Insulin Pumps

You may have some questions about using an insulin pump, even if you are an experienced pumper.
Some things you may be thinking about:
-Where do I put my pump site?
-How often should I change my site?
-Where can I put my pump?
-Will I still have to prick my finger to check my blood sugar?
-Will my insulin pump detect when I need insulin and administer it automatically?
-Does the site hurt?
Although I am most familiar with a Medtronic pump that delivers insulin through tubing, many of the following recommendations can be used with a “Pod”-type inslulin pump.

Where do I put my pump site?
There are several spots on your body that will work well with your pump site. Your site can really be put wherever it is comfortable and does not interfere with your daily activities or the delivery of insulin. Some experimentation may be necessary to find your “favorite spots”. One thing to keep in mind is if there is more fatty tissue in your site area you will probably experience less discomfort. That said, some favorite spots are the lower abdomen, below the belly button, and upper behind and hip area. You can also use your arms, legs, upper abdomen, and even breast tissue. It should feel comfortable so you do not feel it as a hinderance. As a woman, I have never used my legs for my sites because I feel like I might rip the site right out every time I pull my pants down to use the bathroom, however, this may be a better spot for men. The following link has photos of different pump site locations:

How often should I change my site?
Just about every recommendation to change your site will be at least every three days. My Endocrinologist has recommended that I change it every 2 days in the summer time because your body is warmer and will sweat more. This may cause loosening of the tape around your site, which you want to keep secure to ensure proper insulin delivery. Another reason to change your site frequently is to avoid any infection. I will admit that I have left my site in for more than 3 days at a time, and I have had no problems. However, I do not do this on a regular basis. You should figure out how much insulin you will use in a 3 day period, and fill your reservoir accordingly. Every person has a different skin sensitivity, so although I had no infection or problems with my site healing after 3 days, someone else may be more susceptible to an infection.

Where can I put my pump?
Luckily there are lots of options for this question also. Most insulin pump users do not want their pump hanging out in the open, prompting the question, “I didn’t know they still made pagers! Do you need one for work? You must be a doctor or a nurse.” Others may not care, but most of us, I believe, like to wear our pumps discretely. Men seem to have an easier time concealing their pumps, they can just slip it into a pocket of their pants or shorts without a problem. For women, we have to be more creative when we wear skirts or dresses or more fitted clothing.
Most pumps come with some sort of clip. This can be used on pant waistbands, pockets, or clipped to undergarments. My sister, being more well-endowed than I, can clip her pump right in the middle of her bra and it does not show through her tops at all. I, however, have tried this many times and the result looks like I’m a robot with a control box between her breasts. So depending on your cup size, this may, or may not, be an option for you. Another option in this area is on the side of your bra, almost underneath your arm- this can be done with or without a clip.
Some places that work well for me:
-Clipped inside my yoga pants, or skirts, resting just on the inside of the hip bone (this little curve creates a semi-hiding spot so it is not so blatantly out in the open).
-Clipped or resting just inside my underwear. Maybe not the most comfortable, but a possible necessity in a dress.
-Worn inside a thigh strap, or thigh thing without the clip. This is a spandex-like material that works well under many dresses.
There are many companies now that make different cases, covers, or body wraps to help conceal your insulin pump while keeping it secure and close to your body.

Will I still have to prick my finger to check my blood sugar?
Yes. Unfortunately there is no way around this, but I think things are coming along, and soon this might be a possibility and well-deserved vacation for our fingers.
Medtronic does make a continuous glucose monitoring system where you have a small site under your skin connected to a transmitter, which beams your results to your insulin pump. It will alarm according to settings, for example if your blood sugar rises to high, or drops sharply. I have read that this system is good for monitoring drastic changes in blood sugar, but it is not as accurate because it is measuring sugar in the soft tissue, as opposed to testing your blood directly. There will always be a little difference between the two. So finger-pricks are still more accurate, and required for good maintenance.

Will my insulin pump detect when I need insulin and administer it automatically?
No. You can use a glucose monitoring system, or a meter that connects wirelessly to share information with your pump. If your blood sugar is not in a normal range, your pump may prompt you to administer insulin or eat something (this can usually be changed in the settings of the pump). It is good to get into the practice of learning how many carbohydrates are in the foods you eat, so you can properly bolus.

Does the site hurt?
It can, but not usually. It is helpful to use the fattier tissue on your body to reduce discomfort in your site areas. Sometimes you may feel a little pinch, just like when giving yourself a regular injection, when you inject the site. Most of the time, once you take the injection needle out, and only the cannula is left under your skin, it does not hurt. There may be times when you inject into a tough spot, or the cannula is resting on a vein. This may cause some pain, but it should go away. If it is extreme and the pain persists, it is best to move the site to a new location rather than suffer for three days.
Normally when the pump delivers the insulin you will not feel it at all. Sometimes when I am sleeping I may roll over the site, and it is tweaked in the the wrong way. It is almost like stubbing your toe and you feel slight pain for a few seconds then it disappears. Overall, there is a lot less pain in using an insulin pump than there is taking several injections every day.


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