Administering insulin

Insulin injections and pumps

Living with type 1 diabetes (T1D) requires perpetual insulin delivery. There are two primary methods to administer insulin: injections and insulin pumps.

Insulin injections

Many people manage their T1D with multiple daily injections (MDI). The exact number of injections varies from person to person, and comes in the form of long-acting and short-acting insulin. Long-acting insulin is meant to mimic the body’s natural insulin production, while short-acting insulin is administered to account for the glucose intake from food, given at mealtime, and to correct high blood sugar levels.

Insulin injections typically occur at regularly scheduled times during the day.

Insulin pumps

An alternative to insulin injections is the insulin pump. The pump is a computerized device, about the size of a beeper or pager, often worn on a belt or in a pocket.

The pump delivers a continuous low (basal) dose of insulin through a cannula (a flexible plastic tube), which attaches to the body through a small needle inserted into the skin. The cannula is taped in place and the needle is removed. Common insertion sites on the body include the thighs, buttocks, abdomen, upper arms and other areas with fatty tissue.

When a person wearing a pump eats, they push a button on the pump to deliver an extra amount of insulin called a bolus to provide insulin for their food.

The advantages of the pump include:

• Greater flexibility with meals, exercise and daily schedule
• Improved physical and psychological well-being
• Smoother control of blood-glucose levels

The disadvantages of the pump include:

• Risk of infection
• More frequent hypoglycemia (low blood sugars)
• Ketosis and ketoacidosis (risk of very high blood sugars) if the system is disrupted
• Constant physical reminder of diabetes

Choosing an insulin pump that is right for you

What you need to look for

Progress and developments of insulin pumps have provided an alternative method to deliver insulin, eliminating the need for multiple daily injections by needle.

Every individual has their own unique lifestyle and routine and management of type 1 diabetes is a part of that.  Not all pumps are the same, and one pump might fit your lifestyle better than another.

Some pumps are waterproof; some have larger insulin reservoirs; some have smaller basal and bolus increments; some are tubed and some are tubeless. Diabetes management is not the same for everyone, and it’s important to pick the pump that works best with your lifestyle.

Questions to consider when choosing a pump

• What are the upsides? Is it a color you like? Something easy to integrate with your clothing? Does it have special features other pumps might not have?
• Is the pump waterproof or water-resistant? If not, is it easy to disconnect before going swimming or taking a shower?
• Is the pump tubed or do you prefer tubeless?
• How are the insulin pump’s reviews? Do people seem satisfied with it? If they aren’t satisfied, does the manufacturer’s customer service seem responsive?

These questions are a great starting point to help start thinking about your own needs and preferences. Taking the time to find the perfect pump is an important step in your overall diabetes management plan.