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class="vector-toc-numb">2.2</span> <span>Future developments</span> </div> </a> <ul id="toc-Future_developments-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Dosing" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Dosing"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Dosing</span> </div> </a> <button aria-controls="toc-Dosing-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Dosing subsection</span> </button> <ul id="toc-Dosing-sublist" class="vector-toc-list"> <li id="toc-Bolus_shape" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Bolus_shape"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Bolus shape</span> </div> </a> <ul id="toc-Bolus_shape-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Bolus_timing" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Bolus_timing"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Bolus timing</span> </div> </a> <ul id="toc-Bolus_timing-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Basal_rate_patterns" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Basal_rate_patterns"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Basal rate patterns</span> </div> </a> <ul id="toc-Basal_rate_patterns-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Basal_rate_determination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Basal_rate_determination"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Basal rate determination</span> </div> </a> <ul id="toc-Basal_rate_determination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Temporary_basal_rates" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Temporary_basal_rates"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.5</span> <span>Temporary basal rates</span> </div> </a> <ul id="toc-Temporary_basal_rates-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Security" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Security"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Security</span> </div> </a> <ul id="toc-Security-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input 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Available in 27 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-27" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">27 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%B6%D8%AE%D8%A9_%D8%A5%D9%86%D8%B3%D9%88%D9%84%D9%8A%D9%86" title="مضخة إنسولين – Arabic" lang="ar" hreflang="ar" data-title="مضخة إنسولين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D0%B8%D0%BD%D0%BE%D0%B2%D0%B0_%D0%BF%D0%BE%D0%BC%D0%BF%D0%B0" title="Инсулинова помпа – Bulgarian" lang="bg" hreflang="bg" data-title="Инсулинова помпа" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Bomba_d%27insulina" title="Bomba d'insulina – Catalan" lang="ca" hreflang="ca" data-title="Bomba d'insulina" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Inzulinov%C3%A1_pumpa" title="Inzulinová pumpa – Czech" lang="cs" hreflang="cs" data-title="Inzulinová pumpa" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Insulinpumpe" title="Insulinpumpe – Danish" lang="da" hreflang="da" data-title="Insulinpumpe" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Insulinpumpe" title="Insulinpumpe – German" lang="de" hreflang="de" data-title="Insulinpumpe" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Insuliinipump" title="Insuliinipump – Estonian" lang="et" hreflang="et" data-title="Insuliinipump" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Bomba_de_insulina" title="Bomba de insulina – Spanish" lang="es" hreflang="es" data-title="Bomba de insulina" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%D9%85%D9%BE_%D8%A7%D9%86%D8%B3%D9%88%D9%84%DB%8C%D9%86" title="پمپ انسولین – Persian" lang="fa" hreflang="fa" data-title="پمپ انسولین" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Pompe_%C3%A0_insuline" title="Pompe à insuline – French" lang="fr" hreflang="fr" data-title="Pompe à insuline" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9D%B8%EC%8A%90%EB%A6%B0_%ED%8E%8C%ED%94%84" title="인슐린 펌프 – Korean" lang="ko" hreflang="ko" data-title="인슐린 펌프" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Microinfusore" title="Microinfusore – Italian" lang="it" hreflang="it" data-title="Microinfusore" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%9E%D7%A9%D7%90%D7%91%D7%AA_%D7%90%D7%99%D7%A0%D7%A1%D7%95%D7%9C%D7%99%D7%9F" title="משאבת אינסולין – Hebrew" lang="he" hreflang="he" data-title="משאבת אינסולין" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Inzulinpumpa" title="Inzulinpumpa – Hungarian" lang="hu" hreflang="hu" data-title="Inzulinpumpa" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Insulinepomp" title="Insulinepomp – Dutch" lang="nl" hreflang="nl" data-title="Insulinepomp" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Insulinpumpe" title="Insulinpumpe – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Insulinpumpe" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Pompa_insulinowa" title="Pompa insulinowa – Polish" lang="pl" hreflang="pl" data-title="Pompa insulinowa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Pomp%C4%83_de_insulin%C4%83" title="Pompă de insulină – Romanian" lang="ro" hreflang="ro" data-title="Pompă de insulină" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%98%D0%BD%D1%81%D1%83%D0%BB%D0%B8%D0%BD%D0%BE%D0%B2%D0%B0%D1%8F_%D0%BF%D0%BE%D0%BC%D0%BF%D0%B0" title="Инсулиновая помпа – Russian" lang="ru" hreflang="ru" data-title="Инсулиновая помпа" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Insulin_pump" title="Insulin pump – Simple English" lang="en-simple" hreflang="en-simple" data-title="Insulin pump" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Inzul%C3%ADnov%C3%A1_pumpa" title="Inzulínová pumpa – Slovak" lang="sk" hreflang="sk" data-title="Inzulínová pumpa" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Inzulinska_%C4%8Drpalka" title="Inzulinska črpalka – Slovenian" lang="sl" hreflang="sl" data-title="Inzulinska črpalka" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Insulinska_pumpa" title="Insulinska pumpa – Serbian" lang="sr" hreflang="sr" data-title="Insulinska pumpa" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Insuliinipumppu" title="Insuliinipumppu – Finnish" lang="fi" hreflang="fi" data-title="Insuliinipumppu" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Insulinpump" title="Insulinpump – Swedish" lang="sv" hreflang="sv" data-title="Insulinpump" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%86%D0%BD%D1%81%D1%83%D0%BB%D1%96%D0%BD%D0%BE%D0%B2%D0%B0_%D0%BF%D0%BE%D0%BC%D0%BF%D0%B0" title="Інсулінова помпа – Ukrainian" lang="uk" hreflang="uk" data-title="Інсулінова помпа" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%83%B0%E5%B2%9B%E7%B4%A0%E6%B3%B5" title="胰岛素泵 – Chinese" lang="zh" hreflang="zh" data-title="胰岛素泵" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q941674#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet mw-portlet-associated-pages" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="ca-nstab-main" class="selected vector-tab-noicon mw-list-item"><a href="/wiki/Insulin_pump" title="View the content 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</div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical device to administer insulin</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Automated_insulin_delivery_system" title="Automated insulin delivery system">Automated insulin delivery system</a></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">"CSII" redirects here. 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Unsourced material may be challenged and removed.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Insulin+pump%22">"Insulin pump"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Insulin+pump%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Insulin+pump%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Insulin+pump%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Insulin+pump%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Insulin+pump%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">June 2022</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Insulin pump</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Insulin_pump_and_infusion_set.