Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.
If your diabetes has become difficult to control and you're frustrated, is an insulin pump the answer to your prayers?
Although pumping is a good option for many, it is not the cure-all of diabetes therapy. You need to be certain you are ready to start on this type of treatment. Pumping isn't a bad option by any stretch—it's a wonderful method of controlling diabetes. You just need to be ready for what to expect.
If you are thinking, as I once did, that an insulin pump will just connect and make all the decisions about your diabetes control for you, you may want to take a step back.
What is a pump?
In simple terms, a pump is a device with a reservoir for insulin and an internal computer that can be programmed very specifically for a basal rate. A small amount of insulin gets released from the reservoir via tubing that gets attached by a small catheter into an area such as the stomach. Every few minutes, small amounts of rapid-acting insulin are slowly pulsed out, and these rates can be changed every hour based on the individual. For mealtime or bolus insulin, you match your carbohydrate intake to insulin—just like multiple dose insulin—and push a bolus button on the pump when meals are eaten. This is a simplified version of pump therapy, and many brands and variations are available.
How to know if you're ready
Someone who is ready to use an insulin pump should understand the concept of basal/bolus insulin therapy. You should also be prepared to test your blood glucose frequently, sometimes as often as six times daily—this can vary person to person.
When you first receive your pump
At first, you will be given some parameters that are set by your healthcare team as far as how to program the pump based on your current basal (long-acting insulin) and bolus (short-acting insulin) dosing. Then there is an adjustment period where you will be taught how to fine-tune your insulin pump based on your own individual needs. Here is where the frequent blood glucose testing comes in. You will need to test your post-meal blood sugar, for example, to see if your meal bolus was sufficient. You will need to test pre- and post-exercise, and perhaps a few 2:00 a.m. readings as well to make certain your basal rate is set right for you. If you are currently using basal-bolus insulin, this testing is not new to you, and you probably test routinely to stay in control.
The benefits of technology
Make no mistake—insulin pumps can be very useful in controlling diabetes. If you like technology and understand the concept of basal/bolus insulin therapy, pumping may be right up your alley.
But remember: You need to be an active participant in your diabetes care when you sign up to start using an insulin pump. Handle it with the respect it deserves. It is a tool, and it will work for you if you understand that it will take some effort on your part so you and your healthcare team can program it correctly.
Pumping is not for everyone, but in the right hands, can make a world of difference in your diabetes care. Remember that education is always the best prescription!