Insulin Pump Therapy & Metabolic Monitoring

Insulin pump therapy — continuous subcutaneous insulin infusion (CSII) — represents an advanced method of insulin delivery for patients with type 1 diabetes and selected patients with type 2 diabetes who are unable to achieve satisfactory glycaemic control with multiple daily injections. At SilverOak Health, our endocrinology and diabetes team offers a comprehensive pump therapy programme encompassing patient selection, initiation, education, and ongoing support.

Pump therapy delivers a continuous basal infusion of rapid-acting insulin, supplemented by patient-initiated bolus doses for meals and corrections, mimicking the physiological pattern of pancreatic insulin secretion more closely than injection-based regimens. Adjustable basal rates throughout the day and night, temporary rate changes during exercise or illness, and sophisticated bolus calculators enable fine-tuned glycaemic management that reduces both hyperglycaemia and hypoglycaemia.

Continuous glucose monitoring (CGM) — used alongside or integrated with insulin pump therapy in sensor-augmented pump and closed-loop (artificial pancreas) systems — provides real-time glucose readings every one to five minutes with trend arrows, enabling patients and clinicians to identify and address glycaemic patterns proactively. Automated insulin suspension (low-glucose suspend and predictive low-glucose suspend) and fully closed-loop systems further reduce hypoglycaemia risk, particularly overnight.

Our diabetes technology team includes consultant endocrinologists, diabetes specialist nurses, and dietitians who provide structured pump initiation training, download and analysis of pump and CGM data at clinic visits, and remote monitoring between appointments. The educational programme covers pump mechanics, infusion site management, sick-day rules, exercise adjustments, and troubleshooting to ensure patient competency and safety.

Advanced metabolic monitoring extends beyond glucose to include continuous ketone monitoring, metabolic rate measurement in hospitalised patients, and comprehensive metabolic panel reviews for patients with complex diabetes including those with renal impairment, eating disorders, or post-bariatric surgery metabolic changes. Our holistic approach to metabolic monitoring aims to optimise not just glucose but the entire cardiometabolic risk profile of our diabetes patients.