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Insulin_pump_and_infusion_set.JPG/280px-Insulin_pump_and_infusion_set.JPG" decoding="async" width="280" height="210" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Insulin_pump_and_infusion_set.JPG/420px-Insulin_pump_and_infusion_set.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Insulin_pump_and_infusion_set.JPG/560px-Insulin_pump_and_infusion_set.JPG 2x" data-file-width="2592" data-file-height="1944" /></a></span><div class="infobox-caption">Paradigm insulin pump 530g, showing an infusion set loaded into spring-loaded insertion device called serter. A reservoir is attached to the infusion set (shown here removed from the pump).</div></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q941674" class="extiw" title="d:Q941674">edit on Wikidata</a>]</div></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Insulin_pump_with_infusion_set.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Insulin_pump_with_infusion_set.jpg/220px-Insulin_pump_with_infusion_set.jpg" decoding="async" width="220" height="212" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Insulin_pump_with_infusion_set.jpg/330px-Insulin_pump_with_infusion_set.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/8/89/Insulin_pump_with_infusion_set.jpg 2x" data-file-width="436" data-file-height="420" /></a><figcaption>Insulin pump in use</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b5/Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg/220px-Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b5/Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg/330px-Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b5/Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg/440px-Jonge-diabetespatint-met-insulinepomp-op-de-huid-geplakt-1326488205.jpg 2x" data-file-width="1024" data-file-height="683" /></a><figcaption>Diabetic child wearing a state-of-the-art insulin pump (referred to as a "patch pump"). His waterproof device needs no one infusion set</figcaption></figure> <p>An <b>insulin pump</b> is a medical device used for the administration of <a href="/wiki/Insulin" title="Insulin">insulin</a> in the treatment of <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, also known as continuous <a href="/wiki/Subcutaneous_tissue" title="Subcutaneous tissue">subcutaneous</a> insulin therapy. The device configuration may vary depending on design. A traditional pump includes: </p> <ul><li>the pump (including controls, processing module, and batteries)</li> <li>a disposable reservoir for insulin (inside the pump)</li> <li>a disposable <a href="/wiki/Infusion_set" title="Infusion set">infusion set</a>, including a <a href="/wiki/Cannula" title="Cannula">cannula</a> for subcutaneous insertion (under the skin) and a tubing system to connect the insulin reservoir to the cannula.</li></ul> <p>Other configurations are possible. More recent models may include disposable or semi-disposable designs for the pumping mechanism and may eliminate tubing from the infusion set. </p><p>An insulin pump is an alternative to multiple daily injections of insulin by <a href="/wiki/Syringe#Standard_U-100_insulin_syringes" title="Syringe">insulin syringes</a> or an <a href="/wiki/Insulin_pen" class="mw-redirect" title="Insulin pen">insulin pen</a> and allows for <a href="/wiki/Flexible_insulin_therapy" class="mw-redirect" title="Flexible insulin therapy">flexible insulin therapy</a> when used in conjunction with <a href="/wiki/Blood_glucose_monitoring" title="Blood glucose monitoring">blood glucose monitoring</a> and <a href="/wiki/Carbohydrate_counting" title="Carbohydrate counting">carbohydrate counting</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Insulin pumps are used to deliver insulin on a continuous basis to a person with <a href="/wiki/Type_I_diabetes" class="mw-redirect" title="Type I diabetes">type I diabetes</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Advantages">Advantages</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=2" title="Edit section: Advantages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Users report better quality of life (QOL) compared to using other devices for administering insulin. The improvement in QOL is reported in type 1 and insulin-requiring type 2 diabetes subjects on pumps.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li> <li>The use of rapid-acting insulin for basal needs offers relative freedom from a structured meal and exercise regime previously needed to control blood sugar with slow-acting insulin.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li> <li>Programmable basal rates allow for scheduled insulin deliveries of varying amounts at different times of the day. This is especially useful in controlling events such as the <a href="/wiki/Dawn_phenomenon" title="Dawn phenomenon">dawn phenomenon</a> resulting in fewer and less severe <a href="/wiki/Hypoglycemia" title="Hypoglycemia">low blood sugar</a> events during the night.<sup id="cite_ref-Millstein2015_3-0" class="reference"><a href="#cite_note-Millstein2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li>Many users feel that bolusing insulin from a pump is more convenient and discreet than injection.<sup id="cite_ref-Millstein2015_3-1" class="reference"><a href="#cite_note-Millstein2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li>Insulin pumps make it possible to deliver more precise amounts of insulin than can be injected using a syringe. This supports tighter control over blood sugar and <a href="/wiki/HbA1c" class="mw-redirect" title="HbA1c">hemoglobin A1c</a> levels, reducing the chance of <a href="/wiki/Complications_of_diabetes" title="Complications of diabetes">long-term complications</a> associated with diabetes. This is predicted to result in a long-term cost savings relative to multiple daily injections.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>Many modern insulin pumps have a "bolus wizard" that calculates how much bolus insulin is needed, taking into account expected carbohydrate intake, blood sugar level, and still-active insulin.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li>Insulin pumps can provide an accurate record of insulin usage through their history menus. On many insulin pumps, this history can be uploaded to a computer and graphed for trend analysis.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">Neuropathy</a> is a troublesome complication of diabetes resistant to usual treatment. There are reports of alleviation or even total disappearance of resistant neuropathic pain with the use of insulin pumps.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></li> <li>Recent studies of use of insulin pumps in Type 2 diabetes have shown profound improvements in <a href="/wiki/HBA1c" class="mw-redirect" title="HBA1c">HbA1c</a>, sexual performance, and neuropathy pain.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Disadvantages">Disadvantages</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=3" title="Edit section: Disadvantages"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Insulin pumps, cartridges, and infusion sets may be far more expensive than syringes used for insulin injection with several insulin pumps costing more than $6,000; necessary supplies can cost over $300.<sup id="cite_ref-Millstein2015_3-2" class="reference"><a href="#cite_note-Millstein2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Another disadvantage of insulin pump use is a higher risk of developing <a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">diabetic ketoacidosis</a> if the pump malfunctions.