Pumping Essentials

There’s lot of things you might want to know about pumping, daily life on a pump and how to choose an insulin pump. This section is here to help you out.

Pumping Essentials

There’s lot of things you might want to know about pumping, daily life on a pump and how to choose an insulin pump. This section is here to help you out.

How does pump therapy differ from daily injections?

Having insulin dependent diabetes means you need to take matters into your own hands when it comes to injecting insulin. You can do this either with multiple daily injections (MDI), or with an insulin pump.

You probably know the deal with injections already – you use an injection pen or a needle to inject yourself at least 4 times a day. This includes injecting a long acting insulin once or twice daily as a background (basal) dose and then you’ll also inject rapid-acting insulin each time you eat or if your blood glucose gets too high.

The most common alternative to injections is an insulin pump – it’s a small device that continuously delivers insulin to your body throughout the day. You’ll set it to deliver a ‘basal’ rate continuously in the background, and you’ll then deliver extra ‘on demand’ doses of rapid-acting insulin to match what you’re about to eat or the exercise you’re about to do (‘bolus dose’).

With both injections and pumps, you’ll need to monitor your blood glucose level throughout the day to help you figure out how much insulin you need. You can do this using a finger-prick test, flash glucose monitor or continuous glucose monitor.

It’s expected that in the future, pumps will be able to continuously monitor your blood glucose levels, automatically calculate the amount of insulin required, and then deliver the right dose of insulin. This is known as an ‘artificial pancreas’ or ‘closed-loop system’, and they are currently under development by a few companies. These are not yet widely available for people with diabetes, so in the meantime, most pumps have ‘bolus calculators’ which help you calculate how much insulin you need.

I want to try pump therapy – but how do I choose a pump?

There are loads of different pumps available and finding the one that works best for you is a very personal choice, but here are some of the things to consider:

Type/Wearability

With conventional pump systems, the pump and its controls are combined in a single device which can be kept it your pocket, attached to your clothing or worn in a pouch. This pump is connected to your body with a long piece of plastic tubing which has a cannula (like a soft needle) at the end. The cannula is inserted under the skin, usually on the stomach, to deliver the insulin.

Another type of pump is a ‘patch pump’. These are smaller than conventional pumps, so they attach directly to your skin and are controlled by a remote handset.

Kaleido combines the freedom of a patch pump with the versatility of a conventional pump. The Kaleido pump attaches directly to your skin, like a patch pump, but unlike a patch pump, there is a separate infusion set (where the insulin actually enters your body). The infusion set is connected to the pump by plastic tubing, and there are different tubing lengths available which means the pump doesn’t have to be in the same place as the body patch, giving you flexibility for how you wear it. And unlike a conventional pump, the Kaleido pump is controlled with a wireless handset, so you can make dose adjustments easily and discreetly.

Size and weight

You’ll need to wear the pump 24/7, so it goes without saying that size and weight are important. Kaleido is the smallest pump around, and weighs just 19g, but can still hold 200 units of insulin.

Usability

Pumps have a bad reputation for being too complicated and tricky to learn, but we’re here to change that! Kaleido is simple to use, easy to understand and quick to learn. And whilst we think our pump is pretty intuitive, we also have great training materials and customer care in case you do get stuck.

Compatibility/integration

Some pumps have integrated blood glucose monitors – this is great for some people, but others like to choose their blood glucose monitor and pump separately.

Kaleido doesn’t have an integrated blood glucose monitor so you can choose the option that works best for you, whether that’s a standard meter, continuous glucose monitor or flash meter. And whatever you use, it’s easy to record your readings on your Kaleido handset.

Flexibility

You’ll wear your pump all the time, so it needs to be right for you. With Kaleido you can choose from 10 different colours of pump and handset, two tubing lengths and two cannula lengths, giving you the freedom to find a combination that works for you.

