The Insulin Pump
Find out how pumps can make your diabetes life easier.
By Wil Dubois
This morning I took 2.14 units of insulin to cover my breakfast. Yes, you read that right: two-point-one-four units. Do I have the world's most accurate syringe and trifocals? Uhhh… well, "yes" to the trifocals; but "no" to the syringe.
I use an insulin pump: a marvel of modern technology that allows me to take incredibly precise and ridiculously small doses of insulin. I'll tell you all about how it works in a few minutes, but this accuracy is only a part of the benefit of "pumping." The real strength of insulin pumping is that pumps make life easier. Simpler. And simplified diabetes is always a good thing.
Pumps simplify diabetes by removing some of the grunt work of diabetes control. But let me be 100% clear about this: the pump replaces your pancreas, not your brain. It automates many of the day-to-day tasks of diabetes management, but it's NOT an automatic system. You still need to think about your diabetes, and make intelligent decisions about it.
Pumps are a shortcut, not a cure.
What is an insulin pump?
An insulin pump is nothing more than a fancy syringe. A syringe hot-wired to a computer. It's a cigarette pack-sized box with a supply of insulin which is attached to either a piston or a micro-pump to deliver the life-saving liquid from the box to your body.
While different pumps boast different fancy features, they are all designed to accomplish three basic tasks: to supply basal insulin, to give us insulin to "cover" meals, and to give us insulin to fix elevated blood sugar. That's it.
Let's talk about basal first, as this is the foundation of all insulin therapy. Basal insulin is the medicine that keeps our blood sugar in check between meals and overnight. If you take shots, you'll use either "N," Lantus, or Levemir for this job. But the pump does away with these extended-release insulins and instead covers your basal needs by constantly delivering a little bit of fast-acting insulin into your body. 24-7-365.
The benefit of this system is that you don't need to deliver that drip of insulin at the same rate all the time. You can vary it, creating what's called a basal pattern that better suits the needs of your body than the one-size-fits-all basal insulin shots. If you take a basal shot and have to snack at various times to keep from going low, you'll find this feature of pumps very liberating. You're no longer a slave to your medication — the pump is slave to your lifestyle.
Preset with the help of your medical team, this basal delivery is automatic. The pump takes care of it without any guidance from you. But this is the only thing the pump will do on its own.
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“No!” Charlie said forcefully. “I won’t do it!” Susanne and I stared at each other from the living room with “now what?” looks on our shocked faces. I broke the silence with this: “But Charlie, you said yesterday that you would put the sensor on today.” We waited for his response as if my words were a grenade that we rolled slowly into the kitchen. “No! My arms look terrible. I won’t do...