Type 1 diabetes insulin pump
An insulin pump is an alternative to injections for some people with type 1 diabetes. It can help control the level of sugar (glucose) in your blood.
What does an insulin pump do?
An insulin pump delivers a steady flow of insulin 24 hours a day. It flows through a cannula, which is a very thin plastic tube inserted just under the skin, and is changed every 2 or 3 days.
The pump also allows you to give yourself an extra insulin dose when you are eating, known as a bolus dose.
Insulin pump therapy is also known as continuous subcutaneous insulin infusion (CSII).
The pump itself
There are currently eight pumps available in the UK.
There are different types of pump.
A tethered pump which uses a fine tube to connect the pump to the cannula. The pump can be hooked over your waistband, hung on a belt or be kept in a pocket.
A patch pump or micro pump has no tubing or a very short tube and the pump is usually stuck to the skin. You can take it off for short spells for example when showering or going swimming.
Pumps come in varying sizes but are around the same dimensions as a pager or small mobile phone.
Who are pumps recommended for?
The National Institute for Health and Care Excellence, the government body that decides which treatments should be available on the NHS in England, says insulin pumps are a possible treatment for children under 12, if it's impractical or not appropriate to give them several injections a day.
NICE says pumps can be used in adults and children over 12 if they get too many episodes of low blood glucose ( hypoglycaemia) from injections or if their HbA1c is too high despite carefully trying to manage their diabetes.
In the UK in 2013 around 6% of adults with type 1diabetes used an insulin pump and around 19% of children with the condition used one.
Your diabetes consultant will decide if you are suitable for insulin pump therapy, if you meet the criteria and demonstrate commitment. You may have to go on a short training course to teach you about dosage and how to work your pump.
Some doctors think it may be especially useful for pregnant women, who need to keep a careful watch on their blood glucose.
Shift workers or people who frequently travel across time zones may benefit from insulin pump therapy.
It may also be useful for teenagers who dislike injecting themselves several times a day, but who don't mind testing their blood glucose regularly or dealing with a pump.
Advantages of using a pump
It’s a more flexible way of controlling your diabetes as you don’t have to plan your eating times so carefully.
You need fewer injections – the cannula is only replaced every 2 or 3 days.
It may reduce your need for so much insulin as you improve control of your diabetes.
Pumps are easy to use once you get used to them.
You're less likely to get very low blood glucose (severe hypoglycaemia).
Concerns about using a pump
Pumps aren’t for everyone, you need to be committed to testing your blood glucose levels four times a day as you need to always know what your insulin needs are.
Infection may develop where the cannula enters your skin.
You may get scarring near the insertion site which may mean changing the equipment more often.
You may not like the thought of being attached to a pump all of the time.