Insulin Pump for Diabetes

The insulin pump allows people with diabetes to replace the multiple needle sticks used to deliver insulin and control blood sugars, with technology that more closely replicates how the pancreas works.

An insulin pump is a wearable device that delivers insulin without the need for repeated needle injections.

There are two types of insulin pumps, tubed (tethered) and tubeless (patch).

The tubed insulin pump is a small box, less than the size of a deck of cards, that attaches to a cannula (or tube) underneath the skin. The pump is programmable and refillable. It delivers insulin continuously in small amounts to help control blood sugars. The pump can be kept in a pocket or attached to clothing.

The tubeless patch delivers insulin through a cannula just like the tubed pump, but it is a single pod that attaches directly to the skin. The unit is controlled by a handheld remote.

The insulin pump allows people with diabetes to replace the multiple needle sticks used to deliver insulin and control blood sugars, with technology that more closely replicates how the pancreas works. Small doses of insulin are dripped in continuously (the basal rate), with a bolus dose released before meals to control the expected rise in the blood glucose.

The pumps can be paired with a continuous glucose monitor (CGM), to help customize the amount of insulin needed based on the patient’s blood sugar level in real time.

The tubed insulin pump is a plastic/metal box that has a screen to allow the user to program how much insulin to deliver. Depending upon the model, it has a reservoir that can be refilled with short acting insulin, or a replaceable insulin cartridge. There is also a replaceable or rechargeable battery. The pump is connected through a thin plastic tube to a cannula inserted underneath the skin with an infusion set. The patient uses a small needle to place the cannula under the skin, usually on the abdomen. The pump itself can be kept in a pocket, or attached to a piece of clothing such as a belt loop or bra strap.

The pump is used for continuous insulin delivery. The amount of insulin is programmed and is administered at a constant rate (basal rate). The amount of insulin needed over the course of 24 hours may vary depending on factors like exercise, activity level, and sleep.

The insulin pump also allows the user to program many different basal rates to allow for variation in lifestyle. In addition, the user can program the pump to deliver a bolus (large dose of insulin) during meals to cover the excess demands of carbohydrate ingestion.

The tubing can be disconnected from the pump while showering or swimming. There are some pumps that are waterproof.

Usually, the pump can hold enough insulin for 2-3 days.

The cannula under the skin, and the tubing connecting to the pump are replaced every 2-3 days.

The tubeless (patch) insulin pump is a single use pod containing the insulin reservoir and cannula. It attaches to the skin with an adhesive. Once attached, there is a button that activates a needle to insert the cannula under the skin (the needle retracts automatically once the cannula is in place).

This patch is worn continuously, and like the tubed pump, delivers continuous insulin at a basal and is also able to deliver bolus doses. However, there is no screen and all programming is done on a remote control.

The patch lasts 2-3 days depending up on how much insulin is required on a daily basis and the whole unit is changed out.

The patch unit is waterproof.

Depending on the device and manufacturer, insulin pumps and CGM can be linked to apps on a mobile phone.

The cannula of the tubed insulin pump is often placed in the abdominal wall. The flexible tube is long enough so that the pump can be kept in a variety of places on a person’s clothing.

The patch pump is a self-enclosed unit and can be attached to a variety of places on the body, including the upper arm, abdomen, buttock, hip, and thigh.

Do you wear it all the time?

An insulin pump is meant to be worn all the time to mimic the way a pancreas would work in delivering a continuous small dose of insulin.

The tubed insulin pump is often not waterproof and needs to be removed for swimming, showering, and bathing.

The patch pump is waterproof and can be worn all the time.

Can you wear it on your arm?

The upper arm is an acceptable place to attached the patch insulin pump.

Insulin pumps are a routine option for people with type 1 diabetes, both adults and children. Patients with type 2 diabetes may also benefit. Insulin pumps allow for better blood sugar control and lifestyle flexibility while minimizing the effects of low blood sugar (hypoglycemia).

An insulin pump used in association with CGM can closely mimic the physiologic function of the body when it comes to blood sugar control, and perhaps decreasing the short- and long-term complications of diabetes.

Most people who have type 1 diabetes will gain benefit by using an insulin pump. It is especially useful for adults and children who maintain an active lifestyle, patients who have frequent episodes of hypoglycemia (low blood sugar), patients who have slow stomach emptying (gastroparesis), and women who are anticipating pregnancy.

Some people may have difficulty with wearing a pump.

It requires some manual dexterity to fill the pump reservoir and to use the programming buttons.

People with poor vison may not be able to see well enough to accurately program and use it.

Some people may have a difficult time keeping the pump attached to the skin.

What is the price of an insulin pump? How much does it cost?

Insulin pumps and the infusion sets require a prescription from a health care provider.

There are many insulin pump models. Prices may range from $4,500 to $6,500. Medicare, Medicaid, and private insurance plans may pay for part, or all, of the cost.

Infusion sets (the cannula, flexible tubing and other supplies) cost about $100-$125 per month.

In addition, there is the cost of the insulin required.