Lesson 2 - The Insulin Pump

An insulin pump is a wallet -sized machine that is usually worn on a belt or in a pocket. With the help of a computer chip inside, the pump continuously dispenses predetermined amounts of insulin to the patient through a plastic tube (known as a cannula) attached to a needle or plastic rod inserted underneath the skin. This method of insulin delivery is known as continuous subcutaneous insulin infusion (CSII).

The ideal area for insertion is into the abdominal wall (which has the highest and most consistent rate of insulin absorption on the body) or directly into a vein on the arm or thigh.

These pumps use either lispro or phosphate-buffered insulin, which are less likely to clog the pump.

Weighing usually less than four ounces, the pump is designed to dispense insulin in two different delivery patterns--via (1) the Basal dose and (2) the Bolus dose.

• The Basal dose (which can be adjusted from 0.1 to 10 units per hour) delivers a continuous dose of insulin throughout the day, simulating the body's natural flow of insulin from the pancreas.
• The Bolus dose is an additional, slightly higher dose of insulin that is released before eating a carbohydrate-rich meal (as blood glucose levels rise as the meal digests). This exact dosage of extra insulin is determined by approximating the amount of carbohydrates you will consume as you sit down to dine, and should be reviewed and finalized by your physician or diabetes educator. (For more information on counting carbohydrates in association with blood glucose maintenance, click here for Lesson 1 - "Carbohydrate Counting.")

The average daily Basal dose is usually between 40 to 50 percent of your total daily insulin dose, while the Bolus doses constitute the remaining 50 to 60 percent. Your physician should help you calculate target Basal and Bolus doses before using the pump.

The main purpose of the pump is to provide patients with perfectly measured insulin doses on a predetermined schedule, eliminating the inconvenience, hassle, or, as some feel, embarrassment associated with taking insulin injections throughout the day.

To get a better idea of how an insulin pump does its job, click here for a short instructional video entitled "Peek at the Pump."

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