<sup id="cite_ref-Millstein2015_3-3" class="reference"><a href="#cite_note-Millstein2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> This can happen if the pump battery is discharged, if the insulin is inactivated by heat exposure, if the insulin reservoir runs empty, the tubing becomes loose and insulin leaks rather than being injected, or if the cannula becomes bent or kinked in the body, preventing delivery.<sup id="cite_ref-Millstein2015_3-4" class="reference"><a href="#cite_note-Millstein2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Therefore, pump users typically monitor their blood sugars more frequently to evaluate the effectiveness of insulin delivery. </p> <ul><li>Since the insulin pump needs to be worn most of the time, pump users need <a href="/wiki/Untethered_Regimen" class="mw-redirect" title="Untethered Regimen">strategies</a> to participate in activities that may damage the pump, such as rough sports and activities in the water. Some users may find that wearing the pump all the time (together with the infusion set tubing) is uncomfortable or unwieldy.</li> <li>Possibility of insulin pump malfunctioning, and having to resort back to multiple daily injections until a replacement becomes available. However most pump manufacturers will have a program that will get a new pump to the user within 24 hours or allow the user to buy a second pump as a backup for a small fee. Additionally the pump itself will make many safety checks throughout the day, in some cases up to 4,000,000 and may have a second microprocessor dedicated to this.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2022)">citation needed</span></a></i>]</sup></li> <li>Users may experience scar tissue buildup around the inserted cannula, resulting in a hard bump under the skin after the <a href="/wiki/Cannula" title="Cannula">cannula</a> is removed. The scar tissue does not heal particularly fast, so years of wearing the pump and changing the infusion site will cause the user to start running out of viable "spots" to wear the pump. In addition, the areas with scar tissue buildup generally have lower insulin sensitivity and may affect basal rates and bolus amounts. In some extreme cases the insulin delivery will appear to have no/little effect on lowering blood glucose levels and the site must be changed.</li> <li>Users may experience allergic reactions and other skin irritation from the adhesive on the back of an infusion set. Experience may vary according to the individual, the pump manufacturer, and the type of infusion set used.</li> <li>A larger supply of insulin may be required in order to use the pump. Many units of insulin can be wasted while refilling the pump's reservoir, filling the tubing, or changing an infusion site. This may affect prescription and dosage information.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Accessibility">Accessibility</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=4" title="Edit section: Accessibility"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Use of insulin pumps is increasing because of: </p> <ul><li>Easy delivery of multiple insulin injections for those using <a href="/wiki/Intensive_insulin_therapy" title="Intensive insulin therapy">intensive insulin therapy</a>.</li> <li>Accurate delivery of very small boluses, helpful for infants.</li> <li>Growing support among doctors and insurance companies due to the benefits contributing to reducing the incidence of <a href="/wiki/Complications_of_diabetes" title="Complications of diabetes">long-term complications</a>.</li> <li>Improvements in <a href="/wiki/Blood_glucose_monitoring" title="Blood glucose monitoring">blood glucose monitoring</a>. New meters require smaller drops of blood, and the corresponding lancet poke in the fingers is smaller and less painful. These meters also support <a href="/wiki/Blood_glucose_monitoring#Blood_glucose_meters" title="Blood glucose monitoring">alternate site testing</a> for the most routine tests for practically painless testing.</li></ul> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=5" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 1976, the first insulin pump was created and was named the <b>Biostator</b>. The first pump was a 60 kg bedside device.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> It also had the capability of monitoring blood glucose levels, so this also doubles as the first continuous glucose monitor. Between 1978 and 1988, <a href="/wiki/Robert_Channon" title="Robert Channon">Robert Channon</a>, working with <a href="/wiki/Guy%27s_Hospital" title="Guy's Hospital">Guy's Hospital</a> and the <a href="/wiki/Bristol_Royal_Infirmary" title="Bristol Royal Infirmary">Bristol Royal Infirmary</a>, developed a series of miniature insulin infusion pumps.<sup id="cite_ref-NewScientist_11-0" class="reference"><a href="#cite_note-NewScientist-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Today, insulin pumps are so small that they can fit in a pocket or a purse. </p><p>In 1984, an <b>Infusaid</b> implantable infusion device was used to treat a 22-year-old patient successfully.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>The insulin pump was first endorsed in the United Kingdom in 2003 by the <a href="/wiki/National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence (NICE)</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Developments">Developments</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=6" title="Edit section: Developments"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>New insulin pumps are becoming "smart" as new features are added to their design. These simplify the tasks involved in delivering an insulin bolus. </p> <ul><li><b>insulin on board</b>: This calculation is based on the size of a bolus, the time elapsed since the completion of the bolus, and a programmable metabolic rate. The pump software will estimate the insulin remaining in the bloodstream and relay it to the user. This supports the process of performing a new bolus before the effects of the last bolus are complete and, thereby, helps prevent the user from overcompensating for high blood sugar with unnecessary correction boluses.</li> <li><b>bolus calculators</b>: Pump software helps by calculating the dose for the next insulin bolus. The user enters the grams of carbohydrates to be consumed, and the bolus "wizard" calculates the units of insulin needed. It adjusts for the most recent blood glucose level and the insulin on board, and then suggests the best insulin dose to the user to approve and deliver.</li> <li><b>custom alarms</b>: The pump can monitor for activities during specific times of day and alarm the user if an expected activity did not occur. Examples include a missed meal bolus, a missed blood glucose test, a new blood glucose test 15 minutes after a low blood glucose test, etc. The alarms are customized for each user.</li> <li><b>touch bolus</b>: For persons with visual impairments, this button on the pump can be used to bolus for insulin without using the display. This works with a system of beeps to confirm the bolus parameters to the pump user. This feature is described as 'touch', 'audio', or 'easy' bolus depending on brand. The feature was first introduced in the mid- to late 1990s.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (June 2009)">citation needed</span></a></i>]</sup></li> <li><b>interface to personal computers</b>: Since the late 1990s, most pumps can interface with personal computers for managing and documenting pump programming and/or to upload data from the pump. This simplifies record keeping and can be interfaced with <a href="/wiki/Diabetes_management_software" title="Diabetes management software">diabetes management software</a>.