Giving Yourself Insulin
When a pancreas works like it should, it releases small amounts of insulin all the time. This is called the basal rate. At mealtimes, the pancreas releases a larger amount of insulin to help your body use the glucose from food you eat for energy. This is called a bolus. When your pancreas is not working like it should, you need to basal and bolus insulin yourself.
That's why some people wear an insulin pump – because after you program it, it automatically releases basal insulin every hour and you can bolus for meals or high blood glucose levels at the touch of a button (no injections). The insulin pump is a computerized device about the size of a cell phone. Once programmed and attached to you, you can tell it how much insulin you need and when you need it. An insulin pump can also calculate and suggest bolus amounts based on your blood glucose level and grams of carbs you plan to eat. Since you're already attached to a supply of insulin, you don't have to worry about drawing out the right amount of insulin with a syringe or injecting it.
Some people like the pump because it offers more freedom and flexibility but it still requires a lot of work. It's still important to check your blood glucose regularly so you can make sure the pump is working okay. Failure to check regularly can lead to DKA is there is a problem with the pump or insulin.
There are some very important things to consider before starting a pump:
- Pumps may be a little confusing to use at first – you'll definitely need training
- Pumps and ongoing pump supplies are expensive
- You'll need to wear the pump 24/7
- Some people worry about low batteries or running out of insulin
- Kinks in tubing or cannula can block flow of insulin and increase risk of DKA
- You and/or your parent still need to control the pump
Talk with your diabetes care team to weigh the pro's and con's of an insulin pump.
Insulin Pump Q & A
- How does the insulin pump work?
- How do I connect myself to the insulin pump?
- Once the cannula is in, does it stay in forever?
- Can I shower with the insulin pump?
- Does the pump know how much insulin I need throughout the day?
- If I go on the pump, does that mean I don't need to check my blood glucose anymore?
- Does the insulin pump hurt?
- Why do I have to use rapid-acting insulin in the pump?
- How will I know when the pump is out of insulin?
- What's the best kind of insulin pump?
- Where should I place the pump when its connected to me?
- How old do you have to be to use the pump?
Q. How does the insulin pump work?
A. The insulin pump can hold a supply of rapid-acting insulin for 2-6 days in its reservoir (depending on insulin type and resevoir type). There is a thin plastic tube that carries the insulin from the pump reservoir to you. On the other end of that plastic tube is a small tip called the cannula, which goes under your skin.
Q. How do I connect myself to the insulin pump?
A. You use a small needle to insert the cannula under the skin. It's similar to giving yourself an insulin shot.
Q. Once the cannula is in, does it stay in forever?
A. No, you have to change the cannula about every 2-3 days.
Q. Can I shower with the insulin pump? What about in the pool?
A. Yes, you can wear some pumps in the shower, because some are waterproof. But most people don’t because they have no place to put it – no clothes to hang it on, etc. You can also wear the waterproof pumps in the pool, but most people disconnect before they go swimming. For most pumps, when you want to disconnect, you can detach the tube from the cannula, leaving the cannula in place, and then reattach it when you’re ready. Be careful – if the pump is disconnected for too long DKA (diabetes ketoacidosis) can develop. Talk with your diabetes care team about what to do if you need to be off your pump for a longer period of time.
Q. Does the pump know how much insulin I need throughout the day?
A. Yes, because you program the pump and tell it how much insulin to release throughout the day (your basal insulin). You also have to tell it how much insulin you want to bolus before a meal or throughout the day. Unless you change the basal rate, disconnect the pump or there is a problem with the system, the pump will release the amount of insulin you have programmed in it everyday.
Q. If I go on the pump, does that mean I don't need to check my blood glucose anymore?
A. No. Unfortunately, the pump is not an artificial pancreas. It doesn't know what your blood glucose is so it doesn't know how much insulin you need. You have to check your blood glucose, calculate carbs and decide how much insulin you need. Then you tell the pump how much insulin to release. Most of the new pumps available nowadays are called "smart pumps" because they can actually do a lot of these calculations for you.
Q. Does the insulin pump hurt?
A. Although it might take some getting used to and it's weird to think that there's something (plastic catheter) in you all the time, most people say that it doesn't usually cause pain.
Q. Why do I have to use rapid-acting insulin in the pump?
A. Since the pump lets you get insulin immediately, you don't need to use an immediate-acting or long-acting insulin. You give a bolus right before a meal instead of having to plan when your insulin will peak.
Q. How will I know when the pump is out of insulin?
A. Most pumps have an alarm that will start to beep when your insulin supply gets low. You can decide how low your insulin supply can get before the alarm goes off. But be sure to check your pump's battery and the insulin supply on a regular basis, especially before you go to bed.
Q. What's the best kind of insulin pump?
A. There are many kinds of pumps out there. You'll want to talk to your parents and your D-team to find the one that works best for you. Talk to each of the pump companies and to other people who wear insulin pumps to help you make a decision.
Q. Where should I place the pump when it's connected to me?
A. You can place the pump itself on the waistband of your pants, bra, socks, pocket, or even your underwear. There are many different products out there to help make wearing a pump easier and even fashionable.
Q. How old do you have to be to use the pump?
A. You don't have to be a certain age to be on the pump. Some doctors and parents even put little babies on the pump. But, the thing about being on the pump is that you have to be responsible and committed. For babies, their parents or guardian are responsible for the pump. You have to be good about checking your blood glucose and knowing how much insulin you need. Since you're always connected, you have more freedom, but you know what they always say, more freedom = more responsibility.
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