Pump therapy for severe insulin resistance

Introduction to insulin pumps

This information leaflet has been given to you because the National Severe Insulin Resistance (NSIR) team feels that you may benefit from using an insulin pump. At this stage, we would recommend doing as much research as possible to make sure you are confident with what it would mean and how it would suit you and your diabetes. Please write down and ask as many questions as you would like.

Insulin pumps work by continually infusing quick acting insulin (the insulin you are currently taking at meal times) into the tissue just under the skin (subcutaneous tissue). This offers the closest insulin delivery system to the way the body without diabetes would produce insulin. At mealtimes, you request the pump to deliver extra insulin for carbohydrate containing foods and as a correction dose if your blood glucose levels are running high.

You wear a small adhesive patch which is attached to a cannula sitting just beneath the skin. This is usually made from Teflon, and is around 6mm long. An angled cannula can be used instead. The tubing runs between the cannula and the insulin pump which holds a small insulin reservoir which you will fill up at home.

The hourly rate of insulin infusion and the ratios of insulin to carbohydrates are set on the pump after discussion between you and your care team and will be altered as required based on your glucose readings. It will take some time to adjust your personal insulin requirements.

More information about insulin pumps can be found on the Diabetes UK website (see below for link) and by talking it through with your diabetes team.

Advantages and disadvantages of insulin pump therapy

Although insulin pumps have several benefits for managing blood sugar control, it is not suitable for everyone and is not the 'easy option'. Making the decision to go onto an insulin pump requires careful consideration between you and your care team and should not be rushed.

Advantages:

• more flexibility of insulin delivery
• fewer/ no injections
• lower insulin requirements
• decreased risk of complications by improved control
• possibility of improved quality of life

Disadvantages:

Continuous attachment to a device 24 hours a day, seven days a week, and requiring from you:

• close monitoring of blood glucose levels
• commitment to succeed on the therapy
• potential infusion set/ cannula problems

Next steps: can anyone have an insulin pump?

After reading about insulin pump therapy, you may wish to discuss it further with a member of staff at the NSIR clinic or at your local diabetes centre.

The waiting time to start on an insulin pump may vary depending on your location. This is because insulin pumps are not routinely used as a treatment for your type of diabetes, so an exceptional funding request will need to be completed by the NSIR team. Due to the volume of insulin you may require, pump choice may be limited. We can discuss pump choice at the time of applying for funding.

Note: patch pumps (those without tubing) are generally not suitable for people with severe insulin resistance.

Further information

If you would like to learn more about insulin pump therapy then you may wish to discuss it with your diabetes educator. If you have access to the Internet, you may want to visit:

Diabetes UK (opens in a new tab)
Insulin Pump Forum (opens in a new tab)

Please be aware that much of the information on insulin pump therapy is associated with people with type 1 diabetes. For severe insulin resistance, the function of the pump is to improve the delivery of insulin as large doses of insulin can be less effective and sometimes painful.

SIR educator contacts

(Monday to Friday 09:00 to 16:00)
SIR specialist nurse: 01223 348790
SIR specialist dietitians: 01223 216655