If you’re thinking about using an insulin pump to treat your type 1 diabetes, we have loads of information and the criteria you’ll need to help you find out if it’s right for you.
We’ll explain the different types of pumps you can get, the pros and cons of this technology, and how to get an insulin pump on the NHS. Pumps are only available to people with type 1 diabetes.
What is an insulin pump?
An insulin pump is a small electronic device that gives your body the regular insulin it needs throughout the day and night.
There are two types of insulin pump:
Both are attached to your body by a tiny tube called a cannula, which goes just under your skin. You’ll need to learn how to change the cannula yourself, which eventually becomes really easy.
You need to change your cannula every two or three days and make sure you move to a different place every time you change it. This is really important because you can develop lipohypertrophy, which is where your body forms hard lumps that stop insulin working properly. You should also change sites to stop itching and rashes that form if you stick with the same site for too long.
A tethered pump is attached to your body by another small tube that connects to your cannula.
The pump itself usually has all the controls on it and can be carried on your belt, in a pocket, or in a body band. You can wear it under your clothes if you don’t want it to be on show.
Tethered pumps can be different in things like colour, screen size and some have extra features like Bluetooth remotes.
You attach patch pumps directly on to your body where you’ve chosen to place your cannula. People tend put them on their legs, arms or stomachs.
Patch pumps have no extra tubing, which means the pump sits directly on your skin and it works by using a remote.
Unlike a tethered pump, patch pumps are disposable. You’ll need to change the whole device when the pump alerts you, not just the infusion set and location.
Your healthcare team will talk with you about the pump they think will work best for you, or which one you can get on the NHS.
To get a pump for free, you’ll have to meet certain criteria set by the National Institute for Health and Care Excellence (NICE for short).
If you live in England and Wales, you’re over 12 years old and have type 1 diabetes, you need to meet one or more of the following criteria:
- You can’t get to your target HbA1c without severe hypos.
- Your HbA1c remains high despite carefully trying to manage your diabetes.
If you live in Scotland or Northern Ireland, the criteria is different. Your healthcare team will give you advice on whether you meet your local criteria for getting a pump and what the next steps are.
If you’re thinking about an insulin pump for your child, the criteria is different. Pumps are recommended for children under 12 when multiple daily insulin injections aren’t practical or appropriate. Make sure you speak to your diabetes specialist about if this is the best option for your child.
We understand that trying to get an insulin pump can be very frustrating, and you might feel disappointed if you can’t get one. If you have any questions at all, or you just need someone to talk to, call our helpline.
Pumps are currently not available for people with Type 2 on prescription. You can self-fund, but make sure you have a discussion with your healthcare professional if you’re thinking of trying one.
How much does an insulin pump cost?
If you meet the criteria for a pump, you should be able to get your pump on the NHS for free.
If you don’t meet the criteria, they cost around £2000 to £3000 and should last between 4 to 8 years. This is a lot of money, and is a big commitment. If you want to talk to us about your options then give our helpline a call. But remember to speak to your healthcare team too.
It’s important to remember that you’ll also have to buy other things that make the pump work, like your infusion set. These cost around £1500 a year. This doesn’t include your prescription insulin, which you get for free.
Pros and cons of an insulin pump
Diabetes technology isn’t right for everyone. Here we’ll take you through the pros and cons of having an insulin pump, so you’ve got all the information you need to make your own decision.
“The pump suits me well and gives me a greater level of flexibility over what I can eat and drink”
Advantages of insulin pumps
Disadvantages of insulin pumps
Blood sugar levels more often in your target range. Most people often have fewer highs and lows.
You'll need to have your pump attached to you all the time. Only take it off for small breaks, like when you're swimming or showering.
You won't have to inject as often.
The infusion set can sometimes get blocked, so you might need to change it at short notice.
You can tailor your insulin more easily before, during and after exercise.
You'll need to take a lot of time to learn about your pump, especially when you first get it.
You'll have more flexibility in what, when and how much you eat.
There's always a small risk of infection from the cannula.
Better accuracy when you're bringing down high sugar levels.
You’ll still need to inject sometimes.
Bolus and basal insulin
When we talk about treating diabetes, we talk about two different types of insulin doses, which are basal and bolus. We’re going to explain what these mean.
Bolus insulin is a rapid-acting insulin. You take a bolus dose when you eat or if you need to give yourself a correction dose if your levels go high.
Most pumps have bolus calculators to help you figure out the right amount of insulin you’ll need.
Basal insulin, also known as background insulin, is the insulin that your pump gives you continuously throughout the day and night.
This is usually a small amount and can be changed depending on things like the time of day and how active you’re being. Your healthcare team will help you set your basal rates based on your individual needs.
Help and support with your insulin pump
You should get pump training and ongoing support from your diabetes healthcare team.
Pump manufacturers also give support if you need help with the technology or if it breaks, and most have helplines you can call if you’re struggling.
We have loads more information about diabetes technology in our Tech Hub, and you can join the conversation about insulin pumps on our forum.