Diabetes: Should I get an insulin pump? - Quest Diagnostics Patient Health Library

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the facts

Your options

Get an insulin pump.
Keep doing insulin injections.

Key points to remember

An insulin pump can free you from a strict regimen of meals, sleep, and exercise, because you can program it to match your changing schedule.
It's important that you be prepared to take on the responsibilities involved in using an insulin pump. Using and caring for a pump takes time and effort.
After you learn how to work with a pump, it can make living with diabetes easier. But it takes some time and effort to learn how to use the pump to keep it working properly and to control your diabetes.
Using a pump includes checking your blood sugar 4 or more times a day and carefully counting the grams of carbohydrate that you eat.
If you give yourself shots 2 times a day or less, having a pump may help you keep your blood sugar closer to normal. If you are already giving yourself shots 3 or more times a day, a pump may not improve your control, or it may improve your control only slightly.
Using an insulin pump can keep your blood sugar at a more constant level so that you don't have as many big swings in your levels. People who use pumps have fewer problems with very low blood sugar.
Insulin pumps cost as much as $6,000. Many insurance companies cover the cost of insulin pumps, but they have strict guidelines that you will have to follow before they will pay.

FAQs

What is an insulin pump?

An insulin pump constantly gives you a small amount of insulin, called a "basal rate," throughout the day and night to help control your blood sugar. When you need extra insulin to cover a meal or to correct high blood sugar, you tell the pump to give you a small dose of rapid-acting insulin.

You wear the insulin pump , which is about the size of a deck of cards, clipped to a belt or somewhere in your clothing. Plastic tubing connects the pump to a catheter just under your skin. The catheter is a tiny plastic tube that you insert into your skin using a special needle. You have to change the catheter every 2 or 3 days.

A pump does not work by itself. You have to program it. It will not measure your blood sugar, so you will still have to do that. It will not deliver extra rapid-acting insulin unless you tell it to. For example, if you figure out that you need an extra 5 units of insulin to cover a meal, you have to punch in that number on the pump.

You can disconnect the pump from the catheter site for brief periods when you want to go swimming or take a shower.

What are the benefits of using an insulin pump?

With a pump, you can plan your insulin around your life instead of planning your life around your insulin shots. Your basal rate is set and runs automatically. If you decide to stay out late, skip a meal, or work at a job with changing shifts, you can adjust your insulin at the push of a button.
Instead of giving yourself shots several times a day, you only need to insert a catheter needle once every 2 or 3 days.
With a pump, you don't have to stop what you're doing and pull out a syringe or an insulin pen to give yourself insulin. You just push a button to give yourself the right dose.
A pump may help you keep your blood sugar closer to normal. People who use a pump have fewer big swings in their blood sugar levels.
Pumps work well for people who can't find an insulin dose that keeps blood sugar under control without also causing low blood sugar.

What are the drawbacks of using an insulin pump?

You may have to stay in the hospital, or spend a whole day at a clinic, while you learn how to use your pump.
Setting your basal rates for the first time may take a few days. You may have to skip a few meals and check your sugar levels extra often while you get used to the pump.
People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. So you will need to check your blood sugar often, at least 4 times a day, when you use an insulin pump.
If you are not good at counting your carbohydrate grams, an insulin pump may not help you control your diabetes.
Infection at the area where the catheter goes into the skin is the most common problem with insulin pumps. It is one of the most common reasons why people stop using pumps.¹ So it's important to take good care of the site and change the catheter on schedule.
The pump could stop working without your noticing. A pump has an alarm system to tell you when something is wrong with insulin delivery or if the pump's battery is getting low. But the alarm system will not tell you if the catheter is bent or has pulled out, so it's important to check the site often.
Diabetic ketoacidosis (DKA), a life-threatening condition, may happen more often and more quickly with an insulin pump than with injections.² Your blood sugar could get too high if something goes wrong with the catheter or pump without your noticing. Most studies show that this is usually not a problem with training and practice.³
Insulin pumps cost as much as $6,000. Many insurance companies will pay for insulin pumps, but they have strict guidelines that you will have to follow before they will pay.

Why might your doctor recommend an insulin pump?

Your doctor might encourage you to get an insulin pump if:

You have big swings in your blood sugar levels,
You cannot find an insulin dose that keeps your blood sugar under control without also causing low blood sugar.
Your eating and activity schedules change a lot, making it hard to schedule insulin shots.
You don't need more than 100 units of insulin each day.

