Types of Insulin Pumps
How to access Insulin Pumps?
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There are many different types of insulin pumps available, with 15 devices currently licenced in the UK. Insulin pumps are rapidly evolving and harnessing new technology to ensure more stable blood sugars, fewer hypos and hypers and protection against the long term complications of diabetes.
Insulin pumps are battery-powered, portable devices that deliver insulin into your bloodstream 24 hours a day. Pumps supply basal or background insulin around the clock; you can also add insulin boluses to match the carbohydrates in your diet.
When you have diabetes, it can feel like your life is all about controlling your food, insulin and blood sugar. An insulin pump allows you greater flexibility to eat, exercise and live without sticking to a rigid timetable.
How do insulin pumps work?
An insulin pump delivers a steady supply of insulin into your body using battery power. The device contains a reservoir that stores insulin, which attaches to your body through a fine tube called a cannula. The pump inserts the cannula into the fat under your skin. The device pumps insulin from the reservoir into your body.
Many insulin pumps use a remote control or smartphone app to programme the insulin pump. You can set the pump up to deliver a steady supply of basal insulin around the clock. When you eat or drink, you can count the carbs and add a bolus of insulin through the pump at the touch of a button.
At the moment, around one in a thousand people with diabetes in the UK have a pump- but they are becoming more popular. The NHS has quite strict requirements for pump eligibility. However, a wide range of pumps is available privately for adults and children living with diabetes.
Insulin pumps are beneficial for adults and children with type 1 diabetes, especially if it is brittle, very poorly controlled, requires multiple insulin injections or if there are frequent hypos or hypers. An insulin pump can also help people who are struggling with multiple insulin injections for type 2 diabetes.
Benefits of insulin pumps
Insulin pumps have many benefits over traditional insulin injection therapy. Research evidence shows that pumps are better at controlling blood sugar and cause fewer complications. People using insulin pumps have fewer episodes of severe hypoglycaemia and less than half the admissions for the serious complication of diabetic ketoacidosis. Insulin pump advantages include:
- Better diabetes control
- More flexibility around meals
- Fewer hypos and hypers
- Reduced complications and DKA
- The pump is small and discreet – usually smaller than a pack of cards
- Delivers a steady supply of insulin 24 hours a day
- You can add a bolus of insulin at meals quickly and easily
- The insulin is introduced through a cannula, meaning fewer injections
- You only need to change the cannula every 2-3 days
- Pumps simplify your regime because you only need rapid-acting insulin
Types of insulin pumps
Tethered pumps are also known as line pumps. They use a narrow tube to connect the pump to the cannula. You pop the pump into a pocket or carry it in a bag or on a belt. Intelligent pumps are controlled by remote controls or a smartphone app, allowing you to programme the pump and give extra boluses of insulin around mealtimes. You need to change the cannula and pump location every 2-3 days to keep the skin healthy and prevent lipohypertrophy. Tethered pumps include the Accu-Chek Spirit Combo, Animas Vibe and the Medtronic MiniMed Paradigm Veo.
Tethered pumps
This technology uses readings from the G6 CGM to predict hypos and reduce the frequency and duration of hypoglycaemic events. This system constantly operates in the background. Basal- IQ can suspend insulin or levels drop to 3.9 mmol or lower. It can also stop if your levels are predicted to fall below 4.4 mmol per litre.
Although the technology can help you control your diabetes and reduce the need for finger pricking, it’s important to remember that you still need to manage your diabetes actively. You will need to input information, monitor data, finger prick to check readings and respond to your diabetes symptoms, treating them according to your specialist’s advice.
Patch pumps
Unlike a tethered pump, you attach a patch pump directly onto your skin using adhesive. The pump inserts a cannula without a connecting tube. You programme and control the pump using a remote device that you can put in a bag, bum bag or pocket. Instead of changing the cannula, you regularly change the whole pump. The OmniPod pump is the only patch pump currently available in the UK. It is a waterproof, wireless patch pump that is stuck to the skin without tubes. It communicates wirelessly with a touchscreen Personal Diabetes Manager (PDM), which controls basal and bolus insulin delivery.
Insulin pumps with integrated CGMs
New pump technology enables pumps to interact directly with a continuous glucose monitor. This innovative facility enables some systems to directly respond to low glucose readings by stopping the insulin supply, which is important for people who have hypos overnight. Pumps with integrated technology include the Medtronic MiniMed 640G and the Medtronic MiniMed Paradigm Veo.
Closed-loop systems
Also known as an artificial pancreas, closed-loop systems use a smartphone app to automatically adjust the dose on your insulin pump according to the readings from an implanted glucose monitor. CamAPS® FX is a closed-loop system that runs on Android devices. Closed-loop insulin delivery has been shown in research to offer better diabetes control, lower HbA1c readings and fewer hypos and hypers.
Implanted insulin pump (IIP)
Implanted insulin pumps are the very latest in insulin pump technology. The pump is inserted into the abdomen, in the peritoneal cavity. The pump stays inside the body permanently unless there is a problem which means it has to be removed.
The implanted insulin pump delivers insulin into the peritoneal cavity. This area is supplied by many blood vessels, so the insulin is rapidly absorbed into the bloodstream. There are very few IIP users, but those that have implanted pumps report very positively on their experience. At the moment, pump implantation and refilling are only carried out in Montpellier, which limits their application. However, usage is likely to become more widespread in the future.
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Sources:
https://www.diabetes.co.uk/insulin-pumps/insulin-pump-types.html
https://jdrf.org.uk/information-support/treatments-technologies/insulin-pumps/
https://my.clevelandclinic.org/health/articles/9811-insulin-pumps
https://www.informationaboutdiabetes.com/lifestyle/lifestyle/types-of-insulin-pumps-the-basics
https://www.webmd.com/diabetes/insulin-pump
https://docs.google.com/spreadsheets/d/1yccvXMf6WBLoC-sEqM5v3YfA4AVrRlQme_i73bxbo-4/edit#gid=0
Private diabetes clinics
A private diabetes clinic like The London Diabetes Centre provides expert assessment, training and access to the most cutting edge insulin pumps. The London Diabetes Centre will tailor your training so that you have the knowledge, skills and confidence to make the most of your pump and control your diabetes.
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Sources:
https://www.tandemdiabetes.com/en-gb/home
https://www.nice.org.uk/advice/mib227/chapter/The-technology
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