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Insulin Pump Management

Nestoras Mathioudakis, M.D., MHS, Saira Khan, M.D.
Insulin Pump Management is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Insulin pumps (technically called Continuous Subcutaneous Insulin Infusion, CSII) deliver insulin at programmed rates, from a pump worn externally through a small catheter tip inserted into the skin.
  • CSII is an option for treating type 1 diabetes or unstable, insulin-requiring type 2 diabetes.
  • Sensor-augmented insulin pump therapy: Insulin pump is used in conjunction with a continuous glucose monitor (CGM), which displays real-time blood glucose (BG) readings and allows patient to make informed decisions about insulin dosing.
  • Recently FDA approved pump (Medtronic MiniMed 670G system) offers insulin-only closed-loop system in which basal insulin doses are automatically adjusted up and down to prevent/respond to hypoglycemia and hyperglycemia.[25]
  • Automatic suspension of insulin delivery to prevent hypoglycemia is a useful safety feature for patients with hypoglycemic unawareness.
  • Only use rapid-acting (e.g. aspart, lispro or glulisine) or regular insulin (U-100). U-500 regular insulin has been studied in small case series and appears safe for use with CSII; however, the prescribing information from the manufacturer notes that its safety and efficacy for use in CSII has not been determined. While U-200 may be an attractive option for insulin-resistant patients who have high insulin requirements, U-200 insulin is currently available only in pen form and not intended for use in insulin pump.
  • A fully-automated closed-loop system ("artificial pancreas") based on CGM is not yet available commercially, but shows promise based on results from clinical trials.[4][1]

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Last updated: March 4, 2018


Mathioudakis, Nestoras, and Saira Khan. "Insulin Pump Management." Johns Hopkins Diabetes Guide, 2018. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547077/all/Insulin_Pump_Management.
Mathioudakis N, Khan S. Insulin Pump Management. Johns Hopkins Diabetes Guide. 2018. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547077/all/Insulin_Pump_Management. Accessed August 19, 2019.
Mathioudakis, N., & Khan, S. (2018). Insulin Pump Management. In Johns Hopkins Diabetes Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547077/all/Insulin_Pump_Management
Mathioudakis N, Khan S. Insulin Pump Management [Internet]. In: Johns Hopkins Diabetes Guide. ; 2018. [cited 2019 August 19]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547077/all/Insulin_Pump_Management.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Insulin Pump Management ID - 547077 A1 - Mathioudakis,Nestoras,M.D., MHS AU - Khan,Saira ,M.D. Y1 - 2018/03/04/ BT - Johns Hopkins Diabetes Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547077/all/Insulin_Pump_Management DB - Johns Hopkins Guide DP - Unbound Medicine ER -