Advantages and Disadvantages of the Insulin Pump

What is an Insulin Pump?

An insulin pump is a small computerized device that delivers insulin throughout the day for the treatment of diabetes. It appears to mimic the pancreas but you still have to monitor your glucose level and give it instructions for the correct amount of insulin to be released.

It releases insulin in two ways: a basal rate where a small continuous quantity of insulin is released in between meals and overnight to keep a constant glucose level in the body and a bolus rate where much higher insulin is released before meals to control the glucose release from the food you plan to eat.

Advantages of Insulin Pumps:

• Fewer needle pricks: The pumps require a needle stick every 2-3 days in comparison to the multiple pricks in a single day from insulin injections.
• Precision: They allow accurate delivery of insulin to the 1/10^th that is beneficial to people sensitive to small doses, like children.
• Dose calculations: Pumps have a calculator that saves the user from the extra math by helping to determine the doses based on the carb intake, blood glucose levels and the amount of insulin still active from the previous doses.
• Flexibility, convenience, and spontaneity: They allow easy adjustments with buttons to either increase or decrease the bolus for accommodating the changes in daily life like dining out, sports, growth, and illness or managing the dawn phenomenon (drop in glucose levels at night time).
• Eliminates unpredictable effects of long-acting insulin-They use rapid-acting insulin that has an efficient action for a short duration instead of intermediate or slow acting insulin that take a while to reach their peak values and tend to accumulate under the skin which makes it difficult to predict the action of insulin.
• Reduced episodes of severe low blood sugar: By using rapid-acting insulin and allowing better control of released insulin during or before activities that tend to lower blood glucose, you have less risk of having a hypoglycemic attack.
• Pumps improve A1C scores.
• Less glucose variability (high to low or low high swings).
• Weight control
• Lower risk of complications.
• Better quality of life.
• Data analysis: Pumps store a plethora of information that can be used for analysis and treatment planning.

Disadvantages of Insulin Pumps

• Cost: Insulin pumps are more expensive than the syringes. Although most insurance plans cover insulin pump and supplies, there are often co-pays and deductibles to take care of. There is also a difficulty in getting approval from NHS to cover the costs of the insulin pumps.
• Steep learning curve: It takes a few days for the user to get used to changing infusion sets, getting the basal and bolus doses regulated and learning to avoid problems like bubbles.
• Complication: A higher risk of developing diabetic ketoacidosis if the pump malfunctions. This can happen if the battery is discharged, if the insulin is inactivated by heat exposure, if the reservoir runs out, if the tubing becomes loose there is a leak of insulin or the catheter is bent or kinked preventing delivery. Therefore, it is important for pump users to monitor their blood glucose levels frequently.
• Inconvenience: Since the pumps need to be worn all the time, it can become an issue during sleep, rough sports or doing activities like swimming. The tubing can also get caught on hooks.
• Skin problems: Users develop a scar tissue in the area where the cannula is inserted. These scar tissues do not heal easily and soon develop lower insulin sensitivity that requires the user to change spots. A patient may run out of viable spots to wear the pump. The user may also experience skin irritation in the area where the pump is inserted.
• Changing issues: Although the pump requires a change at every two-three days, the process is longer, more involved.
• Wastage: Many units of insulin can be wasted while refilling the reservoir or changing the infusion site. This can affect dosage information.

Sources:

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