What is a pump
and how does it work?
An insulin pump is a small electronic device, about the size of a mobile phone, that can be easily carried on a belt, inside a pocket, or even attached to a bra thus becoming virtually invisible to others and allowing a very discreet therapy.
The pump can help you more closely mimic the way a healthy pancreas does: the pump, through a Continuous Subcutaneous Insulin Infusion (CSII), replaces the need for frequent injections by delivering precise doses of rapid-acting insulin 24 hours a day to closely match your body’s needs.
A programmed insulin rate made of small amounts of insulin delivered continuously mimics the basal insulin production by the pancreas for normal functions of the body (not including food). The programmed rate is determined by your healthcare professional based on your very personal needs. This basal rate delivery can be also customized according to your specific daily needs, for example it can be suspended or increased / decreased for a definite time frame: this is not possible with basal insulin injection.
Additional insulin can be delivered “on demand” to match the food you are going to eat or to correct a high blood sugar. Insulin pumps have bolus calculators that help you calculate your bolus amount based on settings that are pre-determined by your healthcare professional and again based on your special needs.
What are the benefits of insulin pump therapy and how can it help you achieve better glucose control?
Insulin pump therapy offers multiple clinical benefits over multiple daily injection therapy such as1,2
- better HbA1c control
- fewer hypoglycaemic events
- reduction in glycaemic variability
It can help to better manage the need for insulin dose adjustment, particularly for meals and overnight and can thus help to achieve better glucose control.
The MiniMed® 640G insulin pump can also provide you the following advantages, due to the ability to adjust insulin delivery:
- Easier dosing: calculating insulin requirement can be a complex task with many different aspects to be considered. In the MiniMed® 640G pump, the built-in Bolus Wizard® feature helps to ensure accurate dosing by taking into account any insulin already in the body, the current glucose levels, carbohydrate intake and personal insulin settings to determine the right dose.
- Greater flexibility: the MiniMed® 640G pump can be instantly adjusted to allow for exercise, during illness or to deliver small boluses to cover meals and snacks. This can be easily done with a touch of a button. There is even a temporary basal rate option to proportionally reduce or increase the basal insulin rate, an option that can be used during exercise or illness, for example.
- More convenience: the MiniMed® 640G offers the additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate Bolus Wizard® calculations and to deliver insulin boluses discreetly.
The pump therapy as a system: how does the insulin get into your body?
The insulin pump (1) has a compartment that holds a reservoir (2) that is filled with insulin. From the pump's reservoir insulin is infused into your body through an infusion set (3). The infusion set is inserted to your body by the infusion set insertion device (4) and is infusing through a tiny flexible tube called cannula that sits just underneath your skin. The infusion set is connected to the reservoir through a small tubing and you can easily disconnect and reconnect it from your body whenever you want to. This can be helpful, for example when you want to swim, shower or play sports.
1. Insulin pump
A small durable electronic device that has:
- Buttons to program your insulin and navigate through the menu
- LCD colour screen to show what you are programming
- Battery compartment to hold 1 AA alkaline battery
- Reservoir compartment
A plastic cartridge that holds the insulin that is locked into the insulin pump. It comes with a transfer guard (blue piece at the top that is removed before inserting the reservoir into the pump) that assists with pulling the insulin from a vial into the reservoir. A reservoir can hold up to 300 units of insulin and is changed every two to three days when you change the infusion set. The MiniMed™reservoirs have been designed to make filling a convenient process.
3. Infusion set
An infusion set includes a thin tube that goes from the reservoir to the infusion site on your body. The cannula is inserted with a small needle that is removed after it is in place. It goes into sites (areas) on your body similar to where you give insulin injections.The infusion set is changed every two to three days. MiniMed® infusion sets are available in a widest range of features (cannula type, length and inclination) so that you can choose the right infusion set for your comfort and protection.
4. Infusion set insertion device
An infusion set is placed into the insertion device and with a simple push of a button the infusion set is inserted quickly and easily, for a virtually painless procedure.
Is insulin pump right for you?
Many people with Type 1 diabetes may benefit from an insulin pump without even knowing it. In general if they experience any of the following, they could get better control with an insulin pump:
- Fear of needles
- Difficulty in managing highs and lows
- Fear of hypoglycaemia, especially at night
- HbA1c outside target range
- Reduced hypoglycaemia awareness
- Concerns about long-term complications
- Seeking more flexibility in everyday life
Talk to your physician about insulin pump therapy and whether it may be right for you.
1. J. C. Pickup and A. J. Sutton Severe hypoglycaemia and glycemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion Diabetic Medicine 2008 :25, 765–774
2. Bergenstal RM1, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN,Joyce C, Perkins BA, Welsh JB, Willi SM, Wood MA; STAR 3 Study Group. Sensor-augmented pump therapy for A1C reduction (STAR 3) study: results from the 6-month continuation phase. Diabetes Care. 2011 Nov;34(11):2403-5. doi: 10.2337/dc11-1248. Epub 2011 Sep 20.
* Ly T.T, Nicholas J.A., Retterath A. et al. Reduction of Severe Hypoglycemia with Sensor-Augmented Insulin Pump Therapy and Automated Insulin Suspension in Patients with Type 1 Diabetes [abstract]. Diabetes 2013; 62 (supplement 1): 228-OR