Insulin pumps are small devices that deliver insulin continuously throughout the day and night. The fitting process varies slightly depending on the type of pump, but generally involves these steps:
Types of Insulin Pumps and Their Fitting
There are two main types of insulin pumps: traditional pumps and patch pumps.
Traditional Insulin Pumps
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Insulin Cartridge Insertion: The pump's insulin cartridge is filled with fast-acting insulin. This cartridge is then carefully inserted into the pump itself. (https://www.diabetes.co.uk/insulin/how-insulin-pumps-work.html)
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Infusion Set Attachment: An infusion set, consisting of thin plastic tubing and a needle or cannula (a small, flexible tube), is connected to the pump. (https://www.webmd.com/diabetes/insulin-pump)
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Infusion Site Insertion: The needle or cannula is inserted into the subcutaneous (under the skin) tissue, typically in the abdomen, thigh, or arm. This can be done manually or with an injecting device. (https://my.clevelandclinic.org/health/articles/insulin-pumps) The insertion site is carefully selected to avoid areas with excessive scar tissue, prominent blood vessels or bruising.
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Pump Attachment: The pump itself is then attached to the body using a clip, belt, or pouch. It's important to ensure the tubing doesn't kink or get pulled. (https://www.medtronicdiabetes.com/products/insulin-pump-style-and-accessories) This allows for easy access while ensuring secure placement.
Patch Pumps
Patch pumps differ significantly in their fitting:
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Cannula Placement: The cannula is inserted into the subcutaneous tissue in a chosen location on the body— commonly legs, arms, or stomach. (https://www.mountsinai.org/health-library/special-topic/insulin-pumps, https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/insulin/insulin-pumps)
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Pump Attachment: The patch pump is then directly applied to the skin over the cannula insertion site. It adheres directly to the skin and eliminates the need for tubing. The pump is controlled remotely. (https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/insulin/insulin-pumps)
Programming and Use
Regardless of pump type, the device must be programmed with the user's specific insulin needs. This involves setting basal rates (continuous background insulin delivery) and bolus doses (insulin for meals and corrections). Healthcare professionals provide detailed instructions on programming and managing the pump. (https://www.umassmed.edu/dcoe/diabetes-education/pumps_and_cgm/, https://www.nhs.uk/conditions/type-1-diabetes/treatment/)
