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About Insulin Pumps

Published:
1-July-2005

Insulin pumps are computerized devices, about the size of a cell phone or pager (a fact that seems to be totally acceptable to teens.) Kids most often wear their pumps hooked to their belts, or in their pants or shirt pocket. The internal workings of a pump are both simple and amazing. There's a reservoir that looks like a large version of a regular syringe.

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The reservoir typically holds a two to three day supply of short-acting insulin. (Since pumps can immediately supply insulin to the wearer, medium- or long-lasting insulins are not used.) Just like a regular syringe has a plunger that's pushed to force the insulin out of the syringe, the reservoir has a plunger that's pushed by a small pump, which is why we call this device an insulin pump.

The pump must be told exactly what to do. So, for example, if the wearer's meal plan calls for five units to cover a meal, he or she punches in (boluses) that number on the pump's screen. With this command, the exact amount of insulin is pumped into a thin, clear plastic (length) of tube that ends in a small tip called a cannula. The cannula rests just below the skin in the fatty tissue of the pump wearer. The cannula is changed every two or three days. With the aid of a small needle, the plastic is inserted through the skin into the fatty tissue and is taped in place. In the newer products, the needle is removed and only a soft catheter remains in place.

The insulin bolus empties out of the cannula and is absorbed into the body in the same way insulin injected through a syringe would be. The place where the tube connects with the cannula is called the infusion set. The wearer can disconnect the tube from the set for sports, showering, or anything other short-time activity. The pump delivers basal insulin (the constant base line) in much the same way.

Working with his or her health care team, the pump wearer programs the amount of insulin to be released throughout the day. Unless it's changed by the wearer, the basal program releases the same amount every day. What Makes One Pump Different from the Next? There are several outstanding models of insulin pumps to choose from. While they all work in a similar manner, manufacturers offer unique programming options, battery types, infusion set possibilities, reservoir styles, and warranties.

Here are some items to compare pump-to-pump as you narrow your search. Size Weight Battery life Infusion sets Number of basal rates available Basal range Smallest basal possible Obstruction alarm Over-delivery alarm Near-empty alarm Warranty Special features What an Insulin Pump is NOT Insulin pumps are not mind readers. Pumps have no extrasensory perceptions. An insulin pump is not an artificial pancreas. True, these machines do a pretty good job of imitating a pancreas. But unlike a healthy pancreas, pumps can't work automatically, can't decide how much insulin you need or when you need it. Which makes the person running it most important part of the pump. Every action a pump makes starts with the user.

So everything that's important in controlling diabetes by using insulin and syringes is just as important when wearing a pump. To use a pump you must be willing to check your blood glucose frequently and learn how to make adjustments in insulin, food, and physical activity in response to those test results. As truly remarkable as a pump is, it is not the cure for diabetes. It is simply a different way to deliver needed insulin. And for some people, it's a better way.