18 9 11
We have watched our grandson brave a minimum of 4 insulin injections a day for the past year to manage his type 1 diabetes.
Insulin pumps are becoming more popular but they are rather complex devices.
If you are contemplating using a pump it is imperative to fully understand how to use the pump and how to troubleshoot should something malfunction.
Not knowing how to properly use the pump or not knowing what to do if it fails you could be at serious risk of complications.
For this reason, we will take a closer look at insulin pumps and learn all we can.
How Insulin Pumps Work
An insulin pump is worn externally and delivers a continuous dose of fast-acting insulin 24 hours a day.
The main components of an insulin pump are:
- the pump that delivers insulin to the body
- a cartridge where the insulin is stored
- an infusion set, a small tube that connects the pump to the cannula inserted just under the skin to deliver the insulin
You place the cartridge in the pump, insert the cannula which is held in place by a sticky patch ( should be replaced after 24-72 hours). The cannula is connected to the pump with a short tube. The pump is then programmed to deliver the appropriate dosage continuously.
There are two types of insulin delivered by the pump:
- Basal insulin dosage is delivered continuously stabilizing blood glucose levels between meals and overnight
- Bolis insulin doses are delivered by the push of a button after meals and whenever a correction dose is required to treat a ‘high’
An insulin pump can be worn in different locations on the body and can be attached to a waistband, tucked into a bra, placed in a pocket, at night laid by your side. It should be removed for swimming or bathing.
Always work with your doctor when considering the use of an insulin pump. Your diabetes management team will be able to assist you in making the best choice for you.
Is an Insulin Pump Right for Me or My Child
Some children and adults find an insulin pump beneficial.
It is not a requirement to have perfect diabetes control.
Many people (children included) can significantly improve their blood sugar control once they switch to using a pump.
Consider a pump if:
- attend regular doctor appointments
- are knowledgeable about diabetes
- feel confident with carb counting
- are prepared to do at least 8 – 9 blood sugar checks per day
- pay attention to detail
- have strong decision-making and problem-solving skills
Are you considering using an insulin pump?
If you believe an insulin pump may be beneficial to you and/or your child, speak with your health care team.
They will assist you in determining if a pump is right for you and also which one.
Before deciding whether to use a pump, let’s consider both the benefits and disadvantages of insulin pumps.
Benefits of an Insulin Pump
The use of the insulin pump has increased due to its many benefits.
- Insulin levels can be adjusted more precisely. They allow you to more closely resemble the way the body naturally delivers insulin
- pumps can help achieve lower Hba1c levels with fewer fluctuations. This results in a lower risk of hypoglycemia and hyperglycemia events
- it is only 1 needle prick every 3 days instead of a minimum of 4 needles pricks per day ( that sounds better, what do you think?)
- after the initial learning how to use the pump it offers more freedom with eating, exercising, and sleeping
- improved blood sugar control means a lower risk of complications in the future
Disadvantages of an Insulin Pump
When considering an insulin pump it is important to also look at the disadvantages before making a decision.
- The pump only delivers fast-acting insulin so in the event of a mechanical failure there is nothing to fall back on. this increases the risk of blood glucose and ketone levels increasing rapidly
- maybe difficult for children to have the help or support they need at school to trouble-shoot a problem
- insulin pumps are very expensive and not all insurance covers them
- Some find it too noticeable or in the way when they want to be active and they find it is a constant reminder that they have diabetes
- The needle is larger than a typical syringe or pen needle and may hurt more
The use of an insulin pump is only as good as the person using it. You need to be disciplined enough to do more frequent blood glucose and ketone checks. You also need to be capable of troubleshooting if a problem should arise.
Concerns of Insulin Pumps and Children
Babies and Toddlers may be a good candidate for a pump because they are constantly with a caregiver who can monitor for any problems and address them immediately.
The pumps have a ‘lockout’ feature which will prevent the infant from pushing buttons and changing the settings.
School-age children may be unable to check their blood sugar, count carbs, and administer bolus doses correctly if they are quite young.
Parents may be unavailable and the school may have limited resources to aid the child.
