We Know: All About Insulin Pumps What are insulin pumps? Insulin pumps (also called external insulin pumps) are small pumping devices worn outside of the body. It is connected to the body by flexible tubing attached to a catheter that is located under the skin of the abdomen. The pump, controlled by the wearer, dispenses the necessary amount of insulin. The pump is normally pre-programmed to give a steady small dose of insulin, and can give an additional amount in a short time if needed. These pumps allow close control of insulin levels without multiple injections. A user cannot do strenuous exercise that might damage the pump and will still need to monitor blood glucose levels regularly. Why should I use an insulin pump? Insulin pumps are an attractive alternative to injections because they more closely match the natural action of the pancreas by releasing small amounts of shorter-acting insulin. They are effective for Type 1 diabetes, and useful for some people with Type 2 diabetes. How do I learn to use an insulin pump? When beginning use of an insulin pump, you would work with a trainer to determine basal rates, which are rates of insulin release designed to keep blood glucose within 30 points of target blood glucose levels. The training period also helps to you learn about your insulin sensitivity factor, and insulin-to-carbohydrate ratios. How do I purchase an insulin pump? Insulin pumps cannot be bought off the shelf; you will need a prescription to get one. You may need to ask your doctor about using an insulin pump, as less than 1 in 10 doctors who prescribe insulin also prescribe pumps. Are insulin pumps expensive? Insulin pumps can be cost prohibitive, costing over $5,000 with additional supplies being about $100 per month. Health insurance may cover a portion (or even all) of the costs. Medicare patients may also have the costs of their pumps covered. In many cases, the cost is no more than oral diabetes medications, so you would have to explore and compare your options. What are the newest advances in insulin pumps? New advances in managing diabetes are made regularly. Recent advances include: Implantable insulin pumps (also called external insulin pumps) are surgically implanted under the skin of the abdomen. It is controlled with a remote control unit that prompts the pump to give the specified amount of insulin. The pump is refilled with insulin every 2 to 3 months. Unlike injections, which can pool insulin in the tissues before it slowly dispenses into the bloodstream, the pump infuses it directly into the abdomen where it is more quickly absorbed. This type of insulin pump is being used in Europe and undergoing US trials. The U.S. Food and Drug Administration recently approved the MiniMed Paradigm insulin pump and glucose monitoring system, by Medtronic. It is the first device to deliver insulin and monitor sugar in real time and works through a small electrode inserted under the skin. It takes frequent readings, which allows users to take immediate action to improve glucose control.
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