An insulin pump is a little gadget that's about the size of a pager or a deck of playing cards.  It's run by batteries and contains enough insulin for about 2-3 days.  It has a small thin tube that runs from the pump to your body and pumps this insulin continuously 24 hours a day.

Check out our new Insulin Pumpers Web Site for more detailed information

Inside the pump there's a container for insulin and a small microchip that tells it how much insulin to pump into your body. It sends the insulin through a thin piece of long tubing to a tiny, soft piece of plastic or a tiny needle inserted under your skin. From there the insulin enters your body just as when you give yourself an injection of insulin.

The insulin pump is the best way to keep blood sugars under control.  The insulin pump will deliver insulin more the way your body normally would have if things were working properly for diabetics.  There are well over 100,000 diabetics using the insulin pump today and the more word gets around, more people will be put on an insulin pump.

When you use an insulin pump.  You have more freedom to eat what you want and when you want to.  No more schedules and injecting yourself 2, 3 or more times a day.  I've been a diabetic for most of my life and I'm now just getting put on an insulin pump after more than 6 months of talking to my doctor about it.  This to me will be my cure for the time being.

Remember!  An insulin pump is not a cure all for diabetes.  It's going to give you freedom in a way, but you have to keep on top of your diabetes a little more than you have been.  This means you have to learn to use your pump correctly, test your blood sugar at least 4 times a day (6-8 times is better) and you're going to have to buckle down and watch your diet more closely.  This means counting every carbohydrate you eat in order to tell the pump how much insulin to give yourself.

Ok.. Now on with the techy stuff.

Ok.. You have your little pump.  Batteries are installed and you've had your basic training by your doctor on how to use your pump.  You should already have your pump programmed by following your pump's manual.  At time time, you should have the time and date set and the basal rate set.  

Remember the Pumpers Golden Rule: Take care of your diabetes first and your pump second.  Also, always have a syringe and a bottle of insulin handy in case your pump should fail.  If anything happens to your pump and it stops delivering insulin, or your blood sugar suddenly rises for no apparent reason, you'll need to inject yourself with a dose of insulin specified by your doctor.

That needle or little piece of plastic is called a cannula. It stays in your body. It must be taken out and replaced every 2 or 3 days. In fact you change it yourself. It is almost like giving yourself an injection. The cannula fits over a small needle, which you push into your skin. When you pull the needle out, bingo! The cannula stays in your body. It is now inserted.

Once the cannula is inserted and the tubing is hooked up, your pump can begin delivering insulin to you. Using buttons on the outside of the pump, you can program it to give you exactly the insulin dose you need.

OK, I follow you so far...

Now for some tricky new words: you program the pump to give two different types of insulin doses: the basal dose and the bolus dose.

The basal dose is a steady stream of insulin that flows in all the time. It imitates the continuous insulin that a functioning pancreas would provide. Although older pumps used to give you the same rate of insulin all the time, the latest pumps you can program to give different basal rates over the day - for instance, giving you more during the day, less at night, and more again in the early morning hours when your body needs it. You can even reduce it if you are having a very busy active day.

The bolus is an extra little shot of insulin you tell the pump to give you before you are going to eat a meal. Once you've got the food in front of you, you work out roughly how much carbohydrate you're going to eat, program the correct insulin based on this, and the pump does the rest. You can easily take more insulin during the meal if you want to eat more than you thought.

What insulin do I use?

The pump only uses the clear soluble insulins, like Actrapid or Humulin S, or Humalog, which is fast acting. This means two things:

• You can program your insulin doses right when you need them. You don't have to worry about unexpected things coming up, or delayed meals.

• It means your body absorbs the insulin better, because soluble insulins most resemble the insulin your body makes. Long-acting cloudy insulins tend to be more unpredictable.

So how does this all work in practice?

People who wear the pump take only one shot every two or three days - that's the cannula insertion. They have a lot more options when it's time to eat. They don't have to eat at any particular time. And their bodies are getting insulin a lot more like they would if their pancreases were working. That means they feel better most of the time.

If pumps are so good, why doesn't everyone have one?

But before you rush off to your doctor and demand an insulin pump, you need to know a little more. Getting a pump means you have to be on top of your diabetes. When you're on the pump, you have to be diligent about testing. That means 4 times a day at least. (But you should be testing that much anyway.)

You also have to be willing to learn a lot about your diabetes and a lot about your pump. You always need to know what it's doing and how you're feeling. Not only do you have to be able to program it, but you must be able to tell if something's wrong with it.

What sort of things can go wrong?

As with any medical device, little things can happen. The tubing can get crunched, the battery can die, the cannula in your skin can get infected or disconnected from the tubing. Even though pumps have several different alarm systems to tell you when these things happen, they are not foolproof. You have to keep on top of it.

But no doubt about it, most people who go on a pump say it has made their lives a lot better. They get to play sports without worrying as much about going low. They get to eat what they want. They get to sleep in because they can let the pump manage their insulin. They can stay out late for the same reason!

What about things like having a bath, sleeping or swimming?

Pumps come in waterproof models, if you need them. But most pumps can tolerate a little bit of water anyway, so you don't need to worry about getting rained on. But if you want to swim, most people just disconnect the tubing, leaving the cannula in place. They reconnect when finished. You also disconnect when you take a bath or shower, or when having sex. It's normally OK to disconnect for up to an hour.

When you sleep you can just put the pump under your pillow or on the bedside table. The tubing is long enough. Some people just let the pump lie next to them in bed.

How many people use a pump?

The number of people that use pumps varies a lot from country to country. For example, in Germany about 1 in 7 people on insulin uses a pump. In America it's about 1 in 8. In Britain it is about 1 in 1000. This reflects differing opinions amongst healthcare professionals, and differences in healthcare funding policies.

Check out a short history of how insulin pumps have come along through the years.