2. Compare your options

	Using an insulin pump	Not using an insulin pump
What is usually involved?	Instead of giving yourself insulin shots every day, you insert a catheter every few days. The pump stays attached to you, through the catheter, 24 hours a day. You test your blood sugar often, and you carefully count carbs so that you can program the pump. Infusion sites can get infected, so it's important to know how to place the catheter correctly and to keep the area clean.	You keep giving yourself daily insulin shots to control your blood sugar.
What are the benefits?	People who use pumps have fewer big swings in their blood sugar levels. People who use pumps have fewer problems with very low blood sugar. For some people, pumps improve hemoglobin A1c levels.⁴	For some people, daily shots work well to control blood sugar. Daily insulin shots may work better than a pump for people who need more than 100 units of insulin a day.
What are the risks and side effects?	Using a pump may not improve blood-sugar control in people who are already giving themselves insulin shots 3 or more times a day. People who keep their sugar levels in a tight range—which a pump helps you to do—may be less able to sense when their blood sugar is low. Infections are common at the catheter site. The pump could stop working without your noticing.	Daily shots may not control your blood sugar as well as a pump would. People who use daily shots have more problems with very low blood sugar.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topic Type 1 Diabetes: Living With the Disease.

Personal stories about insulin pumps

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I got my insulin pump 3 years ago. I was pretty nervous about how well I'd be able to program my pump and take care of it. There was so much to learn! But I had a great team of people helping me, including my doctor, my dietitian, and even the manufacturer of my pump. Still, I almost gave up after 3 months because I was attached to the pump constantly. It was always there to remind me that I had diabetes, you know? But my doctor talked me into sticking with it a little longer. Now I would not want to go back. Before the pump, diabetes controlled my life. With the pump, I feel like I am now in control of my diabetes—and my life."

— Sally, age 50

" I was on an insulin pump for more than 2 years, and then I quit. I know most people just love their pumps, but I could not handle being attached to it all the time. For me, the hassle of constantly taking my blood sugar and figuring out how to program my doses wasn't worth it. Plus, I got a lot of infections at the catheter site. I went back to injections and feel happier with my life now."

— Abner, age 35

"I got my pump as a teenager, and I love it. But my parents had to work really hard to get the insurance company to pay for it. We had to keep detailed logs for months to show them what I ate, what my blood sugar was, and how much insulin I gave myself every day. I had to prove to them that I was willing and able to work hard to keep my blood sugar under control. After about 3 months, they agreed to cover my pump. I'm a police officer now, and having a pump makes it much easier to do my job."

— Jake, age 22

"I have several reasons for not wanting an insulin pump. I'm a pretty private person and I wouldn't want people to notice that I'm wearing a pump. Also, I play football and basketball almost year-round, and it's a big part of my life. I know you can safely disconnect the pump for an hour or so, but my games last longer than that. I just don't like the idea of being hooked up to a pump 24 hours a day."

— Xiang, age 29

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to get an insulin pump

Reasons not to get an insulin pump

I wish I didn't have to give myself insulin shots every day.

I am comfortable giving myself injections.

More important

Equally important

More important

I can live with being constantly attached to a pump.

I don't like the idea of having to stay attached to the pump.

More important

Equally important

More important

I feel ready to take on the responsibilities involved in using an insulin pump.

Using and caring for an insulin pump seems too complicated for me.

More important

Equally important

More important

I want a more flexible lifestyle than my current insulin shot schedule allows.

My schedule is the same every day, so it's not hard to schedule my shots.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Getting an insulin pump

NOT getting an insulin pump

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1. How can an insulin pump help me manage diabetes?

It will get rid of my need for insulin.
It can help me keep my blood sugar closer to normal.
It can cure my diabetes.
I'm not sure.

You're right. The most important part of managing diabetes is keeping your blood sugar as close to normal as possible. A pump may help you do that.

2. How hard will it be to learn to use an insulin pump?

It will be very easy.
It will take some time and effort.
It will take a lot of training, and it will probably be too hard for me.
I'm not sure.

Correct! Learning how to use and program your insulin pump takes time and effort, but most people find that it's worth it.

3. How will a pump affect keeping track of my blood sugar?

I won't have to worry about keeping track of my blood sugar anymore.
I will only have to prick my finger once a day to check my blood sugar.
I will have to prick my finger 4 or more times a day to check my blood sugar.
I'm not sure.

That's right. People who keep their sugar levels in a tight range may be less able to sense when their blood sugar is low. You will need to check your blood sugar often, at least 4 times a day, when you use an insulin pump.

4. How will a pump affect counting carbohydrate grams?

I will still have to count my carbs every time I eat.
An insulin pump can count my carbs for me.
A pump makes counting my carbs unnecessary.
I'm not sure.

Yes, it's true. You'll need to count your carbs every time you eat so you can tell the pump what to do at every meal and sometimes in between.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

Lenhard MJ, Reeves GD (2001). Continuous subcutaneous insulin infusion: A comprehensive review of insulin pump therapy. Archives of Internal Medicine, 161(19): 2293–2300.
American Diabetes Association (2004). Continuous subcutaneous insulin infusion. Position Statement 2004. Diabetes Care, 27(Suppl 1): S110.
Pickup J, Keen H (2002). Continuous subcutaneous insulin infusion at 25 years. Diabetes Care, 25(3): 593–598.
Retnakaran R, et al. (2004). Continuous subcutaneous insulin infusion versus multiple daily injections: The impact of baseline A1c. Diabetes Care, 27(11): 2590–2596.