Theme: To pump or pen

Choosing between pump or pen therapy means factoring in multiple different causes. For example, when your blood sugar level varies a lot due to regular hypos, or because its level is usually high in the morning, or because your HbAc1 is too high. Or maybe you've simply had enough of having to take injections a few times every day. In any case, you may hope that things will improve with a pump. But you must be willing to put the work into it. Certainly, in the beginning, a pump takes a lot of time and effort. But many children who have gotten used to it are satisfied, and would not want to go without it.

Why a pump?

For people who do not have diabetes, their pancreas makes exactly the amount of insulin needed. When they eat, the glucose levels in their blood temporarily increases and then the pancreas provides exactly enough insulin. The body continuously makes insulin between meals, just enough to keep the glucose level of the blood as normal as possible. When you have diabetes, your pancreas does not make insulin. Your body, therefore, needs to receive insulin in another way. There are two types of insulin: basal and bolus. The amount of insulin your body needs to keep your blood sugar level as normal as possible is called basal insulin. The extra insulin that your body needs during and right after a meal is called bolus insulin.

Fast and slow

When using insulin injections, you reach your basal insulin by administering long-acting insulin yourself. You can administer bolus insulin just before a meal, with short-acting insulin. With this combination of long-acting and short-acting insulin, you try to simulate the effect of the pancreas as close as possible. But sometimes it does not work that well and then your blood sugar levels can fluctuate a lot. This can be a reason to use a pump.


With a pump, you will only be given short-acting insulin. The pump, just like the pancreas, delivers small amounts of insulin throughout the day and night, precisely tailored to the basal needs of your body. If you eat something, and you need a little extra, then you can add bolus insulin through the pump in just a few clicks. The pump can be tuned very precisely. This makes your diabetes much more manageable. It is very important that you regularly test your blood sugar level – even if the pump is properly adjusted.

What does the pump look like?

The pump is a small device that you wear under or in your clothes. It is not very big, about the size of a debit card. You can easily wear it under your clothes, but you can also attach it to your belt. There is a tube with insulin, an engine and a battery. The insulin runs through a small tube to a small needle that can be inserted in your stomach, buttock or leg. A special plaster ensures that the needle stays in place. The tube lasts for three days. You can read the data on a small screen. You’ll also be able to see if the pump is empty, if the tube or the needle is blocked, or if the battery is almost empty.

Do you always have to wear it?

You always carry the pump with you, day and night, because you need insulin 24 hours a day. But you can of course temporarily disconnect it if you prefer. For example, if you go swimming, take a shower, or exercise. The needle remains in your skin but you can put the pump and the tube away. In principle, you can do anything with a pump. It takes some getting used to in the beginning, but after a while, you don’t notice that you have it on you. You can just exercise and move normally. With some pumps, you can even take a shower and swim. Some children carry their pumps under their clothes, but others turn their pumps into a fashion accessory. For example, they buy a nice bag or create a nice case for themselves.

What if you don’t like it?

You should always try it for a while. After you have used it for about six months, you’ll know whether the pump is right for you. If you find that the pump doesn’t suit you, you can always switch back to the insulin pen.