Diabetes: Living With an Insulin Pump
Diabetes: Living With an Insulin Pump
How to live with an insulin pump
Choosing a pump
Some people say choosing which
pump to use is actually harder than deciding to switch to a pump in the first
place. There are a number of insulin pump companies, and each pump is slightly
Ask members of your diabetes team which pumps they
recommend. If you have insurance, find out which pump brands are covered. Then
ask those companies to send you information. Insulin pump companies also have
websites where you can get all kinds of information. Your diabetes educator
likely will have a variety of pumps that you can look at.
improvements in insulin pumps are happening so fast, your local hospital may
have open houses a few times a year so that pump makers can show their products
and tell you how they work.
Ask the company to send a sales
representative to your home. That way you can see each pump you are
considering, see how easy it is to program the pump, and learn how to give
yourself a bolus (extra insulin).
You should be able to try out
the pump with saline solution. That way you can really see how it works and
- How do I choose which insulin pump to buy?
Your infusion site
infusion site is the area on your body where you have attached your infusion
- Infusion sites can get infected, so it's
important to know how to place the catheter correctly and to keep the area
- Replace your infusion set every 2 or 3 days or as often as
your doctor advises. Insert a new infusion set at least
1 in. (2.5 cm) away from where
the last one was. Moving your infusion sites around may help your tissue absorb
insulin properly over the years. For example, you might trade off between your
belly, your hip, and your thigh.
- Scar tissue can make it hard for the pump to get the
insulin into your tissue. So it's best to keep the infusion set at least
1 in. (2.5 cm) away from your
belly button and any scars you may have.
- You can buy special skin preparations to help
your infusion set stick better to your skin, especially when you expect to
sweat a lot. These products can also help keep your skin from being irritated
by the infusion set's tape. If your skin is very sensitive, you can try paper
tape, such as Micropore.
- To help keep your set stuck to
your skin during sports or other sweaty activities, spray some antiperspirant
on the skin around your infusion site to help keep it drier. Your insulin pump
company may have other products you can buy to help your set stay in place.
- Don't wear your infusion set under a waistband or a
tight seam that might rub against the tape and loosen it.
- An infusion set may leave sticky adhesive behind on
your skin when you take it off. You can buy adhesive removers to remove the
- There are a number of companies that make infusion
sets. If you don't like one, try another.
Where to wear your pump
Hooking your pump on a waistband or carrying it in your pocket may be the
obvious choices, but when you don't have a waistband or a pocket, you have to
come up with other ideas.
If you wear your pump on a belt or
somewhere else in plain sight, you may get questions. Most people will just
think you're wearing a pager, especially if your tubing is out of sight. But if
the thought of having to answer questions about your diabetes bothers you,
there are lots of ways to keep your pump hidden. Just make sure you can get to
your pump easily when you eat or need to correct your blood sugar level.
Pump companies offer various holders that fit their pumps and allow you
to carry your pump on your thigh, your calf, or your arm. Clothing makers are
starting to make clothing especially for insulin pump users, with special
Here are some other ideas:
- Cut a small hole in a pocket to slip your
catheter through. That way your pocket contains only the pump, and your
catheter is out of the way.
- New lines of clothing for children and
teens include special pockets for MP3 players. The pockets are perfect for
insulin pumps, and they even have a hole you can slip your catheter
- Sew a baby sock into the inside of your clothing to hold
your pump in place.
- Wear trouser socks, and slip the pump inside
the top of one sock.
- If you wear your pump next to your skin, put it in a baby sock
first. That may make you more comfortable and may also help keep the sweat off
of the pump during sports.
- Wear a garter belt with thigh-high nylons, and tuck the pump into
the top of one of the nylons.
- Slip the pump into the top of
- Clip the pump into your bra, either between your breasts
or under your arm.
- Under a dress, wear a pair of biking shorts, and
clip your pump inside one of the legs.
Traveling with your pump
Planning ahead can help make your travels easier. Here are some
- Always carry a backup kit of extra pump
batteries, extra insulin (rapid-acting and long-acting), pump supplies, and an
insulin syringe or pen for emergencies. That way you will never have to worry
if something goes wrong with your pump.
- If you're flying, pack your
backup supplies in your carry-on bag, not your checked
- Stay up to date with airport security rules, and follow
- When you get ready to go through security,
tell the security officer that you have diabetes and are carrying diabetes
supplies with you.
- People going through security screening with
insulin pumps must also have insulin with them. And the insulin must be clearly
- Pump manufacturers say that airport metal detectors won't
damage your pump. But if you're worried, tell the officer that you are wearing
an insulin pump and would like a pat-down and visual exam instead of going
through the detector. Explain that the pump cannot be removed because it is
inserted into your skin.
