What is an insulin pump?

An  'insulin pump' is made up of a battery operated pump, a pump reservoir similar to that of an insulin cartridge, and a computer chip that allows the user to control how much insulin the pump delivers. It is all contained in a plastic case the size of a beeper.

How does it work?

The pump is attached to a thin plastic tube (an infusion set) that has a soft cannula (or plastic needle) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen. The cannula is changed every two to three days. The pump delivers insulin 24-hours a day in two ways: continuously at a low dose every few minutes 24-hours a day to maintain a 'basal' level. This insulin keeps blood glucose in the desired range between meals and over-night. The larger or 'bolus' doses are given before meals and the amount of insulin 'bolus' by the user depends on results of blood glucose monitoring and the amount of food intended to eat. The tube or infusion set can be disconnected from the pump when showering or swimming.

The amount of insulin needed over the course of 24 hours varies depending on factors like exercise, activity levels and sleep. The insulin pump user can program different rates to allow for these changes in lifestyle.

Insulin pumps are expensive (around £2800) and cost more than a £1000 every year to run. These pumps require considerable expert medical back-up and a great deal of commitment from the patient. NICE (The National Institute for Clinical Excellence) has recently approved insulin pump therapy for people with type 1 diabetes who find it difficult to achieve adequate blood glucose control without experiencing hypoglycaemia. In the UK Medtronic and Disetronic market the insulin pump.

Reasons for using an insulin pump

Some of the young people we talked to are using or are thinking about using an insulin pump. The main reason is that they have found or are finding it difficult to control their blood glucose level. They talked of being unable to assess how much insulin to take; of going constantly high and low for no apparent reason and of getting bad HbA1c's. (See also 'Managing diabetes as a teenager', 'Hypos' and 'Highs'). One young woman was 12 when she started using the pump because at that point she had had to increase the number of injections she was having and was still not getting satisfactory control of her diabetes. Another young woman registered blind at the age of 23 and pursuing a career in performing arts found that her glucose level would go very high every time she performed and asked her diabetes team for help. 

Explains why an insulin pump will suit her and what an insulin pump does.

For about four years he was having difficulties controlling his blood glucose level.

Her sport was her main motivation to use an insulin pump.

Every time she was on stage her glucose level would go very high due to hormonal changes. Her diabetes team helped her to get an insulin pump.

According to the young people we talked to an insulin pump gave or will give them greater flexibility and freedom regarding mealtimes and what they can eat. These young people are mostly students and tend to have unpredictable daily routines. One young woman going to university next year and suffering from high blood glucose levels says that her consultant suggested she uses an insulin pump. Her consultant emphasized however, that it will only work if she is willing to work with it. A university student said that she has a busy daily routine so it is not uncommon not to have a meal and eat something on the go instead.

Her consultant suggested that if her present insulin regimen does not suits her she could try the insulin pump.

Says that now it is possible to eat something on the go but that she couldn't have done that on a four injections a day insulin regimen.

Two young persons were provided with an insulin pump by their Primary Care Teams, one girl has been offered one and another has applied for it. She said that there is a long list of people waiting to receive a pump. The parents of two young girls bought their insulin pumps themselves.

Her mother got a loan to buy the insulin pump and consumables but the training and support was given by a 'pump rep' at the hospital.

Learning to use an insulin pump

The young people we talked to said that you would need a lot of help and supervision from specialist diabetes 'pump' doctors and nurses. Also that having a practice session and talking to other young people who already use an insulin pump is a good idea before you decide about it.

She talked to other young people already on insulin pumps and had a trial session before deciding if she wanted to use one herself.

Any young person considering using an insulin pump needs to be aware that to make it work requires commitment, time and a willingness to learn. The young people we talked to said that you need to understand much more about carbohydrate counting; that you need to become more accurate about the insulin/carbohydrate ratio. Also, at the beginning you will need to do lots of blood glucose tests. Young people said that it takes several months to feel confident about it and some still find some things difficult to do. 

Describes getting used to wearing his pump, inserting a new cannula and working out the carbohydrate/insulin ratio.

She has been using an insulin pump for almost 6 years and says that it takes several months to get used to it and that after a year she was still learning new things.

The young people we talked to said that initially they were a bit concerned about the insulin pump being so visible. They also said that it gets in the way when you are trying to sleep. One young woman was afraid of people coming too close to her in case it hurt. On the plus side they said that an insulin pump can be disconnected for about one to two hours so there in no problem when going for a shower or doing sports.

Says that at first she was not so sure about using the pump because she had to attach it to her most of the time.

Not everyone likes using an insulin pump

An insulin pump is not for everyone. One young man who initially thought about using one decided against it because he found it too unpractical and went on to try another insulin regimen instead. One young girl found it difficult to cope with the curiosity of others at school and became depressed. She changed to insulin injections.

Decided not to use an insulin pump and says that his new insulin regimen works in the same way without the medical 'clutter'.

She found the insulin pump to be a constant reminder that she has diabetes.

Young people seem to find out about insulin pumps in various ways. Some are asked by their doctors to consider using an insulin pump; others looked and researched the web for alternative diabetes treatments available to type 1 diabetics; other received information about it from parents or read about it in Diabetes UK magazines (e.g. On the Level). Others have approached self help groups. (See also 'Information about diabetes'.) 

Last reviewed April 2010.

Last updated April 2010.