An insulin pump is one of the options when a diabetic patient needs insulin therapy. Generally, insulin pumps are safe, convenient, and to some extent simulate the secretion of insulin in normal people. However, insulin pump is after all a mechanical device, not the so-called “artificial pancreas, intelligent input” as advertised by some manufacturers, with the development of technology, insulin pump will also make some improvements, we look forward to the emergence of a more perfect insulin pump. In the process of application, we should strengthen blood glucose monitoring, reasonably set the infusion procedure, and strictly comply with the operating procedures, so as to achieve relatively satisfactory treatment results. Which type of insulin should be used in insulin pumps? At present, the insulin pump we use can only use short-acting or ultra-short-acting insulin, and medium- and long-acting insulin or premixed insulin cannot be used. The insulins applied in the pump in the early days were mostly short-acting insulins, and nowadays, we prefer to use “ultra-short-acting insulins”. “Ultra-short-acting insulin” can be absorbed into the blood quickly, and the time to reach the peak effect is very fast. Therefore, if ultra-short-acting insulin is used in insulin pumps, it is easier to simulate the effect of human physiological insulin secretion through the basal injection volume and additional injection volume. FAQ 2: How to determine the amount of insulin to be applied 1. Determination of the total amount of insulin per day: It is mainly based on clinical experience and determined by the doctor with reference to the patient’s weight, disease duration, condition, whether he/she has complications and sensitivity to insulin, starting from a small amount. At first, 0.4~1.0U/kg/day can be given. For those who are using insulin, the insulin dosage can be determined according to the existing blood glucose level. After using the pump, the insulin dosage of the patient is generally reduced compared with that before using the pump. For patients who usually have hypoglycemia, their insulin dosage is generally 70%-80% of that before using the pump; for those who have good glycemic control, their insulin dosage is about 85% of that before using the pump; ③ For those who have poor glycemic control, the same insulin dosage as before using the pump is applied first. 2. Determination of basal amount and additional amount before meal: Generally, we divide the total daily insulin into two parts, one is called basal amount and the other is called additional amount before meal, usually basal amount and additional amount before meal account for about 50% each. In normal people, we have insulin secretion at each time point without meal, which is called basal insulin secretion. Each insulin pump usually comes with an “insulin basal dosage chart”. Patients can set their basal insulin dosage for the whole day according to the required basal amount in segments according to the “basal dosage table”. However, each person is different and may need to increase or decrease accordingly at different times. Insulin secretion occurs after a meal, and the additional amount set in our insulin pump is based on this mechanism. Generally, the total preprandial additional dose is divided into three equal parts and injected subcutaneously before each of the three meals. If necessary, the patient’s mealtime additional amount can be increased or decreased accordingly. Many factors such as diet, exercise, emotions, and the nature of food can affect the patient’s blood glucose level and thus the insulin requirement, making it necessary to adjust the insulin pump settings, especially in the early stages of pump use. Blood glucose monitoring as needed is very necessary and is an important part of adjusting the basal amount of insulin and the additional amount at meals to keep blood glucose stable. Generally, within a few days after starting to use the pump, blood glucose monitoring should be performed several times a day, including pre and post meal blood glucose in the morning, lunch and evening, and blood glucose at bedtime and at night. The number of blood glucose monitoring should be gradually reduced after the blood glucose control is relatively good. The use of insulin pump should be strictly aseptic, and disposable consumable materials (including drug reservoir and catheter needle) should be replaced regularly according to the prescribed time to avoid blockage of tubes or skin infection. The insulin pump may cause downtime, too much or too little injection dose if it is not operated properly, and the performance of the instrument should be tested regularly according to the manufacturer’s regulations. If there is an abnormal situation, sudden unexplained too low or too high blood sugar, juggle to check whether the performance of insulin pump is normal. In addition, the drug reservoir should be checked frequently to make sure there is enough insulin in it. Before restarting insulin infusion, be sure to drain all air from the reservoir and infusion line, otherwise air bubbles in the device will slow or stop insulin infusion. When changing the infusion site, be careful to avoid hard knots, scars or broken skin to avoid affecting the absorption of insulin. If the infusion site shows symptoms such as skin redness and spasm itching, the infusion site should be changed.