What Are the Advantages and Disadvantages of an Insulin Pump

What are the Advantages and Disadvantages of an Insulin Pump?

An insulin pump is a small, computerized device that delivers insulin continuously throughout the day. It attempts to mimic the normal pancreas’s release of insulin, but you must tell the pump how much insulin to deliver. A pump delivers some insulin all the time – the basal rate. This is programmed to keep the blood glucose stable between meals and overnight and replaces the need for Lantus or Levemir. A pump delivers some insulin as needed to “COVER” food and high blood sugars – the bolus dose– according to the blood glucose and carbs the patient enters into the pump. The bolus is calculated based upon the total carbohydrates to be eaten and the current blood sugar, and is adjusted for activity level and proper doses of insulin given.

Effective and safe use of the pump requires:

▪Commitment to checking blood sugars at least 4-6 times every day

▪Ability and willingness to count carbohydrates

▪Understanding of insulin dose adjustment based on blood sugar level, carb intake and exercise

▪Child and parental honesty

▪Reasonable Hgb A1C (under 10%) – but not necessarily in great control

▪Basic understanding of diabetes, hypoglycemia, hyperglycemia and problem solving

▪Good communicationwith your diabetes team

The main advantages of pump therapy are:

▪Increased flexibility

▪Precise insulin delivery in smaller amounts (0.025 units minimum)

▪Reduced blood sugar variability

▪Helps manage overnight and early morning blood sugar variation

▪Easier to handle sick days

▪More options for exercise management

The main disadvantages of pump therapy are:

▪Risk of diabetic ketoacidosis (DKA) from pump or site malfunction

▪Risk of skin infection

▪Cost – pumps are expensive (insurance coverage varies by plan)

▪Need to give insulin for every carb – NO free snacks

▪Having a visible medical device (NOTE: It is important for others to know you have a medical device in case of an emergency situation.)

Questions to ask yourself regarding pump therapy:

▪Are you ready for a pump?

▪Are you ready to be attached to a device 24 hours a day for insulin delivery?

▪Do you have realistic expectations (the pump is not magic)?

▪Are you comfortable with the technology?

▪Are you committed to testing blood sugar 4-6 times daily, counting all your carbs, bolusing and communication with your Diabetes Team on a regular basis?

The Diabetes Team at Children’s Hospital of Michigan reserves the right to discontinue insulin pump therapy if diabetes control worsens or unsafe use of the pump occurs.

Web sites to check out: and

Created on 11/1/2010 2:08:00 PM