Modern insulin pumps are complex, multifaceted devices that continue to advance and evolve. A pump—particulary with integrated continuous glucose monitoring—is a powerful tool when prescribed to appropriate and motivated individuals, and can help people achieve their best possible level of glycemic control.
This comprehensive, fully updated edition guides practitioners through all aspects of initiating and maintaining effective pump therapy. Topics include:
Pump therapy advantages and disadvantages
Pump, infusion set, insulin options, and selection
Pump candidate basics
Getting the patient ready
Pump start-up
Pump therapy management
Case studies and guidelines
Chapter 1: Insulin Pump Therapy Advantages and Disadvantages Available to Purchase
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Published:2024
"Insulin Pump Therapy Advantages and Disadvantages", Putting Your Patients on the Pump, Nicholas B. Argento, MD, FACE, Karen M. Bolderman, RD, LDN, CDCES
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Insulin pump therapy is in its sixth decade and is gaining wider popularity. The Type 1 Diabetes (T1D) Exchange, an organization that monitors about 30,000 patients cared for in diabetes centers, reported that 63% of patients in the exchange were using insulin pumps in 2016–2018, with a higher percent age of pumps used in pediatric compared to adult patients (Foster et al 2019). In the U.S. overall, it is estimated that about 30% of those with type 1 diabetes (T1D) are on pump therapy, whereas a much smaller percentage of those with type 2 diabetes (T2D) use pumps. Meta-analyses have demonstrated the benefit of pumps in lowering A1C and reducing hypoglycemia in T1D patients (Yeh et al 2012) as well as poorly controlled T2D patients (Pickup et al 2017). The key American Diabetes Association (ADA) 2023 recommendations on insulin pumps (ADA 2023) are listed in Box 1.1.
People with diabetes are not just concerned about their A1C and hypoglycemia, however important those factors may be; they are also concerned about the impact a therapy has on their quality of life. Insulin pump therapy requires fewer subcutaneous injections compared with multiple daily injection (MDI) therapy; an infusion set and site are changed every 2–3 days, for an average of about 152 infusion site insertions/year, while typical MDI therapy results in about 1,460 injections/year (based on 4 injections/day).
