What Are Insulin Pumps?

An insulin pump is usually used to treat cases of type 1 diabetes mellitus, especially in patients who don't achieve good glycemic control. We explain how it works.
What Are Insulin Pumps?

Last update: 22 July, 2021

Insulin pumps are devices that are used to treat certain cases of diabetes mellitus. Insulin is the molecule that allows glucose to enter the body’s cells. Glucose, in turn, is the fundamental nutrient that cells need for energy.

What happens in diabetes is that the body can’t make or use insulin. As a result, blood glucose levels rise above the correct concentration. This is what causes all the symptoms and complications of the disease.

An insulin pump is very useful for people who have poor glucose control or for those who need more flexibility in their routine, such as athletes. In this article, we explain how they work, and their advantages and disadvantages.

How does an insulin pump work?

An insulin pump is a small device that’s programmed to deliver insulin into the fatty tissue under the skin. It’s also called a continuous subcutaneous insulin infusion device.

For many diabetics, especially type 1 diabetics, treatment is based on administering insulin by subcutaneous injections. The problem is that patients must follow strict monitoring routines to avoid uncontrolled glucose levels.

The insulin pump, as explained in an article from the Clínica Universidad de Navarra, automatically administers basal and pre-meal insulin. It avoids the need for the patient to have to perform the injections.

This device is programmed according to the specific needs of the patient. In other words, the doses and frequency of administration are programmed according to a previous study of each case of diabetes.

Parts of an insulin pump

Insulin pumps, as noted above, are small devices. It’s important to re-emphasize that they’re not smart devices; they have to be pre-programmed to perform their function.

The pump works using a small electric motor. This motor, through a kind of piston, pushes the drug cartridges into the tissue. According to an article in Diabetes Education Online, most pumps contain a reservoir of insulin, a battery, a display, and the pumping mechanism.

Users of insulin pumps can place the device outside their body and connect it to the subcutaneous tissue by a catheter with a Teflon cannula. They can wear the insulin pump itself on a belt designed for this purpose or even carry it in a pocket.

A diabetic injecting insulin.
The need for constant insulin injections make it difficult for patients to comply with treatment.

When are insulin pumps necessary?

An insulin pump may be necessary to improve control of certain cases of type 1 diabetes. As a Medtronic article explains, they’re often useful when a patient can’t achieve good glucose control despite already being on intensive therapy.

Many patients on regular insulin therapy experience frequent episodes of hypoglycemia. This is also an indicator of poor control, so the pump may be helpful.

Diabetics who require low doses can use insulin pumps. Similarly, it’s the treatment of choice for those who require flexibility in their routine.

For example, people who can’t pay the attention needed in order to go about injecting this molecule in the conventional way. This is the case with many sportsmen and women.

Women planning to become pregnant, as well as patients with diabetic neuropathy, are also candidates for this treatment. However, insulin pumps require that the patient meets certain requirements.

It’s essential that they’re involved in the disease management and interested in good glycemic control. In addition, the patient must learn how to operate the pump and perform enough daily blood glucose checks.

Advantages of insulin pumps

Insulin pumps, as one article mentions, have numerous advantages. They allow very efficient control of the insulin dose.

Thanks to them, very small increments can be made, which is very useful in the case of children.

In addition, diabetics can program the basal insulin rate at different speeds, depending on the time of day. For example, it can be set higher during the early hours and lower throughout the night. This reduces the risk of hypoglycemia.

In addition, insulin pumps make it possible to make changes to the basal insulin on a temporary basis. This is very useful for variations in routine. For example, when going on a trip, as this can force changes in diet.

Disadvantages

Although it may seem that insulin pumps only have benefits, the truth is that they’re not without their disadvantages. For starters, they’re external devices, which must remain permanently connected to the body through the catheter.

They can’t ever be removed, not even to sleep. That’s why many people feel uncomfortable attaching the device. In addition, some also consider that it has an aesthetic impact, as it can be noticeable through clothing.

The catheter can become clogged or the pump itself can fail. This means that the patient loses glycemic control in that moment. As such, it’s also important for the people who wear the pump to carry out frequent daily tests.

Care and recommendations

A man measuring her blood glucose.
Frequent blood glucose monitoring is vital to ensure the successful use of pumps.

Insulin pumps require the patient to be conscious of their disease and to be responsible with its treatment. This is because a series of measures are necessary to take care of the device.

As explained by the Diabetes Foundation, the subcutaneous catheter must be changed every 2 to 3 days. As it’s a foreign body connected to the subcutaneous tissue, there’s a risk of infection. Therefore, to change the catheter, it’s necessary to follow some specific steps.

The first thing the user must do is to wash their hands thoroughly in order to be as aseptic as possible. They have to change the area where they insert the catheter from time to time, otherwise the insulin may not absorb properly.

It’s usually placed on different points of the abdomen. It’s necessary to check that the catheter is in good condition and to load the pump syringe without leaving bubbles inside.

They also have to disinfect the skin of the abdomen. Once they’ve inserted the catheter, they tape it down to ensure it doesn’t move from that area. They have to remove the insulin from the refrigerator about 24 hours before the refill.

Insulin pumps require responsibility

Although it may seem that this device is the solution for the treatment of diabetes, this isn’tt always the case. It’s a very useful form of treatment, but it requires the patient to be conscious of the treatment and to know how to manage it.

For this reason, the patient and a physician must make the decision to fit an insulin pump together. It’s important that a number of requirements are met in order for it to be useful.

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