Ask the Harvard Experts: Pros and Cons of an Insulin Pump

Mary Pickett, M.D.

Q: What are the advantages and disadvantages of switching to an insulin pump rather than continuing with multiple daily injections?

A: Insulin pumps are usually used to treat type 1 diabetes. They are rarely used to treat type 2 diabetes.

An insulin pump has several pieces.

The first is a pager-sized device. This is usually clipped to your belt or waist. This device contains your insulin. It pumps insulin into a very thin soft tube (a catheter). The catheter carries insulin from the pump to a "connector" on the skin of your abdomen. The connector is made of an adhesive pad that sticks to your skin. The connector also has a short narrow tube called a cannula.

Each time you attach a connector to your body, a spring-loaded needle punctures your skin and pushes the end of the cannula under your skin. After the connector is attached, the needle is removed.

For most pump kits, the connector needs to be changed once every three days. Removing the connector is no more painful than removing a bandage. Many people choose to remove the pump before intimacy or sexual intercourse. The connector can stay in place for showers or swimming. (The pump cannot. So when you do something that requires you to take your pump off, it's best to reconnect it within an hour.)

An insulin pump does not monitor your blood sugar. You still need to test your blood sugar to know whether your insulin dose is correct.

The pump sends a steady slow stream of insulin to your skin. It can also send a dose before meals with a touch of a button.

A pump usually helps a person with diabetes to stay in better control of blood sugar. It is easier than taking three or four insulin injections each day. And with the pump, there are fewer "highs" and "lows."

The pump can cause fewer problems when meals are delayed, compared with injections that need to be given well-ahead of mealtime.

Compared with injections, the costs of the pump and supplies are higher. It is possible for the catheter to become blocked or to leak. If this occurs, the sugar can increase sharply in a short amount of time.

Some people are self-conscious about wearing a pump.

It is a challenge for some people to adjust to sleeping with the pump. If you choose to take a break from the pump (for example, for a tropical vacation) then you will need to use insulin injections.

Mary Pickett, M.D., is an Associate professor at Oregon Health and Science University where she is a primary care doctor for adults. She is a Lecturer for Harvard Medical School and a Senior Medical Editor for Harvard Health Publications.

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Health - Ask the Harvard Experts: Pros and Cons of an Insulin Pump