</li> <li><b>integration with blood glucose meters</b>: Blood glucose data can be manually entered into the pump to support the bolus wizard for calculation of the next insulin bolus. Some pumps support an interface between the insulin pump and a blood glucose meter. <ul><li>The <a href="/wiki/Medtronic_Diabetes" class="mw-redirect" title="Medtronic Diabetes">Medtronic Diabetes</a> <a href="/wiki/Minimed_Paradigm" title="Minimed Paradigm">Minimed Paradigm</a> series of insulin pumps allow for <a href="/wiki/Radio_frequency" title="Radio frequency">radio frequency</a> (RF) communication. This enables the pump to receive data from a Lifescan (in the US) or Bayer (in other countries) blood glucose meter.</li> <li>The Animas Ping is a pump/blood glucose meter combo that connect to each other using radio frequency. They both can work independently of each other and each have their own history storage. The main purpose of the connection between the pump and the meter is that it allows boluses to be made from the meter or the pump. This is particularly useful when correcting for a high blood sugar as the meter remembers readings and automatically enters them in correction boluses if they are less than 15 minutes old.</li> <li>The DANA Diabecare IISG insulin pump has a blood glucose meter in it. After a blood glucose check with the integrated glucometer, the user can use the bolus wizard to deliver a required bolus.</li> <li>The Insulet <i>OmniPod</i> has a separate remote, also known as a Personal Diabetes Monitor (PDM), that features a built-in meter that uses Freestyle test strips. This eliminates the need to carry and manage a separate meter or transfer blood glucose results from device to device.</li></ul></li> <li><b>integration with continuous glucose monitoring systems</b>: Some insulin pumps can be used as a display for interstitial glucose values obtained from a continuous glucose monitoring system or sensor. <ul><li>The Minimed Paradigm series' RF link also supports a <a href="/wiki/Blood_glucose_monitoring#Continuous_blood_glucose_monitoring" title="Blood glucose monitoring">continuous blood glucose sensor</a> known as the Paradigm REAL-Time Continuous Glucose Monitor that wirelessly provides an interstitial glucose value every 5 minutes on the pump screen. The Medtronic REAL-Time System was the first to link a continuous monitor with an insulin pump system. In the Minimed 530G with Enlite (in the US) or Paradigm Veo (in other countries), the pump can enter a low glucose suspend mode stopping all insulin delivery (bolus and basal insulin) if interstitial glucose values fall below the hypoglycemia threshold. In the Minimed 640G insulin pump series, low glucose suspend mode can also be entered based on predicted hypoglycemia.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup></li> <li>The Animas Vibe is an insulin pump that is fully integrated with the Dexcom G4 Continuous Glucose Monitor. The two connect wirelessly to monitor and track blood glucose levels and detect patterns. The Dexcom G4 has the advantage of being designed to monitor glucose levels every five minutes throughout 7 days of continuous wear.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The Animas Vibe was approved for use in Europe in 2011, and Canada and the United States in January and December 2014, respectively.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> NOTE: Animas insulin pumps are not available due to Johnson & Johnson's decision to cease operations at their Animas subsidiary.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li> <li>The <a href="/wiki/Tandem_Diabetes_Care" title="Tandem Diabetes Care">Tandem Diabetes Care</a> t:Slim X2 was approved by the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">U.S. Food and Drug Administration</a> in 2019 and is the first insulin pump to be designated as an alternate controller enabled (ACE) insulin pump. ACE insulin pumps allow users to integrate <a href="/wiki/Continuous_glucose_monitor" title="Continuous glucose monitor">continuous glucose monitors</a>, automated insulin dosing (AID) systems, and other diabetes management devices with the pump to create a personalized diabetes therapy system.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Many users of the t:slim X2 integrate the pump with the <a href="/wiki/Dexcom" title="Dexcom">Dexcom</a> G6, a continuous glucose monitor approved by the FDA in 2018. It was the first CGM authorized for use in an integrated therapy system. The device does not require users to provide fingerstick calibrations and lasts for up to ten days.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup></li></ul></li> <li>Other options may include remote control, tubeless pod, touch screen interface, rechargeable battery, pre-filled insulin cartridge, and mobile bolus.</li></ul> <p><b>MiniMed 670G</b> is a type of insulin pump and sensor system created by <a href="/wiki/Medtronic" title="Medtronic">Medtronic</a>. It was approved by the US FDA in September 2016 and was the first approved hybrid <a href="/wiki/Closed-loop_transfer_function" title="Closed-loop transfer function">closed loop system</a> which senses a patient's <a href="/wiki/Basal_(medicine)" class="mw-redirect" title="Basal (medicine)">basal</a> insulin requirement and automatically adjusts its delivery to the body.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p><b>Mylife YpsoPump</b>, developed by <a href="/wiki/Ypsomed" class="mw-redirect" title="Ypsomed">Ypsomed</a>, was launched in Europe in 2016.<sup id="cite_ref-:0_23-0" class="reference"><a href="#cite_note-:0-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Eli_Lilly_and_Company" title="Eli Lilly and Company">Eli Lilly</a> had planned to work with Ypsomed to introduce this to the United States, but that effort was terminated in 2022.<sup id="cite_ref-:0_23-1" class="reference"><a href="#cite_note-:0-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p><b>Omnipod 5</b>: On January 28, 2022, Insulet Corporation announced the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">FDA</a> has approved the Omnipod 5, the first tubeless closed loop insulin pump with Smartphone control, working with the <a href="/wiki/Dexcom" title="Dexcom">Dexcom G6</a> <a href="/wiki/Continuous_glucose_monitor" title="Continuous glucose monitor">Continuous Glucose Monitor</a>. The Omnipod 5 will have a feature named SmartAdjust technology that allows for the increase, decrease, or suspension of insulin based on the user's custom <a href="/wiki/Blood_sugar_level" title="Blood sugar level">blood glucose</a> targets.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p><b>INSUL by AgVa</b>: AgVa Healthcare announced that Insul by Agva is the world's most advanced and affordable Insulin pump. Features such as a built-in glucometer, Bluetooth connectivity, android and IOS app, as well as long-lasting and economical disposables.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Future_developments">Future developments</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=7" title="Edit section: Future developments"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>When insulin pump technology is combined with a <a href="/wiki/Blood_glucose_monitoring#Continuous_blood_glucose_monitoring" title="Blood glucose monitoring">continuous blood glucose monitoring</a> system, the technology seems promising for real time control of the blood sugar level. Currently<sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="The time period mentioned near this tag is ambiguous. (July 2022)">when?</span></a></i>]</sup> there are no mature algorithms to automatically control the insulin delivery based on feedback of the blood glucose level. When the loop is closed, the system may function as an <a href="/wiki/Artificial_pancreas" class="mw-redirect" title="Artificial pancreas">artificial pancreas</a>.</li> <li>Insulin pumps are being used for infusing pramlintide (brand name Symlin, or synthetic <a href="/wiki/Amylin" title="Amylin">amylin</a>) with insulin for improved <a href="/wiki/Postprandial" class="mw-redirect" title="Postprandial">postprandial</a> <a href="/wiki/Diabetes_management#Glycemic_control" title="Diabetes management">glycemic control</a> compared to insulin alone.