‘This is my insulin pump’ I say, whipping it out of my cleavage when people see it neatly tucked in my bra front (perhaps I wear tops that are too low??). I try to explain what it does but often I see some unasked questions lurking as curiosity behind peoples eyes, such as ‘Where does that tube actually go?’ and ‘Is there a needle inside you?’ or ‘Does that go into your blood stream?’. Sometimes I explain but much of the time, to be honest, I can’t be bothered.
I’ve had an insulin pump now for 3 years (or there about). So my blog this week is about the mechanics of pump use and an attempt to answer some of those questions I can see people want to ask but probably think its too rude to!
I, of course, use a particular brand of pump and ‘giving set’ (that’s the tubing and bit that goes into me) but I think most pumps are similar, at least in principle.
I will also share with you the mechanics of my continuous glucose monitor – just in case you didn’t like to ask. I intend to blog properly about this later when the results are in as I’m still mid way through that experience.
So insulin pumps are essentially little pumps that push a regulated amount of insulin through a tube and into subcutaneous tissue. Subcutaneous means beneath the skin and refers to the connective tissues and adipose tissues that are between the outer layer of skin and above the muscles
They are similar to other types of syringe drivers found in hospitals but are much smaller as they are attached to the person 24 hours everyday and insulin is administered in very small quantities
My pump has a reservoir of insulin of 3 mls, which clips into the pump.
This then has a tube connected to it like this:
The end of the tube has a tiny plastic tube that is inserted into the subcutaneous tissue. It is introduced with a special inserter device and a needle which is shown here:
The needle is withdrawn once the tubing is in place.
The inserter needle removed from the inserter!
The tubing is around 60 cm long and allows the pump to lie next to me in bed at night. How I coped with the pump in bed was one of my biggest worries before I got the pump but I soon settled into moving it around with me in bed; I rarely get tangled up.
You can remove the pump and tubing to shower and bathe (and other times as necessary 😉 ). You leave the little cap, with the plastic tube attached and reattach the tubing and pump once you are done.
This is one I have had in place for around 3 days and removed. You have to change the giving set every 3 days.
Removed cannula (sorry its a bit fuzzy – iPhone :))
There are many different types of cannula and tube – this just happens to be the one I use. A cannula is a hollow tube with a sharp, retractable inner core that can be inserted into a vein, an artery, or another body cavity, or in this case subcutaneous tissue.
Sometimes the little bit of tubing gets kinked and this can interrupt the delivery of the insulin and you might see me bemoaning a kinked cannula on Twitter as its a real pain when this happens, although for me its been a rare event.
A continuous glucose monitor, sometimes called a CGM, in my case refers to a small electric sensor that is inserted into subcutaneous tissue. Here is the last one I removed – its slightly bent but still worked fine, although bending is not a ‘good’ thing!
It is attached to a small transmitter – here is a picture of the transmitter attached to me.
The CGM in place – coovered in opsite dressing!
The transmitter wirelessly send the measurement of glucose in the interstitial fluid – the fluid in and around your body’s cells – to my pump which then can give a picture of my glucose levels continuously over the day and night. This is not the same as blood glucose which we measure with our meters but is less invasive than connecting something into the venous system. The readings are calibrated with blood sugar readings taken by a usual finger prick measurement.
Here is a picture of the measurement showing on my pump.
I hope that explanation and the picture answered some questions 🙂
There are different types of pumps and CGMs and the products are improving all the time – it will be interesting to see the development of patch pumps or pods, which seem to be the emerging next generation. Everyone with Type 1 diabetes is likely to be watching these developments with some degree of interest.
I am still very grateful for my pump. It transformed my life and made me feel so much more ‘well’, its hard to explain. For my treatment and care, including my pump, I remain eternally gratefully to the NHS and the people who work in it.