Insulin Pumps – Frequently Asked Questions
What is a pump?
It’s a small device that holds insulin. A small tube runs from the device into
your body delivering insulin continuously (this constant delivery is known as
“basal” insulin). When you eat , you push a sequence of buttons to deliver a
lump sum of insulin to cover the carbohydrate content of the meal (this is
called a “bolus”). You may also bolus just to correct for high blood sugars.
Does a needle stay in me all the time?
The small tube in your body is placed with an “introducer needle”. The
needle is then withdrawn leaving a soft, flexible cannula (tube) under the
skin (this is your “infusion site”). Most people don’t even feel the cannula
once it’s in place. You also have the option to use an infusion set where the
needle stays in.
Is the cannula something the Doctor puts in?
No. You will insert your own infusion sets at home. It’s similar to giving an
injection. You’ll need to do this at least every two to three days.
What kind of insulin do pumps use?
Pumps are filled with only rapid acting insulin (Humalog, Novolog or Apidra).
You will no longer be using any long acting insulin. The pump most closely
replicates the body’s output of insulin by giving little bits of rapid acting
insulin continuously.
Do I have to wear my pump all the time?
You can be disconnected from most pumps up to 2 hours. You will not be able
to disconnect from “patch pumps” like the Omnipod. Remember, you have no
long acting insulin in your body and the fast acting wears off in 2-4 hours.
Without insulin, you will produce ketones (a potentially dangerous situation)
within hours. Occasionally people take “pump vacations”. This involves
coming off of your pump and going back onto shots (both long and short
acting insulins) for a time.
Will it give me perfect blood sugars?
No. You’ll still have highs and lows but hopefully fewer than what you have
now. The pump’s just a tool. Your wise use of it is what can make it a
success.
Does it test my blood sugars and give me insulin automatically?
No. You still have to test. In fact, testing 4 times daily minimum
(breakfast, lunch, dinner, bedtime) is a prerequisite for going on the pump
(most “pumpers” test 6 to 8 times a day). Then you have to push the buttons
to deliver insulin in response to the numbers you get.
Do pumps ever accidentally deliver the wrong dose?
Pumps all have safety systems in them that keep them from delivering any
insulin other than what you request.
There will be times when the pump is unable to deliver insulin (ex. out of
insulin, dead battery, kinked tubing, pump malfunction). This requires an
injection of insulin with a standard syringe to prevent ketones from
developing.
How much do they cost?
Pumps cost between $3000 and $6500. The supplies to operate them are
another $200 - $400 a month. Most of these expenses are covered by
insurance under your Durable Medical Equipment benefits. It’s important to
check with your insurance provider about coverage.
Where can I learn more about pumps?
The book, “Understanding Insulin Pumps and Continuous Glucose Monitors” by
H. Peter Chase, MD is a great resource. It’s available online at
www.Children’sDiabetesFdn.org or it can be purchased at the front desk of
The Barbara Davis Center for $15. Chapter 26 in the “Understanding
Diabetes” (Pink Panther) book is a nice introduction to “pumping”. It’s also
available at the website or at our front desk for $25. In addition, there
are many websites such as childrenwithdiabetes.com or the pump company
sites that have lots of useful information.
What do I have to do to get one?
First, you need to discuss with your health care provider if a pump is right
for you. You need to be dosing your rapid acting insulin using carb to insulin
ratios. Then, you’ll need to choose a pump. Your Doctor, Nurse Practitioner
or Physician’s Assistant may recommend a specific brand. You can also
research them yourself. Following are the 4 pumps we use (because they’re
all reliable and downloadable):
Accu-chek Combo
Neil Henson
Cell:303-906-6608
Neil.henson@roche.com
www.roche.com
Animas:
Katie Love Jetten MS, RD, CDE
Cell: (303) 524-5478
Fax: (866) 945-7655
Kjetten@its.jnj.com
www.animascorp.com
Medtronic:
Michelle Shaw
Cell: 303-548-7519
Michelle.r.shaw@medtronic.com
www.minimed.com
Omnipod:
Cory Lloyd
Cell: 801-745-5409
clloyd@insulet.com
www.MyOmnipod.com
TSlim:
Carrie Ann Liebrock
Cell: 303-548-5360
1-877-801-6901
cliebrock@tandemdiabetes.com
www.tandemdiabetes.com