Endocrine Research Society

An insulin pump is a small motorized, battery-powered device that delivers insulin through a small catheter inserted under the skin.

These devices can be programmed to deliver insulin at various rates throughout the day by slow continuous infusion (the basal rate) and in larger quantities over a short time in preparation for meals (bolus). The pump is worn continuously and the user must measure glucose values throughout the day to monitor the effect of the pump and to determine meal dosages; the pump does not do this automatically.

The safe operation of the pump requires education by a qualified pump instructor. This usually takes about 8 hours over a number of sessions. Therapy also requires education from a qualified dietitian to provide insights on the effects of food on insulin requirements, as well as carbohydrate counting. Pump therapy should be supervised by a medical practitioner, usually an endocrinologist with training and expertise in pump therapy.

Pump therapy has been shown to be superior to conventional therapy in the treatment of Type 1 diabetes. Studies have shown long-term benefit with this form of therapy. Some studies have also shown improvement in the ability to sense low glucose levels (hypoglycemic unawareness), greater flexibility in lifestyle and improved quality of life.

This is a personal decision. Your success with using an insulin pump depends on the following:

1. Motivation to improve your diabetes management

2. Being prepared to test your blood glucose frequently

3. Have had basic education with regards to diet

You need to recognize that the pump is not a cure, merely a device to help manage your diabetes better.

Yes! Insulin Pump Therapy (IPT) is a very technical way to deliver insulin physiologically. Pump trainers are superb at starting people on IPT but ongoing responsibility of IPT must rest with you and a health care provider with IPT experience, usually an endocrinologist.

Absolutely! All pumpers will need to continue to use their usual glucose meters. Most of these meters have software programs to allow useful interpretation of data that can be downloaded onto a computer.

Dexcom G6

Abbott Freestyle

Medtronic Sensors/Meters

Lifescan Onetouch

Acensia Contour

There are several brands available in Canada. The centre is familiar with all types of pumps and these are listed in alphabetical order.

Medtronic

Omnipod

Tandem

Carbohydrate counting is adding up the amount of carbohydrates in grams in your meal/snack to help you decide on an insulin dosage for that meal/snack. It also involves a method to adjust your blood glucose level to a healthy target. If you are not yet familiar with carbohydrate counting, a visit to your local diabetes centre may be helpful.

Is carbohydrate counting absolutely necessary? No, you can use other techniques to establish insulin dosages.