Insulin Pump

An insulin pump is a very sophisticated means of delivering insulin. There is a small cartridge of insulin, which can be refilled periodically, usually every 2-3 days. Sophisticated electronics control the basal rate of insulin. Boluses can be given for meals based on carbohydrates intake, pre-meal blood sugar, and anticipated activity level. Most insulin pumps have a fine plastic tubing that connects to a catheter placed on the skin, usually in the abdomen or thigh. The Omnipod does not have an infusion catheter. These insulin pumps are generally waterproof or may come with a waterproof casing for showers and/or swimming. Insulin pumps continuously inject or pump a small amount of insulin 24 hours a day, called basal insulin. This mimics your pancreas in producing a small amount of insulin all the time, and with each meal or snack, you are to give yourself a bolus of insulin based on the number of carbohydrates you eat.

The advantage of the pump is that it mimics insulin delivery similar to your pancreas. Generally, with the pump, you can achieve much tighter blood sugar control. The frequency of low blood sugars can also be reduced by appropriate adjustment of the insulin delivered. Fluctuations in blood sugars can be reduced. The insulin pump has the advantage of being able to deliver different basal rates at different times of the day, which cannot be achieved by basal insulin injection. Another advantage of the pump is, for every snack, one can take insulin appropriately. A fraction of a unit can be injected with a pump; this would not be possible with a syringe or pen. Insulin pumps have alarms that signal when the tubing is blocked, or the insulin is running low, or the battery is dying. Unfortunately, they do not warn you when the catheter has come out of the skin, which very occasionally occurs. It is generally recommended that you check your blood sugars at least four to six times a day if on the pump. Continuous Glucose Monitors are currently available to help warn of changing blood glucose by giving out alarms. Rarely the catheter site does get infected. Changing the catheter every 48 to 72 hours is recommended. The catheter site should be cleaned before insertion and kept clean at all times to reduce the risk of infection. Antibiotic ointments can be used prophylactically; also protective covers are available for use over the catheter site. Occasionally the patients have an allergic reaction at the catheter site. Non-allergenic tape or Teflon catheters can be obtained in such situations.