Insulin Pumps

Insulin pumps are used for the administration of insulin, also known as continuous subcutaneous insulin therapy. The device configuration may vary depending on the design and manufacturer. A traditional pump includes:

the pump (including controls, processing module, and batteries)

a disposable reservoir for insulin (inside the pump)

a disposable infusion set, including a cannula for subcutaneous insertion (under the skin), and a tubing system to connect the insulin reservoir to the cannula.

Other configurations are possible. More recent models may include disposable or semi-disposable designs for the pumping mechanism and may eliminate tubing from the infusion set.

An insulin pump is an alternative to multiple daily injections of insulin by insulin syringes or an insulin pen and allows for flexible insulin therapy when used in conjunction with blood glucose monitoring and carbohydrate counting.

There are no consensus guidelines for choosing between an insulin pump and multiple daily injections and the decision as to which to use depends on cost, patient preference, and which works best for the patient in terms of maintaining the optimal HbA1c level and avoiding hypoglycemia.

 

Continuous subcutaneous insulin therapy (3 components) •Pump •Disposable reservoir •Disposable infusion set   •Advantages to insulin pump use

 

Insulin Pens

Insulin pens are preferred by most patients and compared to syringes and vials, insulin pens are more convenient, the delivered dose is more accurate, glycemic control is improved (the dose is consistently more accurate, and the shorter needle length avoids intra-muscular injection), patient adherence to the medication regimen is improved, and the risk of hypoglycemia is less.

 

In 2017, the Food and Drug Administration (FDA) approved the first insulin pen that can be combined with a smartphone application. This device, the InPen®, automatically tracks many aspects of insulin therapy and helps patients calculate doses and manage their insulin therapy. The InPen system is compatible with lispro (Humalog), aspart (Novolog), and Fiasp rapid-acting insulin cartridges. While it isn’t compatible with long-acting insulin, the smart phone apps allow for manual entry of long-acting insulin and set reminders.

 

The NovoPen Echo is designed for use by children, is compatible with aspart (Novolog), allows half-unit dosing, and administers up to 30 units per injection. There are several other smart insulin pens that are not yet available in the United States.

Preferred over syringes and vials More convenient More accurate delivery Less pain (shorter needle) Improved patient adherence Decreased risk of hypoglycemia   Smart Pens •InPen® •NovoPen Echo ®