Lesson 2 - The Insulin Pump

While they do help make life a little more "livable" for diabetes patients, insulin pumps are far from flawless. However, when handled thoroughly and correctly, these pumps can offer additional comfort and convenience in maintaining optimal insulin levels.

• Not only do insulin pumps allow exact doses of insulin to be delivered automatically throughout the day, they can also be programmed to vary the rate of infusion for different times.
• Since only one type of insulin is used, it is easier to predict or foresee any complications or conditions that may arise.
• Most pumps have dosage limits to prevent accidental overdose (usually a one- or two-day supply of insulin at any given time).
• Convenience and discreetness (especially for those with irregular eating and exercise patterns).
• The pump can withstand substantial abuse (dropping it, submerging it in water) without malfunction (although you probably wouldn't want to leave it submerged overnight in a hot tub).
• The pump may be removed temporarily, usually for one to two hours, for such everyday activities as swimming, showering, or being intimate (although the pump should be worn at all times). It is recommended that the pump be temporarily removed during any physical activities that can lower blood glucose levels, including dancing or lovemaking.
• The pump's computerized mechanism requires a minimum amount of attention. On average, a single insulin pump can be effective for at least five to eight years (the batteries need to be replaced every eight to ten weeks, and a new cannula needs to be reintroduced under the skin only once every two to three days). To keep it free of dirt and moisture, the outer covering should be periodically cleaned with a damp and soapy cloth.
• Comes in a wide assortment of colors (the kids LOVE this one).

• Because the pump is mostly mechanized, eventual breakdowns are possible. Most mechanisms have a "fail safe" warning signal that will go off in the event of a malfunction or clog, and will not distribute any further insulin until the problem has been addressed. Unfortunately, the pump will not alert the user to a slow flow of insulin, meaning the diabetic will still have to monitor his or her blood glucose levels daily.
• Some patients may find the mechanism restrictive or embarrassing, especially younger children who may be teased at school. (Click here to see how four teenage girls turned their diabetes into a beneficial singing career in "Pump n' Roll: A New Spin on Diabetes.")
• Although rare, some patients can develop infections, irritation, or swelling at the point of insertion; usually this can be easily corrected by keeping the area clean and sterile, changing the area of insertion every few days, or choosing a different type of needle or tube (a physician can also suggest an alternate area of entry). Be sure that the new insertion areas are at least one to two inches away from the last point of insertion, and be sure to avoid scar tissue or moles.
• If the cannula is cracked, bent, or twisted, it can interfere with the flow of insulin into the body; left unattended, this may escalate into a more severe health concern (like hypoglycemia).
• Also, since insulin levels must be carefully and exactly measured and programmed into the pump, it is IMPERATIVE that anyone using the pump check his/her blood glucose levels at least five to six times a day. Many patients believe that the pump is insulin "cruise control;" actually, having a pump is a larger responsibility than simply remembering to take your insulin shots!

For one diabetic's personal story about getting used to being "wired" 24 hours a day, seven days a week, click here for a look at "Diary: A Week with the Pump."

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