Insulin Pumps: Benefit For Some, Burden To Others

Insulin pumps are wearable computerized devices that users - typically people with type 1 diabetes - program to deliver their insulin doses throughout the day.

The device, about the size of a small cell phone, is usually kept in a pocket, clipped to a belt, or hidden beneath clothing. The insulin is delivered via a small catheter or needle placed under the skin.

Pump Disadvantages

Despite the several advantages users of insulin pumps enjoy, there are also some disadvantages to consider before switching from manual syringe injections to insulin pump therapy.

The primary disadvantages are:

• Monitoring: the necessity of checking blood glucose levels at least four times during the day.
• Cost: pumps are pricey, and there is the monthly cost of pump supplies such as catheter sets to think about (syringe therapy is cheaper).
• Risks: infections can occur at catheter sites, and pump malfunction or insulin absorption problems can lead to DKA (diabetic ketoacidosis).
• Revealing: though pumps are discreetly worn they may be noticed by others, revealing the wearer has diabetes.
• Learning Curve: most pumps are designed for ease of use, but they require a basic level of digital device skill, or a willingness to learn.

Potential pump users need to ask themselves whether they are okay with others finding out they have diabetes, and with faithfully checking glucose levels several times each day. If not possessing a sophisticated knowledge of carb intake, activity level, and insulin dosing, they need a willingness to acquire this knowledge—and to face-down any gadget anxiety.

Pump Benefits

However, even if some of these pump drawbacks seem daunting, a diabetes care team familiar with insulin pump use can help people turn the drawbacks into doable challenges. The effort may be worthwhile since the advantages of pump therapy are considerable, including:

• Predictable, precise insulin delivery that provides tighter blood sugar control while lowering the chance of low blood sugar.
• Fewer episodes of severe hypoglycemia, and reduced broad fluctuations in blood glucose.
• More lifestyle flexibility.
• Better management of the dawn phenomenon (an abnormal early morning elevation in blood sugar).
• Fewer needle sticks: there may be one catheter insertion every three days versus 15 to 18 syringe injections during a three-day period.

Though insulin pump therapy involves more cost, training, and maintenance than injections do, pump use eventually becomes a familiar part of the daily routine for users who love the freedom and accuracy provided.

Other individuals find pump therapy too costly, or find wearing the pump, and the specter of infections or malfunctions burdensome—but this does not mean they are short-changing their health. By giving due diligence to glucose monitoring and carbohydrate counting, people choosing the low tech approach of syringe injections can also achieve excellent blood sugar control.

Source: Joslin Diabetes Center
Photo credit: Regan Walsh