</li> <li>Dual hormone insulin pumps that infuse either insulin or <a href="/wiki/Glucagon" title="Glucagon">glucagon</a>. In event of hypoglycemia, the glucagon could be triggered to increase the blood glucose. This would be particularly valuable in a closed loop system under the control of a glucose sensor. The <a href="/wiki/Artificial_pancreas" class="mw-redirect" title="Artificial pancreas">Artificial Pancreas</a>, currently in clinical trials for FDA approval, is a recently developed device designed with this technology in mind.<sup id="cite_ref-pearls_26-0" class="reference"><a href="#cite_note-pearls-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup></li> <li>Ultrafast insulins. These insulins are absorbed more quickly than the currently available Humalog, Novolog, and Apidra which have a peak at about 60 minutes.<sup id="cite_ref-Humalog_insulin_prescribing_information_27-0" class="reference"><a href="#cite_note-Humalog_insulin_prescribing_information-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Faster insulin uptake would theoretically coordinate with meals better, and allow faster recovery from hyperglycemia if the insulin infusion is suspended. Biodel is developing an ultrafast insulin<sup id="cite_ref-Linjeta_28-0" class="reference"><a href="#cite_note-Linjeta-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Dosing">Dosing</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=8" title="Edit section: Dosing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Insulin_pump_reservoir.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/64/Insulin_pump_reservoir.jpg/300px-Insulin_pump_reservoir.jpg" decoding="async" width="300" height="54" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/64/Insulin_pump_reservoir.jpg/450px-Insulin_pump_reservoir.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/64/Insulin_pump_reservoir.jpg/600px-Insulin_pump_reservoir.jpg 2x" data-file-width="1950" data-file-height="348" /></a><figcaption>Filling an insulin pump reservoir. (Left to right) 1: Reservoir in sterile packaging. 2: Filling the reservoir. 3: Reservoir with needle and plunger removed, ready for attachment to infusion set.</figcaption></figure> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Standard_bolus.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/e/ed/Standard_bolus.JPG/300px-Standard_bolus.JPG" decoding="async" width="300" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/e/ed/Standard_bolus.JPG/450px-Standard_bolus.JPG 1.5x, //upload.wikimedia.org/wikipedia/en/e/ed/Standard_bolus.JPG 2x" data-file-width="576" data-file-height="364" /></a><figcaption></figcaption></figure> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Extended_bolus.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/6/63/Extended_bolus.JPG/300px-Extended_bolus.JPG" decoding="async" width="300" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/6/63/Extended_bolus.JPG/450px-Extended_bolus.JPG 1.5x, //upload.wikimedia.org/wikipedia/en/6/63/Extended_bolus.JPG 2x" data-file-width="576" data-file-height="364" /></a><figcaption></figcaption></figure> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Combo_bolus.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/Combo_bolus.JPG/300px-Combo_bolus.JPG" decoding="async" width="300" height="190" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/Combo_bolus.JPG/450px-Combo_bolus.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/1/11/Combo_bolus.JPG 2x" data-file-width="576" data-file-height="364" /></a><figcaption></figcaption></figure> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Super_bolus.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/5/53/Super_bolus.JPG/300px-Super_bolus.JPG" decoding="async" width="300" height="189" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/5/53/Super_bolus.JPG/450px-Super_bolus.JPG 1.5x, //upload.wikimedia.org/wikipedia/en/5/53/Super_bolus.JPG 2x" data-file-width="577" data-file-height="364" /></a><figcaption></figcaption></figure> <p>An insulin pump allows the replacement of slow-acting insulin for basal needs with a continuous infusion of rapid-acting insulin. </p><p>The insulin pump delivers a single type of rapid-acting insulin in two ways:<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <ul><li>a <a href="/wiki/Bolus_(medicine)" title="Bolus (medicine)">bolus</a> dose that is pumped to cover food eaten or to correct a high <a href="/wiki/Blood_glucose" class="mw-redirect" title="Blood glucose">blood glucose</a> level.</li> <li>a <a href="/wiki/Basal_(medicine)" class="mw-redirect" title="Basal (medicine)">basal</a> dose that is pumped continuously at an adjustable <a href="/wiki/Basal_rate" title="Basal rate">basal rate</a> to deliver insulin needed between meals and at night.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Bolus_shape">Bolus shape</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=9" title="Edit section: Bolus shape"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>An insulin pump user can influence the profile of the rapid-acting insulin by shaping the bolus. Users can experiment with bolus shapes to determine what is best for any given food, which means that they can improve control of <a href="/wiki/Blood_sugar" class="mw-redirect" title="Blood sugar">blood sugar</a> by adapting the bolus shape to their needs. </p><p>A <b>standard bolus</b> is an infusion of insulin pumped completely at the onset of the bolus. It's the most similar to an injection. By pumping with a "spike" shape, the expected action is the fastest possible bolus for that type of insulin. The standard bolus is most appropriate when eating high carb low protein low fat meals because it will return blood sugar to normal levels quickly. </p><p>An <b>extended bolus</b> is a slow infusion of insulin spread out over time. By pumping with a "square wave" shape, the bolus avoids a high initial dose of insulin that may enter the blood and cause low blood sugar before digestion can facilitate sugar entering the blood. The extended bolus also extends the action of insulin well beyond that of the insulin alone. The extended bolus is appropriate when covering high fat high protein meals such as steak, which will be raising blood sugar for many hours past the onset of the bolus. The extended bolus is also useful for those with slow digestion (such as with <a href="/wiki/Gastroparesis" title="Gastroparesis">gastroparesis</a> or <a href="/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a>). </p><p>A <b>combination bolus</b>/<b>multiwave bolus</b> is the combination of a standard bolus spike with an extended bolus square wave. This shape provides a large dose of insulin up front, and then also extends the tail of the insulin action. The combination bolus is appropriate for high carb high fat meals such as pizza, pasta with heavy cream sauce, and chocolate cake. </p><p>A <b>super bolus</b> is a method of increasing the spike of the standard bolus. Since the action of the bolus insulin in the blood stream will extend for several hours, the basal insulin could be stopped or reduced during this time. This facilitates the "borrowing" of the basal insulin and including it into the bolus spike to deliver the same total insulin with faster action than can be achieved with spike and basal rate together. The super bolus is useful for certain foods (like sugary breakfast cereals) which cause a large post-prandial peak of blood sugar. It attacks the blood sugar peak with the fastest delivery of insulin that can be practically achieved by pumping. </p> <div class="mw-heading mw-heading3"><h3 id="Bolus_timing">Bolus timing</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=10" title="Edit section: Bolus timing"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since the pump user is responsible to manually start a bolus, this provides an opportunity for the user to pre-bolus to improve upon the insulin pump's capability to prevent post-prandial hyperglycemia. A pre-bolus is simply a bolus of insulin given before it is actually needed to cover carbohydrates eaten. </p><p>There are two situations where a pre-bolus is helpful: </p> <ol><li>A pre-bolus of insulin will mitigate a spike in blood sugar that results from eating high glycemic foods. Infused insulin analogs such as <a href="/wiki/NovoLog" class="mw-redirect" title="NovoLog">NovoLog</a> and <a href="/wiki/Apidra" class="mw-redirect" title="Apidra">Apidra</a> typically begin to reduce blood sugar levels 15 or 20 minutes after infusion. As a result, easily digested sugars often hit the bloodstream much faster than infused insulin intended to cover them, and the blood sugar level spikes upward as a result. If the bolus were infused 20 minutes before eating, then the pre-bloused insulin would hit the bloodstream simultaneously with the digested sugars to control the magnitude of the spike.