Insulin Pump Cost
What are the drawbacks?
By Gary Scheiner, MS CDE
Making an educated decision about pump therapy means that you should be aware of the potential drawbacks associated with its use.
- Cost — Insulin pumps and disposable pump supplies (infusion sets, cartridges, batteries) cost far more than conventional syringes. However, insurance companies have come to realize that insulin pump use can result in fewer health problems. As a result, most insurance companies now cover most or all of the cost of pumps and supplies.
- Adjustment Period — Just as it took some time to get your blood sugars regulated when you first started on insulin injections, it will take some time to get regulated on the pump. Expect at least a few weeks of "ups and downs" as you and your health team work together to establish proper basal rates and bolus formulas.
- Inconvenience — While insulin pump therapy does allow greater lifestyle flexibility, wearing the pump around the clock can be inconvenient at times. The pump must be worn while you sleep, work, and play in order to provide a continuous flow of insulin. However, the "beeper-like" size of the pump, availability of convenient clips and carry-cases, extra strong/durable tubing (difficult to damage or pull out), and "quick disconnect" mechanism make wearing the pump easier than it might seem.
- Technical Difficulties — As with any mechanical device, there are bound to be technical problems from time to time. Although today's pumps are far more safe and efficient than in years past, there remains the possibility of occasional infusion set clogs, computer chip glitches, and damage due to typical wear and tear. Luckily, new durable materials, warning alarms, and safety features minimize these types of problems and guarantee against accidental insulin delivery.
- Skin Problems — One of the most common problems associated with insulin pump use involves skin irritation. Today's infusion sets feature hypo-allergenic adhesives that truly minimize skin irritation, but those with very sensitive skin may still experience itching, rashes, or inflammation. A variety of alternative tapes are available for those who need them. Skin infections are another potential problem. Typically, skin infections will not occur as long as the skin is cleansed well prior to needle insertion and the infusion set is changed on a regular basis.
- Ketosis — Ketones are potentially harmful chemicals produced in large amounts when cells are not able to burn sugar for energy, usually due to an insufficiency of insulin. If not treated quickly, mild ketosis can become DKA (diabetic ketoacidosis), a life-threatening condition that requires emergency treatment at a hospital. Because there is no long-acting insulin with pump use, any interruption in insulin delivery (due to an infusion set problem, for example) for more than a few hours can lead to ketosis. For this reason, pump users must check their blood sugar level several times a day, and should test their urine for ketones with any abnormally high blood glucose readings or when sick. The presence of ketones in the blood or urine usually means that the pump is not delivering insulin properly. All insulin pump users should be trained on how to respond to ketosis in order to prevent DKA.
- Sports — Wearing an insulin pump during daily recreational activities can present a challenge. Some people feel uncomfortable or inhibited while wearing the pump and choose to simply disconnect for short intervals. Some even feel uncomfortable about having the small infusion set attached to their skin. The ability to quickly disconnect and re-connect has made pump use much more convenient, but issues of vanity, personal appearance, or the practicality of doing physical activities with a pump (like sliding into home base during a game of baseball) may still be a consideration.
Gary Scheiner is an author and CDE who has type 1 diabetes. He also offers his expertise and services via his website, www.integrateddiabetes.com.
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