Many families manage to find a way for the child to receive the support and assistance they require.
Our daughter worked at the school as a TA which meant she was available to manage her son’s diabetes care although he does not use a pump yet. He is only 5-years-old and would not be able to troubleshoot or calculate bolus insulin at lunchtime. Our daughter won’t always be working in the same school he attends.
Pre-teens and teens may be physically more able to assume their diabetes care but are they emotionally ready to take over.
We all know children mature at different rates so while one child may be able to assume responsibility at 10 -12 others maybe not until 17 -18.
You know your child and what they are capable of. Start with little things and gradually build on them until they can successfully manage their diabetes.
Diabetes management is complicated and there are constantly changing variables so don’t rush them. Remember they will have to do this for the rest of their life so don’t rush them.
Because the pump only provides rapid-acting insulin, blood sugar and ketones can rise very quickly if something goes wrong. It is important to check blood sugar frequently and address any problems quickly.
When using an insulin pump, it is important to always carry:
- a blood sugar meter
- blood sugar test strips
- ketone test strips
- an insulin pen loaded with rapid-acting insulin, in case of pump failure
- an extra infusion set
- an extra insulin vial.
The most important factor for a child’s successful use of an insulin pump is strong family support. The parent and the child must be committed to making the pump work.
Keep in mind the pump is a mechanical device and it can break down. Possible problems could be:
- low batteries (pumps do have an alarm to alert you when batteries are low or the tube is clogged)
- a mechanical problem with the pump
- a break, kink, or clog in the tubing
- insulin may freeze in the tube in cold weather
- the cannula may slip out of the site
- inflammation or infection at the insertion site making the delivery of insulin difficult
- failure to be alerted about a low reservoir or cartridge
If the pump malfunctions, Diabetic Ketoacidosis can occur quite quickly. To rule out any other reason why your child may be ill, check to see if the pump is working properly.
- Check the bolus history to determine whether the last dose was missed. If the last bolus was missed give a correction bolus
- check the tubing for air bubbles. If you find bubbles follow the step-by-step commands on your pump
- check the infusion site for leakage or a dislodged cannula. If you find a problem insert a new infusion site and give a correction bolus
Insulin pumps are very expensive, about $7,000. You then need to add another $1500 – $3000 per year for supplies( insulin cartridges, infusion kit(cannulas and tubes), adhesive patches, and batteries).
Each province also offers its financial assistance to those living with diabetes.
What is a Diabetic Insulin Pump is not something we think about unless we or a family member has type 1 diabetes.
It is a method of delivering insulin to the body 24 hours a day.
For some diabetics, it is a great alternative to requiring several needles a day.
There are advantages:
- more precise insulin dosage resembling how the body naturally delivers insulin
- can help achieve lower A1c levels
- fewer needle pricks as the cannula only need replacing once every three days
- offers more freedom while eating, exercising, or sleeping
- lower risk of diabetes-related complications later because of consistently lower blood glucose levels
Naturally, there are also disadvantages:
- only delivers fast-acting insulin so there is no fall back in case of mechanical failure
- children may not have the necessary assistance at school to troubleshoot any problems
- not covered by all insurance plans and are very expensive
- need to find a place to wear it, some think it is too obvious
- the needle is larger than syringes so may hurt more at the time of insertion
The decision to use an insulin pump or not is a decision that must not be taken lightly.
It will require diligence to ensure it is working properly and of course, you still have to count your carbs to calculate your bolus dosage at each meal.
If you think you may be interested in an insulin pump, speak to your doctor about whether it may be a viable option for you.
Our daughter and our grandson’s diabetes care team concluded that the pump is not the best option for him at this time.
Naturally, as he grows and matures they will revisit that possibility, he is only 5 after all.
Be sure to check out the assistance offered by each province to see if you qualify for assistance with the high cost of diabetes management.
“I am not in any way a medical practitioner, please do not rely on the information on our website as an alternative to medical advice from your doctor or another healthcare provider. We only share our experiences.”
How do you manage your type 1 diabetes?
Do you use an insulin pump?
I look forward to reading about your experiences in the comment section below.
18 9 11