Bolus calculator

Most pumps will have a bolus calculator to help you work out how much insulin you need with each meal, or to correct your levels. Using a few important stats, they take some of the guess work out of delivering a bolus. But some calculators are more sophisticated than others – our ‘Kaleidoculator‘ is easy to use and has some great features, like customisable settings to match your body clock, 24/7.

What evidence is there to support the use of pump therapy?

Lots of scientific research has been done to see how pump therapy compares with multiple daily injections in managing diabetes and researchers have found some really important benefits: When compared to multiple daily injections, using pump therapy…

…. gives better control of blood glucose levels

Lots of studies have been done to find the best ways to keep blood glucose levels under control and researchers have found that insulin pump treatment consistently provides better HbA1c control compared with multiple daily injections, without a higher rate of hypoglycaemia. (1, 2, 3) This makes sense, because pump therapy is more precise, consistent and adaptable than MDI, delivering tiny doses of fast-acting insulin so you can make small corrections in your glucose level as and when needed.

…. improves your quality of life

A large, high-quality study from the UK found that people using insulin pumps had better quality of life than those using multiple daily injections in two important areas; less restriction in diet and fewer ‘daily hassles’.(4) Pump users were also more satisfied with their treatment overall than injectors. A second study found that using a pump helped people to worry less about their diabetes compared with multiple daily injections. (5) So to cut a long story short, pumps can help you live life on your own terms!

….has added benefits before and during pregnancy

Poor glucose control at conception and during pregnancy is risky both for mother and baby, increasing the risk of birth defects and long-term developmental issues.(6) But keeping your blood sugar levels under tight control is especially hard in pregnancy, as levels can rapidly change (e.g. as glucose passes across the placenta from mother to baby) and regular eating patterns are disrupted by nausea and strange food cravings. Using an insulin pump can therefore be a great way to help keep blood glucose levels under tight control during this crucial time.

And the benefits can continue after the baby is born, as a pump may fit better with the unpredictable schedule of life with a newborn! Researchers have found that new mothers who first started on an insulin pump during pregnancy to help keep their blood glucose under tighter control, often want to continue their use of pumps after pregnancy due to the flexibility they provide. (7)

… gives you a data goldmine

Insulin pumps can store loads of data, which can be really helpful in tracking your progress and refining your future treatment plans. For example, the Kaleido handset stores up to 90 days of information about your blood glucose levels and insulin delivery, and it’s all downloadable so you can keep it as long as you like, and upload it to diabetes management tools. Again, it’s all about giving you more control.

But remember…

Despite all these benefits of insulin pumps, it is important to keep in mind that they are not a cure for diabetes. All treatment methods need ongoing support to be as beneficial as possible. Education and regular follow-up care is vital to ensure pumper therapy is working for you the best it can.

1 Fatourechi MM, Kudva YC, Murad MH, et al. Hypoglycemia with intensive insulin therapy: a systematic review and meta analyses of randomized trials of CSII versus MDI. J Clin Endocrinol Metab 2009;94:729-40.

2 Jeitler K, Horvath K, Berghold A, et al Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia2008;51:941-51.

3 Monami M, Lamanna C, Marchionni N, et al. CSII versus MDI in type 1 diabetes: a meta-analysis. Acta Diabetol2010;47:77-81.

4 Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)

5 Barnard, Katharine D., and T. Chas Skinner. “Cross‐sectional study into quality of life issues surrounding insulin pump use in type 1 diabetes.” Practical Diabetes International 25.5 (2008): 194-200.

6 Castorino, Kristin, et al. “Insulin pumps in pregnancy: using technology to achieve normoglycemia in women with diabetes.” Current diabetes reports 12.1 (2012): 53-59.

7 Gabbe, S., Holing, E., Temple, P., & Brown, Z. (2000). Benefits, risks, costs, and patient satisfaction associated with insulin pump therapy for the pregnancy complicated by type 1 diabetes mellitus. American Journal Of Obstetrics And Gynecology, 182(6), 1283-1291. doi: 10.1067/mob.2000.106182

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