Choosing to switch to an insulin pump to help manage your diabetes is a big decision. It’s important to know the pros and cons of insulin pumps before asking your doctor for a prescription.
For a real-life, personal experience on multiple daily injections vs an insulin pump, you can read Christle Oerum’s, founder of Diabetes Strong, blog post. If you want more background information on how an insulin pump works, start with reading my other blog post, Diabetes Insulin Pump: A Complete Guide to Getting Started.
Once you know how they work, you can then weigh the pros and cons of using an insulin pump.
A quick summary of the pros and cons of insulin pumps:
First, we’ll cover the longer list of insulin pump pros.
Eat when and what you want
Gone are the days where you must eat at precisely 8 AM, noon, and 5 PM to take your insulin. No more snacking on foods with less than 15 grams of carbs so you can avoid taking another insulin shot.
As long as you know (or have a good idea) how many carbs are in the foods you’re eating, you can plug that number into your pump and it will give you a certain amount of insulin to cover those carbs. Time of day doesn’t matter.
And of course, if you do like snacking on low carb foods such as nuts, cheese, or hard boiled eggs (I know I do!) that’s perfectly fine to keep doing. An insulin pump just gives the option to eat higher carb snacks if you’d like.
Flexibility with exercise
Along with eating flexibility, an insulin pump also allows for exercise flexibility.
You can program the pump to give you less basal insulin or bolus insulin 1-2 hours before beginning exercise. If you choose to wear the pump during exercise, some pumps may have a feature where basal insulin delivery adjusts to keep your blood sugars a bit higher than normal.
This may help prevent severe lows or highs that can sometimes happen with exercise.
Insulin pumps allow you to customize the amount of insulin you receive at different hours of the day/night. These settings can help reduce the frequency of nighttime lows and highs which = better sleep.
Adjustable insulin delivery rates/times
Have you ever reduced your long-acting insulin by a unit or two because you were going low overnight, only to wake up with high numbers? Maybe you need less insulin between the hours of 11 PM and 2 AM, but then need more insulin around 2:30 AM to prevent a morning spike.
An insulin pump allows for customization using different insulin rates at different times. If you’d like to know more about how exactly an insulin pump works, read my blog post on Diabetes Insulin Pump: A Complete Guide to Getting Started.
Always with you
No more remembering to pack insulin pens and a couple needles. Depending on the pump brand, the pump either attaches directly to your skin or is in your pocket/on your waist band while an infusion site attaches to your skin.
With insulin injections, you’re likely poking yourself with a needle 4-5 times per day. Even more so if you don’t have a CGM and are manually checking your blood sugar.
Expect to poke yourself with a needle for a pump site change once every 2-3 days.
Less severe low blood sugars
The insulin pump’s algorithm takes into account when you last bolused and how much active insulin is in your body before calculating a correction or meal bolus. And like I mentioned before, you can customize insulin delivery rates/times. This reduces your chances of having a severe low blood sugar which is a win for everyone.
Longer time in range (TIR)
While your doctor probably uses your A1c to evaluate your diabetes control for the past 3 months, this test isn’t as meaningful as time in range (TIR).
TIR refers to how long your blood sugars are in the target range (typically between 70 and 180 mg/dL). The goal is to have at least 70% TIR for good blood sugar control and to reduce the chances of diabetes complications (1). Because insulin pump settings are so customizable and can communicate with a CGM to adjust insulin delivery, blood sugars are in range longer.
Finally, we have technology.
With an insulin pump, you have access to the best technology in the diabetes world. Today’s insulin pumps communicate with CGMs to adjust insulin delivery settings to help keep your blood sugars in range longer.
Insulin pump and CGM reports also make it easier for your doctor to determine where your settings may need adjusting. You may even be able to upload pump/CGM data from home if you can’t make it to your doctor’s office.
Even though there are many pros to using an insulin pump, there are also some cons.
Cost is probably the biggest con to using an insulin pump.
The upfront cost for purchasing an insulin pump ranges from $900-7300, depending on how much insurance will help pay. Then, you need to pay for insulin pump supplies monthly or every three months. Supply costs can range from $100-500. Then, you still have to buy vials of fast or ultra-fast acting insulin for your pump.
Attached to you all the time
Even though it’s great not having to remember to bring an insulin pen with you to a restaurant, some patients find it quite annoying being attached to something nearly all day and night.
It can also take some time to get used to the pump tubing (if you choose this option) which you can easily hook on a cupboard handle and accidentally rip out your site.
Packing extra supplies
The final con of having an insulin pump is remembering to pack extra supplies when leaving the house. Accidents happen and you may need to change your site when you’re away from home.
I would recommend packing two of each supply item when leaving the house for errands or leaving extra supplies at your place of work (as long as they aren’t exposed to extreme temperatures). For long trips, I’d pack one of each supply for every day you’ll be gone.
With all of this to pack, you may end up bringing an extra bag just for your diabetes supplies!
In this post, we covered the pros and cons of insulin pumps. While pros such as flexibility in eating and less severe low blood sugars are the dream of anyone with diabetes, it’s also important to consider cons such as cost and wearability.
If you decide an insulin pump is right for you, scroll to the bottom of my other blog post, Diabetes Insulin Pump: A Complete Guide to Getting Started, to learn how to start the process.
Megan is a Registered Dietitian, Certified Diabetes Care and Education Specialist, and a Certified Insulin Pump Trainer. She has a Bachelor of Science in Dietetics from Iowa State University. She has had type 1 diabetes since she was 11 years old and has taught diabetes education for many years.