</li> <li>A pre-bolus of insulin can combine a meal bolus and a correction bolus when the blood sugar is above the target range before a meal. The timing of the bolus is a controllable variable to bring down the blood sugar level before eating again causes it to increase.</li></ol> <p>Similarly, a low blood sugar level or a low glycemic food might be best treated with a bolus <i>after</i> a meal is begun. The blood sugar level, the type of food eaten, and a person's individual response to food and insulin affect the ideal time to bolus with the pump. </p> <div class="mw-heading mw-heading3"><h3 id="Basal_rate_patterns">Basal rate patterns</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=11" title="Edit section: Basal rate patterns"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The pattern for delivering basal insulin throughout the day can also be customized with a pattern to suit the pump user. </p> <ul><li>A reduction of basal at night to prevent low blood sugar in infants and toddlers.</li> <li>An increase of basal at night to counteract high blood sugar levels due to growth hormone in teenagers.</li> <li>A pre-dawn increase to prevent high blood sugar due to the <a href="/wiki/Dawn_effect" class="mw-redirect" title="Dawn effect">dawn effect</a> in adults and teens.</li> <li>In a proactive plan before regularly scheduled exercise times such as morning gym for elementary school children or after-school basketball practice for high school children.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Basal_rate_determination">Basal rate determination</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=12" title="Edit section: Basal rate determination"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Basal insulin requirements will vary between individuals and periods of the day. The basal rate for a particular time period is determined by fasting while periodically evaluating the blood sugar level. Neither food nor bolus insulin must be taken for 4 hours before or during the evaluation period. If the blood sugar level changes dramatically during evaluation, then the basal rate can be adjusted to increase or decrease insulin delivery to keep the blood sugar level approximately steady. </p><p>For instance, to determine an individual's morning basal requirement, they must skip breakfast. On waking, they would test their blood glucose level periodically until lunch. Changes in blood glucose level are compensated with adjustments in the morning basal rate. The process is repeated over several days, varying the fasting period, until a 24-hour basal profile has been built up which keeps fasting blood sugar levels relatively steady. Once the basal rate is matched to the fasting basal insulin need, the pump user will then gain the flexibility to skip or postpone meals such as sleeping late on the weekends or working overtime on a weekday. </p><p>Many factors can change insulin requirements and require an adjustment to the basal rate: </p> <ul><li>continued beta cell death following diagnosis of type 1 diabetes (<a href="/wiki/Honeymoon_period_(diabetes)" class="mw-redirect" title="Honeymoon period (diabetes)">honeymoon period</a>)</li> <li>growth spurts particularly during <a href="/wiki/Puberty" title="Puberty">puberty</a></li> <li>weight gain or loss</li> <li>any drug treatment that affects insulin sensitivity (e.g. <a href="/wiki/Corticosteroids" class="mw-redirect" title="Corticosteroids">corticosteroids</a>)</li> <li>eating, sleeping, or exercise routine changes</li> <li>whenever the control over hyperglycemia is degrading</li> <li>and according to the seasons.</li></ul> <p>A pump user should be educated by their diabetes care professional about basal rate determination before beginning pump therapy. </p> <div class="mw-heading mw-heading3"><h3 id="Temporary_basal_rates">Temporary basal rates</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=13" title="Edit section: Temporary basal rates"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since the basal insulin is provided as a rapid-acting insulin, the basal insulin can be immediately increased or decreased as needed with a temporary basal rate. Examples when this is helpful include: </p> <ul><li>As a passenger during a long car drive, when insulin needs are different due to inactivity.</li> <li>While driving on an extended trip, to reduce the risk of hypoglycemia, a lower temporary basal rate may be programmed.</li> <li>During and after spontaneous exercise or sports activities, when the body needs less insulin.</li> <li>During illness or stress, when basal demand increases due to <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a>.</li> <li>When blood <a href="/wiki/Ketone_bodies" title="Ketone bodies">ketones</a> are present, when additional insulin is needed.</li> <li>When on an extended fast (such as Ramadan, Lent, or Yom Kippur) when basal requirements may be lower.</li> <li>During <a href="/wiki/Menses" class="mw-redirect" title="Menses">menses</a>, when additional basal insulin might be needed.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Security">Security</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=14" title="Edit section: Security"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In August 2011, an <a href="/wiki/IBM" title="IBM">IBM</a> researcher, Jay Radcliffe, demonstrated a security flaw in insulin pumps. Radcliffe was able to hack the wireless interface used to control the pump remotely.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Pump manufacturer <a href="/wiki/Medtronic" title="Medtronic">Medtronic</a> later said security research by <a href="/wiki/McAfee" title="McAfee">McAfee</a> uncovered a flaw in its pumps that could be exploited.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=15" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Automated_insulin_delivery_system" title="Automated insulin delivery system">Automated insulin delivery system</a></li> <li><a href="/wiki/Continuous_glucose_monitor" title="Continuous glucose monitor">Continuous glucose monitor</a></li> <li><a href="/wiki/Minimed_Paradigm" title="Minimed Paradigm">Minimed Paradigm</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=16" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output 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FDA. 28 September 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Recently+approved+devices%3A+The+670G+System+-+P160017&rft.pub=FDA&rft.date=2016-09-28&rft_id=https%3A%2F%2Fwww.fda.gov%2FMedicalDevices%2FProductsandMedicalProcedures%2FDeviceApprovalsandClearances%2FRecently-ApprovedDevices%2Fucm522764.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-21">^</a></b></span> <span class="reference-text">a. Dealing with any kind of medical technology, there are going to be pros and cons. With an insulin pump there are many to consider. Some of the pros of insulin pump therapy are precise insulin delivery down to the 0.025 minimum. They also replace the need to give a shot each time you eat. It allows for easier exercise management. Another large pro to an insulin pump is the reduced chance of variability with the patient’s blood glucose levels. Some of the cons are the cost of the insulin pump and supplies, the risk of infection at the pump site, and risk of DKA because of a pump malfunction.