Insulin pump therapy refers to not only a different way of administering insulin, but also an important technological advance that benefits patients with type one diabetes. It involves administering insulin through a plastic tubing into the subcutaneous plane (just under the skin) from a port. The port has to be changed every three days.
The insulin pump has three essential components.
The insulin pump once it is programmed will pump the insulin from insulin reserve wire via a plastic tubing into the subcutaneous patch. The insulin pump has a sophisticated microchip within, which can record all details regarding insulin delivery and the same can be studied retrospectively.
Insulin pumps represent an important advance over subcutaneous insulin, due to the fact that one can give a variable basal rate of insulin. When we treat type 1 diabetes patients with subcutaneous insulin, we usually administer two different types of insulin ie. basal insulin & prandial insulin. Basal insulin is given either once or twice a day and is given to replace the normal small quantity of insulin that is always present in the body. Prandial insulin refers to the insulin that is given with every meal. Every patient with type 1 diabetes, will be getting a basal and prandial insulin usually. The disadvantage with basal insulin is that even with the best basal insulin,
we are able to administer only a fixed quantity of insulin into the bloodstream over a period of time and we are unable to vary this rate. In this context, an insulin pump is an advance over subcutaneous insulin therapy because we can program the insulin pump to administer a variable basal rate. For example if a patient requires 20 units of basal insulin throughout the day – we can administer 8 units per hour for a certain number of hours and one unit per hour for a certain number of hours in order to make it 24 hours. This key advance makes sure that the basal insulin administration rate is tailored to the basal insulin requirements of the patient.
Carefully done clinical trials have clearly shown that when used properly insulin pumps can improve glycaemic control i.e. the HbA1c over a period ranging from six months to several years along with reducing episodes of low sugar or hypoglycaemia in patients with type one diabetes. Even in the context of type2 diabetes, similar effects are observed but to smaller degrees. Several patients with type 2 diabetes who have had the disease for over 20 to 30 years become insulin-dependent, and patients with type one diabetes may be very good candidates for insulin pump therapy.
Insulin pumps will always use a rapid acting insulin analog in its razor wire. We cannot use basal insulin in the reserve wire because there will be a delay from the time the insulin is administered subcutaneously to the time it is absorbed defeating the purpose of the insulin pump. Even human regular insulin cannot be used in the reserve wire because with regular human insulin, there is a lack between injection and absorption times.
If you are on an insulin pump, you will be able to do all your day today activities including swimming, cycling, hiking etc.
Insulin pump therapy is recommended for all patients with type one diabetes or patients with type two diabetes who have had advanced diabetes and or require multiple daily injections.
We have over 100 patients cumulatively on insulin pump therapy across the Magna centres. At every centre, we do have a diabetes educator, a nurse and a pharmacist who is well-versed in insulin pump therapy and can sort out your problems if you are already on an insulin pump.