Insulin Pumps and Continuous Glucose Monitors


Insulin Pump Therapy 

What is an insulin pump? An insulin pump is a small device with the ability to deliver insulin continuously (basal) or quickly (bolus) for carbohydrate intake.  You can also correct a high blood glucose level by entering (typing) your blood glucose or grams of carbohydrate to be eaten, into the pump. There is a variety of insulin pumps on the market, offering choices to meet individual needs. 

How does it work?  Information in the insulin pump is programmed to meet the needs of the individual wearing it.  The insulin is infused into the fatty tissue via a small plastic tube (cannula) that is attached to a reservoir in the pump.  The cannula is inserted under the skin by a needle, that is then removed.  This is called an infusion set.  It is changed every 2 to 3 days to prevent infection.  Using an insulin pump eliminates the need for multiple daily injections of insulin.  Only rapid acting insulin is used in a pump.  Since the pump is worn and delivers insulin continuously, there is no need for long acting insulin.

Why use an insulin pump? Studies have shown that using an insulin pump can improve diabetes control and lessen the risk of hypoglycemia.  In addition, many people find increased flexibility in the timing of meals and exercise when wearing an insulin pump. 

Who should consider an insulin pump?  Good candidates for insulin pump therapy are people who take multiple daily injections of insulin, check their blood glucose levels several times per day, are motivated to use the pump, and have good problem solving skills. Open communication between the individual wearing the pump and their health care team is essential.

We offer a robust insulin pumping program at the UMass Diabetes Center of Excellence.  Each patient has an opportunity to work with our entire team throughout the process, including physicians, diabetes educators and insulin pump representatives.  

Continuous Glucose Monitors (CGM)

 Checking blood glucose levels only provide information about the glucose level at that specific point in time.  It does not identify trends or whether the blood glucose is rising or dropping.  Continuous Glucose Monitors measure the glucose level in the tissue, but not the blood.  A CGM requires a small sensor which is inserted under the skin into the fatty tissue.  A sensor is connected to a transmitter that sends information to a receiver (or a smartphone).  The user can see what their glucose level has been, what it is at that moment, and which way it is trending.  Trends in blood glucose levels allow an individual to anticipate and prevent hyperlycemia and hypoglycemia.  Some CGM sensors even alert the wearer (and/or family members) when the glucose goes too high or too low.  The FDA has approved some sensors to replace daily blood glucose checks.