Insulin Delivery Systems: An Overview
Pen, Pump, or Syringe? continued...
- Expense. Because insulin pens cost slightly more than syringes (about $30 - $40 a pen), many insurance companies won't cover the cost.
- Lack of options. Some types of insulin aren't available in pen form.
An insulin pump is a device that's about the same size as a pager. You wear it on your belt or in a pocket, and it delivers a steady stream of insulin to your body 24 hours a day through a needle attached to a flexible plastic tube. Whenever you eat, you press a button on the pump to give yourself an extra boost of insulin, called a bolus.
The pump is an option for people with type 1 diabetes who haven't reached their target blood sugar level using other delivery methods. It’s also a good option for people with diabetes that have very active lifestyles. It's not clear whether people with type 2 diabetes benefit from using a pump.
- Steady insulin release. "The pump's advantages are linked to its very nature, which is to try to mimic the way the body makes insulin -- a small amount all the time and a boost at mealtimes," Fonseca says. Pumps are so efficient that you can use less insulin than you would with a syringe or pen.
- Ease of use. You'll no longer have to give yourself injections of insulin throughout the day--the pump will do it for you automatically. You can also eat whenever you choose.
- Better blood sugar control. Because it delivers insulin steadily like your pancreas, the pump helps prevent blood sugar swings.
- Ease of monitoring. Your pump can communicate with your glucose monitoring system so you can track your blood sugar over time and make changes to your routine as needed.
- Constant wear. "The disadvantage is that you are hooked to a device that your life is dependent on," according to Fonseca. You're going to be attached to this pump nearly all of the time -- even when you sleep.
- Risks. You need to be very careful about changing the needle every couple of days because there is a slight risk for infection. You also have to monitor your blood sugar levels, because you may be more likely to have a drop in blood sugar (hypoglycemia) with the pump than with a syringe or pen. If the catheter slips out or the pump fails, you might not get the insulin you need and over time your sugars can increase and you could develop a dangerous complication called diabetic ketoacidosis.
- Cost. Pumps run about $5,000, plus you have to pay for the ongoing cost of supplies (such as batteries and sensors). That can really add up over time.