What is an insulin pump?
The insulin pump is a device for continuous
insulin delivery. An insulin pump is composed of a pump reservoir similar to that of an insulin cartridge, a battery-operated pump, and a computer chip that allows the user to control the exact amount of insulin being delivered.
How big is an insulin pump?
Currently, pumps on the market are about the size of a standard communications beeper.
How does an insulin pump work?
The typical insulin pump is
attached to a thin plastic tube (an infusion set) that has a soft cannula (or plastic
needle) at the end through which insulin passes. This cannula is inserted under
the skin, usually on the abdomen. The cannula is changed every two days. The
tubing can be disconnected from the pump while showering or swimming. The pump
is used for continuous insulin delivery, 24 hours a day. The amount of insulin
is programmed and is administered at a constant rate (basal rate). Often, the
amount of insulin needed over the course of 24 hours varies depending on factors
like exercise, activity level, and
sleep.
The insulin pump 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.
How common is an insulin pump?
Hundreds of thousands of
people with diabetes worldwide are using an insulin pump. Although insulin pumps were first used by people with type 1 diabetes, people with type 2 diabetes sometime use them as well. Many
children successfully use insulin pumps. Insulin pumps allow for tight blood sugar control and lifestyle flexibility while minimizing the effects of low blood sugar (hypoglycemia). Newer models of the pump have been developed that do not require a tubing, in fact – the insulin delivery device is placed directly on the skin and any adjustments needed for insulin delivery are made through a PDA like device that must be kept within a 6 foot range of the insulin delivery device, and can be worn in a pocket, kept in a purse, or on a tabletop when working.
Probably the most exciting innovation in pump technology is the ability to use the pump in tandem with newer glucose sensing technology, known as an
"artificial pancreas," that administers insulin based on actual glucose levels as determined by the glucose sensor. The first such device was approved by the US Food and Drug Administration (FDA) in September 2013. Manufactured by Medtronic, the device is approved for use in people with diabetes who are 16 years of age or older. With the new device, insulin delivery is halted if a pre-programmed glucose level threshold is met. In a recent study conducted on 95 patients in Australia, the use of sensor-augmented insulin pump therapy with automated insulin suspension reduced the rate of hypoglycemia in patients with type 1 diabetes. Further studies of this coupled
"closed-loop" technology (continuously sensing and responding to the body’s needs) are ongoing.