NHS Lanarkshire Insulin Pump and Technology Service 

NHS Lanarkshire’s Insulin Pump & Technology Team provide support to people living with Type 1 Diabetes in Lanarkshire who are using some form of technology.

Meet our Diabetes Educator & Consultant Teams 

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What is an Insulin Pump?

An insulin pump is a small electronic device that delivers insulin continuously 24 hours a day via a tiny tube called a cannula which sits underneath the skin. An insulin pump allows greater flexibility to match your insulin requirements to your lifestyle.

An insulin pump uses rapid acting insulin only, to deliver a steady basal rate of insulin across the day and night and can be programmed with different amounts of insulin at different times of the day.

When you eat, you deliver a bolus dose of insulin via the pumps bolus calculator to cover the carbohydrate content in each meal or snack.

Insulin pump therapy is also referred to as Continuous Subcutaneous Insulin Infusion therapy (CSII).

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Hybrid Closed Loop System 

Insulin pumps have become more advanced over the last few years and can now communicate with a Continued Glucose Monitor (CGM) or Sensor to provide a Hybrid Closed Loop (HCL).

An HCL system consists of wearing an insulin pump and a sensor that continuously measures glucose levels, and an algorithm that controls the delivery of the insulin.

This system is designed to automatically adjust basal insulin delivery depending on Sensor Glucose levels.

The pump calculates the amount of insulin you need to keep your glucose within a chosen target range.

Criteria for insulin pump therapy are as follows: 

• You have Type 1 Diabetes and you are on multiple daily injections.
• You have attended a structured education programme for the management of your diabetes.
• You are struggling to keep your blood glucose / HbA1c levels within target using multiple daily injections.
• You are experiencing repeated and unpredictable hypoglycaemia episodes, causing anxiety and impacting on your quality of life.
• You are committed to and have the competency to use the equipment effectively.
• For women who are preparing for pregnancy who are unable to achieve appropriate blood glucose / HbA1c levels.

Advantages of insulin pump therapy are as follows:

• It can improve variability in blood glucose and HbA1c levels.
• It can improve Time in Range.
• It can reduce number of hypos.
• It can reduce the burden of Type 1 diabetes.
• It can deliver insulin in much smaller amounts than injections, which manages your control much more accurately.
• No need for multiple injections as you only need to change your cannula or patch pump every 2-3 days.

Disadvantages of insulin pump therapy are as follows: 

• Blood glucose levels need to be monitored regularly and there can be an increased risk of Diabetic Ketoacidosis (DKA).
• Insulin pumps can fail or break, so you will need to ensure that you have an in-date and easily accessible supply of sub-cutaneous insulin supplies in case of problems.
• You will have to be permanently attached to the pump, which could have implications for the clothing that you wear and for your body image.
• You are more at risk of skin infections if you leave the infusion set in for more than 3 days.

What do you need to do? 

• Your commitment to insulin pump therapy will require you to do regular blood glucose monitoring and attend for regular reviews with the dedicated Insulin Pump team based at your hospital site. This may be several times a year and consist of a range of health care professionals – Nurses, Dietitians and Consultants. These specialist staff can support you with training and ongoing self-management of this therapy.
• You will have to complete an education programme with regards to carbohydrate counting and insulin management, so that you can have a good understanding of how carbohydrates will influence your blood glucose levels.
• Insulin pump therapy is not an easy option but, if used appropriately, it can certainly provide a more flexible way of self-managing your day-to-day diabetes control.

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Thinking about Insulin Pump Therapy? 

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Pump and Technology Companies 

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Line Cannula Selection 

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Established Insulin Pump Therapy Users

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Further Resources 

Managing illness when using insulin pump therapy resources:

• Sick Day Rules for Type 1 Diabetes
• Sick Day Rules for Type 2 Diabetes 
• Managing illness when pregnant and using insulin pump therapy (pages 13 & 14 of the guidance)
• NHS Lanarkshire Diabetes Insulin Pump Service Emergency leaflet 

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