Insulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII), is a relatively recent development in diabetic care. In use for several decades, insulin pump therapy is a computerized method of insulin delivery.
While insulin pump therapy has been used in patients with type 1 diabetes for quite some time, during the past decade it has begun to be used in patients with type 2 diabetes. In both cases, the insulin pump has been found to be efficient and effective and is the preferred method of treatment for many patients.
Advantages of Insulin Pump Therapy
Not only does the insulin pump save patients the discomfort and inconvenience of injections, it manages their diabetes continuously, 24 hours a day, through careful medical programming. This method of delivery closely mimics the body's own natural delivery system. The insulin pump makes frequent injections unnecessary, administering insulin in a steady, carefully measured dose, called basal insulin, throughout the day, and supplying a surge, or bolus, dose, at mealtimes to deal with the patient's elevated level of glucose. It is possible to make corrections if the blood glucose level varies beyond usual limits.
The small pump, approximately the size of a cell phone, is worn discreetly on the lower back or abdomen. It delivers insulin directly into the patient's body through a catheter inserted into the fat just beneath the skin. The amount of insulin and the time of delivery are programmed by the patient and can be adjusted during the course of the day. This has been shown to reduce the risk of certain diabetic complications, such as hypoglycemia.
Disadvantages of Insulin Pump Therapy
In spite of its many advantages over insulin injections, the insulin pump is not a panacea for diabetic treatment. For one thing, the pump is not an artificial pancreas, and must be monitored carefully. When using the device, patients must continue to check their blood glucose levels at least four, and often eight, times a day. In addition, the insulin pump is an expensive method of treatment, and the pump itself can malfunction, delivering too much or too little insulin.
There is also a greater risk of ketoacidosis with pump use than with administration of insulin injections, and some patients may find being constantly attached to the device unacceptable. Moreover, for patients who are not able to make the appropriate calculations to program the pump, are ill at ease with computer use, or have limited vision or dexterity, the insulin pump is not a workable solution.