted to my pump. I can then use the "Bolus Wizard" to calculate whether or not I need to take a bolus based on my blood sugar level and the last time I took a bolus. My insulin pump keeps track of "active" insulin following a bolus. If your blood sugar appears to be high, but you ate only 45 minutes ago, the pump may not suggest you take any additional insulin because the amount you took most recently will continue to lower your blood sugar over then next 1-2 hours.

You can program your insulin pump with date and time information, carbohydrate to insulin ratio, and the amount of insulin it requires to lower your blood sugar 100 points. In other words, it can be completely programmed to fit your specific needs. Change it when necessary if you lose or gain weight, are fighting an illness, or travel through time zones.

Instead of daily needles and multiple injections, an insulin pump works by moving insulin from a reservoir in the pump through tubing and into the patient via a port on their body. Any time you need additional insulin, you can take a bolus with your pump, in any incremental amount (from .1 units to 10 units). Otherwise, the insulin pump automatically gives small amounts of insulin based on a basal rate, every 15 minutes.

Every 2-3 days, you will need to change the "infusion site," which is the location of the port in order to prevent infection and keep the absorption of insulin consistent. The infusion site is prepared (usually on the belly) by cleaning the area, wiping it with IV prep solution and then inserting a special needle, subcutaneously, around which is a short tube. The needle is backed out of the skin and the tubing remains; insulin will flow from the pump via the infusion site into the body.

As discussed above, an insulin pump is a mini computer and keeps track of the last time you took a bolus. It can be programmed to vary basal rates over a 24-hour period, and can be shut off when insulin is not needed during physical activity.

Before a switch to an insulin pump is made, you should consider the following:

1. An insulin pump is worn 24 hours a day, 7 days a week. You can take it off for bathing or showering, but otherwise, its connected to you day or night. That means sleeping, bathing, and going to the pool.
2. The freedom of a pump compared to needles may lead to people ingesting more carbohydrates than they ordinarily would. Watch to make sure that you do not unnecessarily gain weight.
3. The convenience of insulin pumps makes it easier to manage Type 1 diabetes in young children. Other people may be more apt to take insulin injections without having to pull out a needle.
4. The cost of insulin pumps and especially supplies can be significant. A pump is about $5000 (as of the date of this posting) and supplies run about $100 per month. Check with your insurance company, if any, to determine the out-of-pocket expenses.
5. Use of insulin pumps has been proven to reduce overall blood sugar levels and A1C readings. More precise control may be the ticket to better health.

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