The insulin pump is a small programmable device (about the size of a pager) that holds a reservoir of insulin. The pump is programmed to deliver insulin into the body through thin plastic tubing known as the infusion set or giving set. The pump is worn outside the body, in a pouch or on your belt.
The infusion set has a fine needle or flexible cannula that is inserted just below the skin (usually on the abdomen) where it stays in place for two to three days.
Only rapid acting insulins are used in the pump. Whenever food is eaten the pump is programmed to deliver a surge of insulin into the body similar to the way the pancreas does in people without diabetes. Between meals a small and steady rate of insulin is delivered.
The insulin pump is not suitable for everyone. So, if you’re considering using one, you must discuss it first with your diabetes health care team.
Insulin Pumps Available in Australia are:
- AMSL – Animas Vibe
- Medtronic – Minimed 640G
- Roche – Accu-Chek Combo
To be suitable for insulin pump therapy, you must have support from your health care team, a suitable level of hospital cover with a private health insurance fund or be eligible for a subsidy through the Australian Government Insulin Pump Programme.
Insulin pumps can be a great way to help manage your diabetes. If you decide to start on a pump you might notice that a few things about food are a little bit different, like closer counting of your carbohydrate exchanges/amounts, and more flexible meal times and amounts of food.
Eating and insulin pumps
Why do you need to count carbohydrates?
We know that carbohydrate foods put glucose (sugar) into your blood stream for energy. The insulin you inject needs to match your carbohydrate foods (and activity) to keep BGLs mostly in the normal range. This is important whether you’re on a pump or not.
When you’re on a pump you can match your food and insulin more closely because every time you eat, you program the pump to give you quick acting insulin (bolus). Your diabetes team will tell you how much insulin you need to give for every carbohydrate exchange you eat. If you’re not sure how much carbohydrate you’re going to eat you can also give the insulin after you eat. Some pumps even let you program in how many grams of carbohydrate you’ve eaten and it then works out how much insulin to give.
How do you work out how much carbohydrate is in different foods?
Your dietitian can help you work out how much carbohydrate is in different foods. You might need to weigh or measure out carbohydrate foods to help you count carbohydrates. You also need to be able read food labels to work out how much carbohydrate is in different foods.
Do you need to follow set carbohydrate exchanges?
When you’re on an insulin pump you don’t need to eat the same number of exchanges at your meals each day. If you’re not very hungry you can eat less and if you’re really hungry, you can eat more. You can then give your insulin depending on how much carbohydrate you’ve eaten.
Do you need to eat snacks between meals?
On an insulin pump you don’t need to have snacks if you don’t want to, but it’s important to eat regular meals to be healthy.
Does being on a pump mean you eat anything you want?
When you’re on a pump, you still need to make healthy food choices. Lollies, soft drinks, crisps and chocolates are not great choices for anyone. On a pump, you should still use diet or low joule soft drinks and keep snack foods as special occasion treats.
What do you do at school when you’re on a pump?
At school, you need to remember to give your insulin bolus when you eat. To do this, you need to know how much carbohydrate is in the foods that you have at recess and lunch. Knowing the amount of carbohydrate in different canteen choices is also important.
What about food for sport when you’re on a pump?
When you’re on an insulin pump you can still play sport. You might find that you still need some extra carbohydrate foods for energy. On a pump you can reduce your insulin before and after sport and you might not need to eat as much extra food to prevent hypos.
How do you find out more about food and pumping?
When you start on a pump your Dietitian can give you some extra healthy eating info.