Insulin pumps: the basics

Thinking about getting an insulin pump to manage your Type 1 diabetes? As an alternative to injecting insulin with a pen, an insulin pump can help improve your diabetes control and give you more flexibility.

insulin pump

What does an insulin pump do?

An insulin pump is a battery-operated device that provides your body with regular insulin throughout the day.

The insulin is provided via a tiny, flexible tube (cannula), inserted under the skin. The tube can be left in for two to three days before it needs to be replaced and moved to a different insulin injection site.

When eating, you can release extra insulin using the pump. This is known as a 'bolus dose'. Your nurse and dietitian will help you to work out how much insulin you need.

 

How can I get an insulin pump?

The National Institute for Health and Care Excellence (NICE) has published criteria for suitability to use an insulin pump. Talk to your diabetes healthcare team about whether a pump is suitable for you. You're entitled to NHS-funded insulin pump therapy if you meet the following requirements:

  • Your diabetes consultant recommends that you use an insulin pump. You'll need to show that you're committed to good diabetes control; for example, by having at least four insulin injections a day, checking your blood sugar levels at least four times a day, counting carbohydrates and adjusting insulin doses.
  • You meet the NICE criteria (Technology Appraisal 151 (2008)) for NHS funding. You're having frequent hypos or hypos without warning that cause anxiety and have a negative impact on your quality of life, or your HbA1c is still 69mmol/mol (8.5%) or above, despite carefully trying to manage your diabetes.

What pump types are available? 

Pumps vary in colour, battery life, screen size and extra features, such as a remote control. Your healthcare team will help you choose.

How will I know how to use it?

You should receive pump training and ongoing support from your diabetes healthcare team – although in some cases you may see a different team for your pump care. You may also get support from the pump manufacturer – many have helplines. There are also support groups, such as INPUT and Insulin Pumpers.

How much does an insulin pump cost?

If you and your team decide a pump is right for you – and you meet the NICE criteria – you should be able to receive an NHS insulin pump for free. If you don’t meet the criteria, you’ll have to buy the pump and supplies yourself, except for insulin. Pumps cost around £2,000–£2,500 and should last four to eight years. Pump consumables cost about £1,500 per year.

 

Advantages of insulin pump therapy

  • Better control of your blood sugar levels, with fewer highs and lows.
  • Fewer injections – the cannula only needs replacing two or three times a week.
  • More flexibility with what, when and how much you eat.
  • Less risk of highs and lows when exercising.
  • More predictable absorption of insulin than injections.
  • Ability to change your basal (background) insulin if you're ill.
  • Greater accuracy in bringing down high blood sugar levels.
  • Better management of blood sugar levels when travelling across time zones.

Disadvantages of insulin pump therapy

  • You need to test your blood sugar levels more often – the insulin is short-acting, which means you constantly need to be aware of your insulin needs.
  • You need to have the pump constantly attached, with only short breaks for a shower or exercise.
  • Risk of infection from the cannula.
  • The infusion line can become blocked, which means changing it more often.
  • A lot of time is needed to learn about the pump and your diabetes, especially in the beginning.