Insulin Pumps

What Is an Insulin Pump?

A pump is a small, computerized device that delivers rapid –acting insulin to the body through a small plastic tube known as a cannula or needle that sits beneath the skin. It delivers insulin in two ways: The first is the basal rate that is delivered continuously throughout the day and night. The basal rate replaces long-acting insulin and is pre-programmed and happens automatically. Its job is to help maintain target glucose levels overnight and in between meals. Basal insulin rates will vary according to age, weight and general activity levels and time of day. The second delivery is called bolus insulin delivered by the pump to cover meals and snacks and to correct a high glucose and bring it back to target.

• Insulin pumps are a more advanced tool for delivering insulin and are more commonly used by people with Type 1 diabetes.  

What Insulin Pumps Do

• Ability to program ratios and calculate pre-meal insulin doses
  • Carbohydrate Ratio
  • BG Correction Factor/Sensitivity Factor
  • Insulin on Board to help prevent stacking of insulin dosing
• Ability to adjust basal rates to better match biologic needs
• Ability to temporarily make adjustments for exercise, stress, illness, etc.
• Data download
• Predictable and a more precise insulin delivery
  • Basal insulin delivery as low as 0.025 units
  • Bolus insulin delivery: 0.025 to 35 units  

What Insulin Pumps Do NOT Do:

• Measure your glucose level; that still requires using a blood glucose meter or a continuous glucose monitor
• Know what you are about to eat; only you know that
• Automatically provide the right amount of insulin; you need to figure out the amount needed and tell the pump to administer. While pumps can do math to assist in calculating the dose needed, the final decision is still made by the person wearing the pump.

Requirements for Using an Insulin Pump:

To use an insulin pump successfully, you must:

• Check glucose at least 4 times a day; every day, and/or wear CGM
• Understand insulin action
• Use advanced carb counting
• Know how to adjust insulin doses for various situations, such as high blood glucose, exercise and sick days
• Practice ketone monitoring
• Use device as instructed
• Know your back-up plan
• Have realistic goals and expectations
• Attend follow-up appointments
• Recognize cost and insurance coverage

Pump Considerations

• Attachment to a device
• Potentially a more visible sign of diabetes
• Not willing to check glucose at least 4 times each day or wear CGM?
• Are you comfortable with the technology and mechanics of operating a pump?
• Are you committed to problem-solving using a sophisticated understanding of insulin, carbohydrates, and activity levels?
• Willing to trouble-shooting hyper/hypoglycemia?
• Do you have realistic expectations?
• Do you have a healthcare team that is familiar with insulin pump

Although this content is reviewed by Joslin Diabetes Center healthcare professionals, it is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.