Key considerations to benefit from continuous insulin infusion therapy

So how can you know for sure you would benefit from continuous insulin infusion therapy? Here are the key considerations:

• You test your blood sugars regularly and know how to lower high sugars and raise low sugars.
• You have had a problem with low blood sugars shortly after eating (taking too much insulin before a meal) and you want to avoid hypoglycemia.
• You aren't especially prone to bacterial infections, and you don't have a problem taking appropriate precautions when you shower, bathe, or go to the beach. (The pump can be disconnected for sports and sex, but only for short periods of time.)
• You are very familiar with the way your body responds to extra insulin, allowing you to use the pump to release a bolus (relatively large amount) of insulin when you eat more than usual.

Insulin pump users don't have to worry about running out of insulin on a trip (assuming they change insulin cartridges ahead of time), and they don't have to worry about giving themselves injections in public places, such as dirty restrooms. On the other hand, some diabetics should avoid using a pump:

• Infections at the insertion site can be very nasty if they are not treated promptly. If you can't see your skin, and you don't have a partner who can tell you when you have an infection, you may be better off not using the pump.
• Since the pump uses only fast-acting insulin (which wears off in four to six hours), you can run into serious problems if the pump fails during the middle of the night. If tend to sleep through diabetic disturbances, you may be better off not using the pump.
• If you tend to drop or break things, you should not rely on a pump for your insulin. Sometimes the electronics of the pump continues to work even after the canula that delivers insulin is broken.

And if you are used to managing your diabetes with Lantus alone, you probably don't want to switch to a pump, either. Lantus insulin is slow acting, giving you plenty of time to correct mistakes. The fast-acting insulin used in pumps requires frequent monitoring of blood sugar levels, certainly before going to bed, upon rising in the morning, and before and after exercise.

Fitting a diabetic with an insulin pump usually costs several thousand American dollars, and you will probably only save about US $20 a month on diabetes supplies. If you just don't want to give yourself injections, however, the insulin pump can be a viable way to keep your blood sugar levels under good control.