Pros and Cons of Insulin Pumps

Insulin pumps are electronic devices that help you stabilise your blood glucose levels and control your diabetes. When you use the right insulin pump effectively, you can reduce diabetes complications like hypos and diabetic ketoacidosis and protect your health. But pumps don’t suit everyone with diabetes. There are advantages and disadvantages of insulin pumps; by considering the pros and cons, you can decide whether a pump is the right choice for you.

What are the pros and cons of insulin pumps?

Insulin pumps can give you the freedom to control your diabetes instead of letting it control you. However, insulin pumps come with challenges. The pros and cons of insulin pumps include:

Benefits of insulin pumps

• A pump can improve your diabetes control. The National Institute for Health and Care Excellence (NICE) reviewed a wide range of research studies on insulin pump use. It concluded that pump therapy reduces Hba1c values in adults, children and teenagers
• As a result of the improved diabetes control, pumps offer a lower risk of developing the long-term complications of diabetes
• Pumps offer greater adaptability around meals and exercise. A pump can help you be spontaneous and have a more flexible lifestyle without maintaining a strict food schedule. They can also help you exercise when you want to, without having to plan ahead
• A pump can improve your quality of life. Many people feel better, are less tired and may need fewer days off work or school
• You should have more stable blood glucose levels with fewer hypos and hypers. Some pumps can automatically stop the insulin supply if you have a dangerously low hypo, which can keep you safe, especially if you are prone to overnight hypos
• With a pump, there is a reduced incidence of diabetic ketoacidosis or DKA
• Your body receives a steady supply of insulin around the clock. The pump administers basal or background insulin, and you can add boluses of insulin around mealtimes. This pattern more closely replicates the pancreas’s natural insulin release
• You can programme your pump to deliver different basal insulin rates at different times of the day and night. This can help reduce overnight hypos and morning hypers or the dawn phenomenon
• You can take any additional insulin you need quickly and easily. It’s simple to add a bolus of insulin through the pump at mealtimes without the need for an injection
• A pump makes it easier to manage sick days
• Fewer injections. The cannula is changed every 2-3 days, or sooner if needed ( in general, you should change a metal cannula every two days and a plastic cannula every 2-3 days)
• More precise insulin delivery with the ability to administer smaller doses of insulin to fine-tune your control
• Most pumps are discreet and easily hidden by clothing
• Some pumps can integrate with a continuous glucose monitor or CGM. Innovative closed-loop systems work with an implanted glucose monitor to automatically adjust your insulin dose and reduce the need for finger-pricking

Disadvantages of insulin pumps

• Insulin pumps can prove more expensive. Pumps are not available to everyone through the NHS or through medical insurance, so you may need to pay for a pump privately. However, your doctor will be able to prescribe your insulin as usual
• You need to commit to testing your blood sugar 4-6 times daily or using a continuous glucose monitor
• You need to count the carbohydrates in your food to work out the correct quantity of insulin to administer with meals and snacks
• You may not like wearing a device on your body 24 hours a day
• You may find wearing the device uncomfortable or constraining
• Although pumps are small, they may be visible, particularly in tight-fitting clothing or sportswear
• With tethered pumps, the tubing can snag and get caught on things. This can be uncomfortable and lead to the cannula becoming displaced
• There is a potential risk of skin infections from the cannula; this can be reduced by careful cleaning and changing the cannula regularly
• You may have an allergic reaction to the adhesive attaching the pump to your skin
• You will need training to use the pump effectively. Some people find it challenging to learn how to programme and control the device, and there is a steep learning curve in the first few weeks. It can take time to become proficient at programming the device, counting carbs and changing the cannula
• Changing the cannula ( together with the infusion set for tethered pumps) is more complicated and time-consuming than giving a simple insulin injection
• Insulin pump therapy can be challenging for people with impaired vision or hearing- it can make it difficult to programme the device and recognise signals and alarms
• There is a risk of diabetic ketoacidosis if the pump malfunctions, the cannula is blocked or displaced, or there’s an air bubble in the tubing

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