Insulin Pump How-To
How does a pump work?
By Gary Scheiner, MS CDE
Insulin pumps are essentially electronic syringes that contain rapid-acting insulin. They include a display and buttons for programming the pump's computer. A sensitive delivery mechanism pushes insulin from the pump into your body by way of a length of plastic tube that is connected to an "infusion set".
Most infusion sets use a needle (about the size of an insulin syringe needle) to insert a small, flexible plastic tube into the layer of fat just under the skin, usually on the abdomen, buttocks, or hip. The needle is then removed and the infusion set is taped securely in place. A new infusion set is inserted every 2 to 3 days, depending on individual usage. Most Infusion sets feature a "disconnect" mechanism that allows the user to temporarily unhook the pump and tubing for situations like bathing, contact sports, and intimacy. One type of insulin pump, called a "patch pump," is placed directly on the skin, so there is no tube other than the infusion set. Patch pumps, as well as some traditional pumps, are programmed using a remote control.
Insulin pumps deliver rapid-acting insulin in two forms: basal and bolus. Basal insulin is a slow, steady flow of insulin that offsets the glucose produced by the liver. Basal insulin delivery can vary by time of day, and is intended to keep blood glucose levels steady between meals and during sleep. Bolus insulin is a quantity of insulin delivered in a rapid fashion at mealtimes and to bring elevated glucose levels down towards normal.
Today's pumps have built-in dosage calculators to aid in calculating bolus doses. All insulin pumps run multiple safety checks and have sensitive alarm systems. Insulin delivery is not usually affected by electro-magnetic fields, pressure changes, temperature extremes or physical impact (although the insulin contained in the pump can be harmed by extreme conditions). Because the pumps "lock up" and alarm in the event of any internal problem, there is virtually no chance of accidental insulin delivery.
Gary Scheiner is the 2014 AADE Diabetes Educator of the Year and author of "Think Like A Pancreas". He has had type-1 diabetes since 1985, and offers diabetes management consulting services worldwide via his website, www.integrateddiabetes.com.
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