Insulin pumps are primarily used by people with type 1 diabetes, but more type 2 diabetes patients are starting to use the pump. The biggest advantage of the insulin pump is improved blood glucose control. For example, in a four-month study of 79 people with diabetes, pump users had an average HbA1c level that was 0.8 percentage points lower than that of people on injected insulin therapy. In this Health Alert Johns Hopkins experts answer the question: Am I a good candidate for an insulin pump?

Insulin pumps have been used to treat type 1 diabetes for the past 20 years. The external pumps are small, computerized devices that deliver insulin through a thin tube inserted via a needle into the skin of the stomach or thigh. Their big advantage is that they offer flexibility, convenience, and an insulin flow that is completely predictable since you program it yourself.

Most people with type 2 diabetes who require insulin have fairly stable blood glucose levels, often requiring just one or two injections per day, so an insulin pump isn’t needed. But in hard-to-treat individuals with type 2 diabetes -- when glucose levels become very unstable and multiple doses of insulin are needed daily -- the insulin pump may be beneficial. One study found that insulin pumps were comparable to multiple daily injections in keeping type 2 diabetes under tight control, and most of the participants preferred the insulin pump to shots.

Individuals who are considering insulin pump therapy must be knowledgeable about their diabetes and committed to regular glucose monitoring. Unlike shots, you have to make sure to set the delivery rate correctly, check the tubing for blockages and change it regularly, and keep the insulin storage chamber full.

Since insulin pumps use rapid-acting insulin, any malfunction can cause a rapid drop in insulin levels, so you need to monitor your blood glucose several times a day. If you think you would benefit from using an insulin pump, discuss it with your doctor.