Everyone with type 1 diabetes and many people with type 2 diabetes need to take insulin to manage their blood sugar levels. For now, there are two options: injecting it with a needle or pen, or using an insulin pump.
An insulin pump is a small computerized device. It delivers insulin through a thin tube that goes under your skin.
How an Insulin Pump Works
The device releases insulin almost the way your body naturally does: a steady flow throughout the day and night, called basal insulin, and an extra dose at mealtime, called a bolus, to handle rising blood sugar from the food you eat. You program the pump for both basal and bolus doses. If you eat more than normal, you can program a larger bolus to cover the carbs in your food. A bolus can lower high blood sugar at other times, too.
The pump is about the size of a smartphone. You attach it to your body using an infusion set: thin plastic tubing and either a needle or a small tapered tube called a cannula you put under the skin. The place where you put it in -- your belly, buttock, or sometimes thigh -- is called the infusion site. Some pumps come with inserters for easier placement even in hard-to-reach areas.
Insulin pumps use short-acting and rapid-acting insulin, but not long-acting insulin. That's because the pump is programmed to deliver a small amount continuously to keep your blood sugar levels even.
Advantages of an Insulin Pump
- You’ll need fewer needle sticks. A pump requires one shot every few days when you change your infusion set.
- A pump is more accurate than shots, helping you better manage blood sugar levels.
- You’ll have fewer blood sugar lows, which is important if you often have hypoglycemia.
- It may improve your A1c levels.
- Dosing for meals and snacks is easier.
- It’s easier to plan for exercise.
- It’s easier to bolus.
- It helps manage early morning high blood sugar, also called the “dawn phenomenon.”
One thing to keep in mind: You’ll always need to have regular injectable insulin on hand in case the pump stops working.
Disadvantages of an Insulin Pump
- You’ll need to enter information into the pump all day and change out the infusion set every few days.
- You’ll need to commit to using it safely, including checking your blood sugar to make sure the pump is working right. Otherwise, you risk a life-threatening problem called diabetic ketoacidosis (DKA).
- You’ll need training to learn to use the pump, which means several visits with your health care team or a full day of outpatient training.
- Pump supplies can be expensive.
An insulin pump may not be right for you if:
- You don’t want to wear a device that lets people know you have diabetes.
- You don’t like the feeling of wearing a device.
- You’re not comfortable operating the pump.
- You don’t want to check your blood sugar at least four times a day.
- You’re not sure you want to do the work to figure out insulin dosing, carbs, and physical activity.
Types of Insulin Pumps
Tethered insulin pumps
A tethered insulin pump delivers insulin through a thin tube connected to a tiny needle or soft tube (called a cannula) that sits just below your skin, usually on your upper arm, belly, hip, buttock, or thigh.
The pump itself has a display screen so you can see your data and change the pump’s settings. Inside, there’s a cartilage of insulin that usually lasts 2 to 3 days. You can wear the pump on your belt, in your pocket, or attached to your clothing. Depending on the model, it may have a rechargeable or replaceable battery. While some tethered insulin pumps are waterproof, you can take them off when you shower or swim.
Tubeless insulin pumps
A tubeless insulin pump delivers insulin without tubes or the need for regular injections. It’s a small, wearable pod that sticks to your skin and gives you insulin through a tiny needle. You can control the pump wirelessly, using either a handheld controller or a smartphone app. You’ll need to switch the pod every 2 to 3 days, and you can use each pod one time. Tubeless insulin pumps are completely waterproof, so you can keep them on when you shower or swim.
Patch pumps
Patch pumps are a type of tubeless insulin pump. They come with an adhesive back that sticks to your skin and delivers insulin through a short needle or tube. Patch pumps tend to be smaller and more discreet to wear. You usually control them with a wireless remote.
EOPatch
EOPatch is a brand of patch pump. Like other patch pumps, it delivers insulin automatically without any tubes. The EOPatch is controlled with a smartphone app, where you can monitor and adjust your insulin doses. Each disposable patch lasts up to 3.5 days and is fully waterproof.
Which Insulin Pump Is Best?
All insulin pumps have benefits and drawbacks. Your choice will depend on what’s most important to you. Do you want an easy setup? Low up-front cost? Ease of use? Since most insurance companies will replace your pump only after several years of use, it’s important to find one that works for you.
Some things to think about:
- Which is best for your lifestyle: a traditional pump, a tubeless pump, or a pump with a handheld remote?
- Pump reservoirs hold between 176 and 315 units of insulin. Kids may be fine with smaller reservoirs, but adults may want larger ones.
- Can the pump deliver insulin in small amounts? Kids and people who are very sensitive to insulin may want one that does.
- Does the pump come with carb counts of common foods to help you decide how much insulin you need?
- Can the pump interact with a blood glucose meter or continuous glucose meter (CGM)?
- Does the pump software work with your phone or laptop?
Insulin Pump Cost
Most insurance companies cover insulin pumps. But if your insurance has a high deductible, you may need to pay a big part of the cost. Your policy may cover only certain pumps, so be sure to check.
If you have trouble paying for an insulin pump, some organizations can help. Most pharmaceutical companies offer financial help to people who have trouble affording medicines and supplies. Ask your doctor about other programs that can help you pay as well.
Different Ways to Take Insulin
Using a pump is an option, not a requirement. And remember that whatever treatment you use, you can change your mind. Many people use their pump continuously, and others switch to shots when they go on vacation, want infusion sites to heal, or just want a break.
Takeaways
Insulin pumps can be a good alternative to injections for managing diabetes. While they can help blood sugar control and lower the frequency of lows, pumps require regular upkeep and can take some time to get used to. Before deciding on a pump, talk to your doctor to see if it’s a good fit for you, and check your insurance coverage.
Insulin Pump FAQs
Who qualifies for an insulin pump?
To qualify for an insulin pump, you should have good blood sugar control and be comfortable with the pumps’ technology. If you’re very active, often have low blood sugar, or are planning to get pregnant, the pump may be a good option. Your doctor will help you decide if a pump is right for you.
What is the average cost of an insulin pump?
In the US, an insulin pump can cost as much as $6,500, depending on the brand, model, and features. The supplies needed to use the pump, such as batteries and cartridges, can add another $2,000-$3,000 each year. How much you’ll actually pay depends on your health care and insurance plan.
How do you sleep with an insulin pump?
If you have a pump with tubes, you can tuck it into your pajama bottoms or wear it fastened around your waist while you sleep. Pumps with long tubes can be placed beside your bed. With a patch pump, you may find it easier to move around in your sleep.
How painful is an insulin pump?
Because the cannula stays under your skin, many people find that insulin pumps are less painful than regular injections.
