Insulin pump FAQ

There is a number of good insulin pumps. They all come in pocket size and are available in several colors. But there are – small but nonetheless important – differences. This is why the choice for one pump or the other is always the result of good consultation with the parents and the child. Below are the most frequently asked questions that we receive about insulin pumps.

Is the cost of a pump always compensated?

When the choice for a pump is made the diabetes team will ask the health insurer for an authorization for the pump and the materials that are used with it. The insurance companies Diabeter works with comply with pump therapy in almost all cases.

Does a pump allow you to eat everything?

Usage of the pump means you have more freedom in variation in your meals and snacks. Not only in the moment you take them, but also in the amount of carbo-hydrates. Not eating for instance means you don’t add an extra bolus. Still a healthy lifestyle remains an important part of good diabetes treatment. The advice is to eat normal, healthy food that fits someone’s age, with special care for not eating too much saturated fat. The lower blood glucose levels and the comfort of adding an extra bolus means there is always the risk of gaining weight. This is something for the child, the parents and the diabetes team to keep a close watch on.

Where to put the pump?

You can use a clip to fix the pump to your trouser belt, but you can also use a separate belt with a special pump bag. A lot of children carry the pump in their trouser pocket. The supplier offers several accessories.

What about sports?

With most sports you will uncouple the pump for a short period of time. Most of the time it is no problem to do this for two to three hours.

Does use of te pump always improve your HbA1c?

Not always. Decrease of the HbA1c can be expected if this was too high before you started using the pump. But lasting improvement of the BbA1calls for a steady involvement and motivation to measure the blood glucose levels and to adjust the pump settings accordingly.

Is there a waiting-list?

Yes, it varies from very short to three months. Much depends on the situation the family is in. It is best to start when the situation is quiet, for instance when there are no school tests or the family is not moving. This gives the parents and the child time to get to know the pump. And this time is of the essence because the parents and the child not only have to know how to use the pump and test the pump for a number of days with water in it. It is often also necessary to freshen-up the knowledge about diabetes and carbo-hydrates. In practice this means that a number of extra visits to our office is needed or about two hours each. They require the presence of the parents and the child, the childrens’ diabetes nurse and the dietician from Diabeter.

How does the start go?

For the so-called “pump-start” we expect the child and both parents at Diabeter on two subsequent days. We will be busy then from nine in the morning till three in the afternoon, to teach the parents and the child how to adjust the pump settings to the blood sugar levels that have been measured and to the amount of carbo-hydrates in meals and snacks. During these days we repeat the guidelines about how to act when a hypo or a hyper occurs, when the patient gets ill and in special circumstances. This often happens in a team.

Prior to these two days there has been much pump practice, with the use of the buttons and the counting of carbo-hydrates. At every visit during the preparation time we take a look at how the knowledge of the parents and the child (if possible) is developing. If this is still insufficient we are obliged to postpone the pump-start and practice longer.

During the first weeks after the start one of our team-members will have daily contact by telephone to see if everything goes as planned. After one, two, four and ten weeks there are in-office controls. We also have contact by email about the information the uploads of the pump offers. These uploads help to recognize and analyse trends. The high and low blood sugar levels we measure help us to optimise the adjustments of the pump. And with the mail contact we have about this we convey this knowledge to the parents and the child.

Is the pump a definite thing?

Going back to injecting insulin is always a possibility. This can be important when the child is in a phase of life – for instance puberty – in which insulin pump therapy doesn’t provide the desired results. But once the choice for pump therapy is made, this deserves a serious chance. Our principle is that the pump should be tried seriously for at least six months.