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The following are common questions that people have about using an insulin pump.
Most studies find that A1c values (3-month average blood glucose) for people who start insulin pump therapy either stay the same or get a bit better. It’s a lot of work to set basal rates, check blood glucose often, and know what the results mean. People who do the same amount of work doing injections often get similar results without an insulin pump.
Yes, you still need to use needles when you’re on insulin pump therapy. If the pump or infusion set isn’t working properly, you’ll have to give yourself insulin with a syringe or pen.
The infusion set also has a cannula that’s inserted using a needle. You remove the needle after the cannula is in, and the cannula stays under your skin. Most people replace the cannula with a new infusion set every 2 to 3 days. Some people need to change sets every day.
Yes. You still have to check your blood glucose with a glucose meter (by doing a finger poke) before you give yourself meal boluses and correction doses, even when you’re using a continuous glucose monitor.
For your safety, the makers of continuous glucose monitors recommend that you do a meter reading to check your blood glucose level before you decide on and give yourself a bolus or correction dose. You also need glucose meter readings to adjust continuous glucose sensors.
Some insulin pumps can adjust insulin automatically, but there are limits. This is called a partial closed loop system. To make these automatic adjustments with this system, you need a continuous glucose monitor. This system doesn’t stop all low or high blood glucose from happening.
You can wear an insulin pump in many ways:
You can disconnect pumps with tubes for a short time, for example when you’re:
The longer you’re disconnected, the higher your blood glucose might go. Your risk for DKA gets higher if the pump is disconnected for 2 hours or more. Never forget to reconnect your pump.
Some insulin pumps with tubing are waterproof. Please check with the company that made your pump. Most people find it easier to disconnect a pump with tubing when they shower. Remember to reconnect it when you’re done.
If you use a tubeless system (pod), you leave it on when you shower.
At night you can:
You can usually wear the pump when you exercise. Make sure the pump doesn’t flop around or get hit. Make sure the cannula can’t be pulled out.
If you play a contact sport like hockey or football, put your pump in a safe spot where it’s less likely to get hit. You might disconnect the pump for a short time, maybe 1 hour. There are ways to replace basal insulin and disconnect for longer times, but talk to your diabetes educator first.
Some pumps are waterproof. Ask the company that made your pump if it’s OK to swim with it on. If it’s not OK, you can disconnect it for a short time, maybe 1 hour. There are ways to replace basal insulin and disconnect for longer times, but talk to your diabetes educator first.
You can wear a pump in cold weather if you’re careful. Make sure to protect your pump and don’t let your insulin freeze. Keep the pump inside your jacket, close to your skin.
You can’t wear a pump near explosive gas. The insulin pump could cause an explosion. If you work with explosive gases, an insulin pump might not be right for you.
Follow the advice from your healthcare provider. You may not know how long the cannula has been out. First you should check your blood glucose. You may also need to test for ketones and give an insulin injection with a syringe. You’ll need to replace the infusion set, using supplies from your safety kit.
Pumps are very durable. But if you drop your insulin pump, check it carefully for cracks and watch its functions (and your blood glucose) closely to make sure it's still working properly. If you’re not sure, call the pump’s 1-800 number. They may guide you through some software tests over the phone.
Cell phones and smartphones can’t break pumps or make them stop giving insulin. These phones can sometimes get in the way of the communication between a remote meter and a pump. If this happens, turn off your phone or carry it further away from the pump.
Yes, you can travel with an insulin pump. Go over your travel plans with your diabetes team to make sure you have enough supplies and information about travelling with diabetes and the pump.
If you’re travelling outside of Canada, know that pump companies in Canada don’t ship replacement pumps outside the country. Ask the pump company for a loaner pump before you leave Canada and always have a plan for how to replace the pump with injections if you need to.
Airport security staff in most countries have seen people on an insulin pump. But it’s a good idea to ask your doctor or diabetes centre for a travel letter, in case security has questions.
Check your pump manual for instructions for flying with your pump. Pumps can go through metal detectors. Check with the company that made your pump about going into a full-body scanner. Pumps shouldn’t go through the conveyor belt x-ray machine. It’s usually not recommended to use the wireless meter or continuous glucose meter on an airplane. Check your pump’s instructions.
You can wear your pump for ultrasounds (a test where sound waves are used to show images of the inside of your body).
Take off your pump for other medical imaging tests such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) tests. Disconnect your pump and keep it in a safe place. If the test is longer than 2 hours, give yourself basal insulin with an injection to stop DKA from happening. Check with the company that made your pump if you’re having other tests.
You might continue with your insulin pump for some short or minor surgeries. For other surgeries, you may need to remove your pump and get insulin replaced through an intravenous (I.V.) in a vein or with injections. After your surgery, your doctor will check if it's safe for you to go back on pump therapy.
If your healthcare team decides that pump therapy is safe for you when you’re in the hospital, you'll need to agree to some self-management terms. For example, when you’re in the hospital you must:
The Alberta Health Services document Guidelines for the Safe Management of Insulin Pump Therapy in Hospital is written for healthcare providers, but it has a form for you. Please read section called “Patient Agreement to Self-Manage Insulin Pump in Hospital” on pages 11 and 12, then sign.