- Carry prescriptions for all your medicines and
supplies. If you are traveling out of the country, ask your doctor to use
generic names. And it's a good idea to carry a letter from your doctor that
states that you use an insulin pump. That way there is no question that it is a
piece of equipment that you need to have with you.
- When you travel
into a different time zone, don't forget to change the clock on your
Sports and exercise
- You can disconnect your pump during sports.
Usually this should not be any longer than an hour, but you will have to
experiment. Check your blood sugar before, during, and after the activity so
you can figure out what's best. Some people give themselves a bolus with a
small snack before they disconnect for longer periods of time.
- If you keep your pump
connected, you may need to lower your basal rate during the activity. Again,
experiment to find out what works best for you. After you figure it out, you
can program your pump to give you the right amount of insulin every time you do
- Some people keep their pumps connected when they go swimming, but
most pumps are not waterproof. You may be able to put yours into a waterproof
case. Talk to your diabetes team about swimming with your pump.
you need to disconnect your pump for sports:
- You will need to give yourself a bolus to
cover the basal rate you will miss while you're disconnected. Talk to your
doctor about whether to do this before disconnecting. Some people will be able
to wait an hour before giving themselves a bolus.
- Don't stop your
pump while it is in the middle of delivering a bolus.
- Check your
blood glucose before you disconnect.
- Don't go longer than 1 to 2
hours without any insulin.
- Every time you eat, you need to tell your pump
to deliver a bolus to cover the amount of carbohydrate in your
- Your diabetes team will help you figure out your bolus doses.
Some pumps have calculators that make this easier.
- Using an insulin
pump lets you eat what you want when you want. So you can eat more carbohydrate
and still keep your blood sugar at the right level. But this can lead to weight
gain. Stay at a
healthy weight by avoiding high-calorie, high-fat
For more information, see the topic Weight Management.
Dealing with problems
Low blood sugar
- Most people with diabetes can sense a drop
in their blood sugar level. But they often lose this ability after they have
had diabetes for a long time. Also, people whose blood sugar levels don't vary
much may not be able to sense low blood sugar. So it's very important to check
your blood sugar often.
- If you get low blood sugar even though you
check it often, deal with it just as you would if you were giving yourself
shots—by eating some emergency glucose or drinking juice.
- With a
pump, you can slow down or stop your insulin for up to an hour until your blood
sugar comes back up. Talk with your diabetes team about low blood sugar so that
you are prepared when it happens.
- A new type of glucose monitor,
called a continuous glucose monitor, is a device you can wear like an insulin
pump. It measures your blood sugar level every 10 minutes or so and tells you
if your blood sugar is low.
High blood sugar
- Very high blood sugar and
diabetic ketoacidosis are life-threatening problems.
People with type 1 diabetes who use insulin pumps are more likely to get these
- Pumps use only rapid-acting insulin, so if something
goes wrong with the pump and you don't get enough insulin, your blood sugar may
rise. You can help prevent high blood sugar by checking your blood sugar often.
- Check your infusion set and your pump
often. Sometimes the catheter gets a clog or a kink in it, falls out, or gets
pulled out. Most pumps have an alarm that will tell you if your catheter is
blocked. But if it simply pulls out of your skin, you may not know it until you
have symptoms of high blood sugar.
- When you get sick,
follow the guidelines your diabetes team gives you for
adjusting your insulin.
- Talk with your diabetes team about high
blood sugar so that you are prepared for it when it happens.
- Most insulin pumps can resist water but are not
waterproof, so you need to disconnect them to go swimming or take a shower or
bath. You can buy special cases that will protect your pump in the shower.
- Sleeping with your pump should not be a problem.
- If you wear pajamas, you can clip your pump
to your nightshirt or pajama bottoms. There is no need to worry about
accidentally rolling onto your pump and changing your insulin dose. This is
very hard to do.
- The tubing should be long enough that you can
clip the pump to your headboard or to the side of your bed while you sleep. Or
set it on your nightstand. Some people just set the pump next to them while
- You will need to test your blood sugar often. The number of times that you test may change every day, depending on when you eat, what you do, and how you feel. For example, you may need to test your blood sugar 5 times one day and 10 times the next day.
- Get into the habit of keeping good records. Record
your blood glucose results, your carbohydrate intake, every change in
your insulin doses, and all of your exercise. Having records that you can look
back on helps you see patterns and is very important for controlling or
improving your blood sugar. Many pumps have features that keep your insulin
dose records for you so that you can upload them to a computer. Some newer
pumps can "talk" to glucose monitors and save both your insulin-dose
information and your blood sugar levels over several days.
Test Your Knowledge
Even with an insulin pump, you'll still have to check
your blood sugar often.
Continue to Where to go from here
Return to Diabetes: Living With an Insulin Pump
E. Gregory Thompson, MD - Internal Medicine
Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism
September 20, 2012
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