</span> </li> <li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.childrensdmc.org/parents/patient-and-family-resources/patient-and-family-resources/advantages-and-disadvantages-of-an-insulin-pump">"What are the Advantages and Disadvantages of an Insulin Pump?"</a>. <i>Children's Hospital of Michigan</i>. 18 November 2019<span class="reference-accessdate">. Retrieved <span class="nowrap">8 May</span> 2021</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Children%27s+Hospital+of+Michigan&rft.atitle=What+are+the+Advantages+and+Disadvantages+of+an+Insulin+Pump%3F&rft.date=2019-11-18&rft_id=https%3A%2F%2Fwww.childrensdmc.org%2Fparents%2Fpatient-and-family-resources%2Fpatient-and-family-resources%2Fadvantages-and-disadvantages-of-an-insulin-pump&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-:0-23"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_23-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_23-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWhooley2022" class="citation news cs1">Whooley, Sean (9 December 2022). <a rel="nofollow" class="external text" href="https://www.drugdeliverybusiness.com/eli-lilly-discontinues-ypsomed-collaboration-insulin-pump/">"Eli Lilly discontinues Ypsomed collaboration to pursue its own U.S. insulin pump offering"</a>. <i>Medical Design & Outsourcing</i><span class="reference-accessdate">. Retrieved <span class="nowrap">10 December</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medical+Design+%26+Outsourcing&rft.atitle=Eli+Lilly+discontinues+Ypsomed+collaboration+to+pursue+its+own+U.S.+insulin+pump+offering&rft.date=2022-12-09&rft.aulast=Whooley&rft.aufirst=Sean&rft_id=https%3A%2F%2Fwww.drugdeliverybusiness.com%2Feli-lilly-discontinues-ypsomed-collaboration-insulin-pump%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.omnipod.com/what-is-omnipod/omnipod-5">"Omnipod® 5 | Omnipod"</a>. <i>www.omnipod.com</i><span class="reference-accessdate">. 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Retrieved <span class="nowrap">29 March</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=INSUL+by+AgVa+%7C+AgVa+Healthcare&rft_id=https%3A%2F%2Finsul.agvahealthcare.in%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-pearls-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-pearls_26-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBrownLiu2014" class="citation web cs1">Brown A, Liu N (31 March 2014). <a rel="nofollow" class="external text" href="http://diatribe.org/issues/62/conference-pearls">"Dr. Ed Damiano Presents Next Set of Bionic Pancreas Study Results at ATTD"</a>. <i>diaTribe</i>. The diaTribe Foundation<span class="reference-accessdate">. Retrieved <span class="nowrap">19 March</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=diaTribe&rft.atitle=Dr.+Ed+Damiano+Presents+Next+Set+of+Bionic+Pancreas+Study+Results+at+ATTD&rft.date=2014-03-31&rft.aulast=Brown&rft.aufirst=A&rft.au=Liu%2C+N&rft_id=http%3A%2F%2Fdiatribe.org%2Fissues%2F62%2Fconference-pearls&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-Humalog_insulin_prescribing_information-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-Humalog_insulin_prescribing_information_27-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://pi.lilly.com/us/humalog-pen-pi.pdf">"Humalog prescribing information"</a> <span class="cs1-format">(PDF)</span>. <i>Eli Lilly and Company</i>. 2019.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Eli+Lilly+and+Company&rft.atitle=Humalog+prescribing+information.&rft.date=2019&rft_id=http%3A%2F%2Fpi.lilly.com%2Fus%2Fhumalog-pen-pi.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-Linjeta-28"><span class="mw-cite-backlink"><b><a href="#cite_ref-Linjeta_28-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20130331002505/http://www.biodel.com/content/pipeline/linjeta.htm">"Linjeta duration of action"</a>. <i>Biodel, Inc</i>. Archived from <a rel="nofollow" class="external text" href="http://www.biodel.com/content/pipeline/linjeta.htm">the original</a> on 31 March 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Biodel%2C+Inc.&rft.atitle=Linjeta+duration+of+action&rft_id=http%3A%2F%2Fwww.biodel.com%2Fcontent%2Fpipeline%2Flinjeta.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.diabetes.co.uk/insulin/Insulin-pumps.html">"Insulin pumps"</a>. <i>Diabetes.co.uk</i>. 15 January 2019.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Diabetes.co.uk&rft.atitle=Insulin+pumps&rft.date=2019-01-15&rft_id=http%3A%2F%2Fwww.diabetes.co.uk%2Finsulin%2FInsulin-pumps.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20110805080153/http://www.foxnews.com/scitech/2011/08/04/insulin-pumps-vulnerable-to-hacking/">"Insulin Pumps Vulnerable to Hacking"</a>. <i><a href="/wiki/Fox_News" title="Fox News">Fox News</a></i>. Associated Press. 22 October 2015. Archived from <a rel="nofollow" class="external text" href="http://www.foxnews.com/scitech/2011/08/04/insulin-pumps-vulnerable-to-hacking/">the original</a> on 5 August 2011.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Fox+News&rft.atitle=Insulin+Pumps+Vulnerable+to+Hacking&rft.date=2015-10-22&rft_id=http%3A%2F%2Fwww.foxnews.com%2Fscitech%2F2011%2F08%2F04%2Finsulin-pumps-vulnerable-to-hacking%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> <li id="cite_note-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-31">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://www.reuters.com/article/us-medtronic-cybersecurity-idUSTRE79O8EP20111025">"Exclusive: Medtronic probes insulin pump risks"</a>. <i>Reuters</i>. 25 October 2011.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Reuters&rft.atitle=Exclusive%3A+Medtronic+probes+insulin+pump+risks&rft.date=2011-10-25&rft_id=https%3A%2F%2Fwww.reuters.com%2Farticle%2Fus-medtronic-cybersecurity-idUSTRE79O8EP20111025&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInsulin+pump" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Insulin_pump&action=edit&section=17" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-pumps.html">American Diabetes Association: Insulin Pumps</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20190714063849/http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-pumps.html">Archived</a> 14 July 2019 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="http://www.diabetes.co.uk/insulin/Insulin-pumps.html">Diabetes.co.uk guide to insulin pumps available in the UK</a></li> <li><a rel="nofollow" class="external text" href="http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/research/12-30-11-AADE_Insulin_WhitePaper_Print.pdf">Diabetes Educator - Insulin pump therapy:Best practices in choosing and using infusion devices </a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20190713191437/https://www.diabeteseducator.org/export/sites/aade/_resources/pdf/research/12-30-11-AADE_Insulin_WhitePaper_Print.pdf">Archived</a> 13 July 2019 at the <a href="/wiki/Wayback_Machine" 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class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Type_1_diabetes" title="Type 1 diabetes">Type 1</a> (SAID cluster)</li> <li>Type 1 diabetes (<a href="/wiki/Latent_autoimmune_diabetes_in_adults" title="Latent autoimmune diabetes in adults">LADA</a> cluster)</li> <li><a href="/wiki/Type_2_diabetes" title="Type 2 diabetes">Type 2</a> (SIDD, SIRD, MOD and MARD clusters)</li> <li>Type 4 (<a href="/wiki/Gestational_diabetes" title="Gestational diabetes">Gestational diabetes</a>) <ul><li><a href="/wiki/Diabetes_and_pregnancy" title="Diabetes and pregnancy">Diabetes and pregnancy</a></li></ul></li> <li><a href="/wiki/Prediabetes" title="Prediabetes">Prediabetes</a> <ul><li><a href="/wiki/Impaired_fasting_glucose" title="Impaired fasting glucose">Impaired fasting glucose</a></li> <li><a