Although insulin pumps offer some advantages over other methods of insulin administration, they also come with potential drawbacks. These include:

• Risk of infection. Bacteria and other harmful organisms may enter the insertion site. Diabetes makes infections harder to control.
  
  
• Risk of hyperglycemia and diabetic ketoacidosis. Dangerously high levels of glucose (blood sugar) and a waste product called ketones can form in the blood because of pump malfunction or problems with insulin absorption.
  
  
• Risk of hypoglycemia and insulin shock. A problem that causes excessive delivery of insulin, such as a pump malfunction or incorrect dosage adjustment by the patient, may cause a dangerous drop in glucose.
  
  
• Higher cost than injection therapy. Pumps can cost thousands of dollars, and supplies can cost hundreds of dollars a month. Health insurance may cover some of this expense.
  
  
• Patient commitment. Although convenience is one of the major advantages of using insulin pumps, the devices still require a major commitment on the part of the patient. Patients using insulin pumps need to check glucose as recommended by their physician, generally at least four times each day. They must be prepared to react quickly if something goes wrong with the pump. If pumps quit delivering insulin for whatever reason, dangerously elevated glucose levels can quickly result. Pumps have built-in alarms that sound a warning when the pumps need attention.
  
  
• Loss of privacy. The pump may reveal the patient's diabetic condition to others. This can be an issue, especially for children and teens sensitive to how they are perceived. However, in many cases pumps can be attached to underclothing.

After the U.S. Food and Drug Administration (FDA) received several reports of adolescent deaths involving insulin pumps, in 2008 it reviewed this population's use of insulin pumps. The FDA found 1,594 "adverse events" over a decade, including 13 deaths, two possible suicide attempts and several other severe episodes of hyperglycemia or hypoglycemia that seemed to be related to the pump. The FDA concluded that adolescents were a special population deserving careful consideration of the risks and benefits of drug pumps.