href="/wiki/Impaired_glucose_tolerance" class="mw-redirect" title="Impaired glucose tolerance">Impaired glucose tolerance</a></li></ul></li> <li><a href="/wiki/Insulin_resistance" title="Insulin resistance">Insulin resistance</a></li> <li><a href="/wiki/Ketosis-prone_diabetes" title="Ketosis-prone diabetes">Ketosis-prone diabetes</a> (KPD)</li> <li>Type 3a (<a href="/wiki/Maturity-onset_diabetes_of_the_young" title="Maturity-onset diabetes of the young">MODY</a>) <ul><li><a href="/wiki/MODY_1" title="MODY 1">Type 1</a> <a href="/wiki/MODY_2" title="MODY 2">2</a> <a href="/wiki/MODY_3" title="MODY 3">3</a> <a href="/wiki/MODY_4" title="MODY 4">4</a> <a href="/wiki/MODY_5" class="mw-redirect" title="MODY 5">5</a> <a href="/wiki/MODY_6" title="MODY 6">6</a></li></ul></li> <li><a href="/wiki/Neonatal_diabetes" title="Neonatal diabetes">Neonatal</a> <ul><li><a href="/wiki/Transient_neonatal_diabetes" title="Transient neonatal diabetes">Transient</a></li> <li><a href="/wiki/Permanent_neonatal_diabetes" title="Permanent neonatal diabetes">Permanent</a></li></ul></li> <li><a href="/wiki/Type_3c_diabetes" title="Type 3c diabetes">Type 3c (pancreatogenic)</a></li> <li><a href="/wiki/Type_3_diabetes" title="Type 3 diabetes">Type 3</a></li> <li><a href="/wiki/Diabetes_and_deafness" title="Diabetes and deafness">MIDD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Blood_test" title="Blood test">Blood tests</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_sugar_level" title="Blood sugar level">Blood sugar level</a></li> <li><a href="/wiki/Biomarkers_of_diabetes" title="Biomarkers of diabetes">Biomarkers</a></li> <li><a href="/wiki/Glycated_hemoglobin" title="Glycated hemoglobin">Glycated hemoglobin</a></li> <li><a href="/wiki/Glucose_tolerance_test" title="Glucose tolerance test">Glucose tolerance test</a></li> <li><a href="/wiki/Postprandial_glucose_test" title="Postprandial glucose test">Postprandial glucose test</a></li> <li><a href="/wiki/Fructosamine" title="Fructosamine">Fructosamine</a></li> <li><a href="/wiki/Glucose_test" title="Glucose test">Glucose test</a></li> <li><a href="/wiki/C-peptide" title="C-peptide">C-peptide</a></li> <li><a href="/wiki/Noninvasive_glucose_monitor" title="Noninvasive glucose monitor">Noninvasive glucose monitor</a></li> <li><a href="/wiki/Insulin_tolerance_test" title="Insulin tolerance test">Insulin tolerance test</a></li> <li><a href="/wiki/Metabolic_Score_for_Insulin_Resistance" title="Metabolic Score for Insulin Resistance">Metabolic Score for Insulin Resistance (METS-IR)</a></li> <li><a href="/wiki/Homeostatic_model_assessment" title="Homeostatic model assessment">Homeostatic model assessment</a></li> <li><a href="/wiki/SPINA-GBeta" title="SPINA-GBeta">SPINA-GBeta</a></li> <li><a href="/wiki/SPINA-GR" title="SPINA-GR">SPINA-GR</a></li> <li><a href="/wiki/Disposition_index" title="Disposition index">Disposition index</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Diabetes_management" title="Diabetes management">Management</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Prevention_of_type_2_diabetes" title="Prevention of type 2 diabetes">Prevention</a></li> <li>Metabolic assessment and monitoring <ul><li><a href="/wiki/Blood_glucose_monitoring" title="Blood glucose monitoring">Blood glucose monitoring</a></li> <li><a href="/wiki/Ambulatory_glucose_profile" title="Ambulatory glucose profile">Ambulatory glucose profile</a></li></ul></li> <li><a href="/wiki/Diet_in_diabetes" title="Diet in diabetes">Diet in diabetes</a></li> <li><a href="/wiki/Diabetes_medication" title="Diabetes medication">Diabetes medication</a></li> <li><a href="/wiki/Insulin_(medication)" title="Insulin (medication)">Insulin therapy</a> <ul><li><a href="/wiki/Intensive_insulin_therapy" title="Intensive insulin therapy">intensive</a></li> <li><a href="/wiki/Conventional_insulin_therapy" title="Conventional insulin therapy">conventional</a></li> <li><a href="/wiki/Pulsatile_insulin" title="Pulsatile insulin">pulsatile</a></li></ul></li> <li><a href="/wiki/Diabetic_shoe" title="Diabetic shoe">Diabetic shoes</a></li> <li>Cure <ul><li><a href="/wiki/Embryonic_stem_cell" title="Embryonic stem cell">Embryonic stem cells</a></li> <li><a href="/wiki/Automated_insulin_delivery_system" title="Automated insulin delivery system">Artificial pancreas</a></li></ul></li> <li>Other <ul><li><a href="/wiki/Gastric_bypass_surgery#Results_and_health_benefits_of_gastric_bypass" title="Gastric bypass surgery">Gastric bypass surgery</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%"><a href="/wiki/Complications_of_diabetes" title="Complications of diabetes">Complications</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diabetic_coma" title="Diabetic coma">Diabetic comas</a> <ul><li><a href="/wiki/Diabetic_hypoglycemia" title="Diabetic hypoglycemia">Hypoglycemia</a></li> <li><a href="/wiki/Diabetic_ketoacidosis" title="Diabetic ketoacidosis">Ketoacidosis</a></li> <li><a href="/wiki/Hyperosmolar_hyperglycemic_state" title="Hyperosmolar hyperglycemic state">Hyperosmolar hyperglycemic state</a></li></ul></li> <li><a href="/wiki/Diabetic_foot" title="Diabetic foot">Diabetic foot</a> <ul><li><a href="/wiki/Diabetic_foot_ulcer" title="Diabetic foot ulcer">ulcer</a></li> <li><a href="/wiki/Neuropathic_arthropathy" title="Neuropathic arthropathy">Neuropathic arthropathy</a></li></ul></li> <li>Organs in diabetes <ul><li><a href="/wiki/Diabetic_angiopathy" title="Diabetic angiopathy">Blood vessels</a></li> <li><a href="/wiki/Diabetic_myonecrosis" title="Diabetic myonecrosis">Muscle</a></li> <li><a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">Kidney</a></li> <li><a href="/wiki/Diabetic_neuropathy" title="Diabetic neuropathy">Nerves</a></li> <li><a href="/wiki/Diabetic_retinopathy" title="Diabetic retinopathy">Retina</a></li> <li><a href="/wiki/Diabetic_cardiomyopathy" title="Diabetic cardiomyopathy">Heart</a></li></ul></li> <li><a href="/wiki/Diabetic_dermadrome" title="Diabetic dermadrome">Diabetes-related skin disease</a> <ul><li><a href="/wiki/Diabetic_dermopathy" title="Diabetic dermopathy">Diabetic dermopathy</a></li> <li><a href="/wiki/Diabetic_bulla" title="Diabetic bulla">Diabetic bulla</a></li> <li><a href="/wiki/Diabetic_cheiroarthropathy" title="Diabetic cheiroarthropathy">Diabetic cheiroarthropathy</a></li> <li><a href="/wiki/Diabetic_foot_ulcer" title="Diabetic foot ulcer">Diabetic foot ulcer</a></li></ul></li> <li><a href="/wiki/Hyperglycemia" title="Hyperglycemia">Hyperglycemia</a></li> <li><a href="/wiki/Hypoglycemia" title="Hypoglycemia">Hypoglycemia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%">Advocacy & <br /> Organizations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/T1International" title="T1International">T1International</a></li> <li><a href="/wiki/Open_Insulin_Project" title="Open Insulin Project">Open Insulin Project</a></li> <li><a href="/wiki/Breakthrough_T1D" title="Breakthrough T1D">Breakthrough T1D</a></li> <li><a href="/wiki/International_Diabetes_Federation" title="International Diabetes Federation">International Diabetes Federation</a></li> <li><a href="/wiki/World_Diabetes_Day" title="World Diabetes Day">World Diabetes Day</a></li> <li><a href="/wiki/Diabetes_UK" title="Diabetes UK">Diabetes UK</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="background-color:turquoise;width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Outline_of_diabetes" title="Outline of diabetes">Outline of diabetes</a></li> <li><a href="/wiki/Glossary_of_diabetes" title="Glossary of diabetes">Glossary of diabetes</a></li> <li><a href="/wiki/Epidemiology_of_diabetes" title="Epidemiology of diabetes">Epidemiology of diabetes</a></li> <li><a href="/wiki/History_of_diabetes" title="History of diabetes">History of diabetes</a></li> <li><a href="/wiki/List_of_people_with_type_1_diabetes" title="List of people with type 1 diabetes">Notable people with type 1 diabetes</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div 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