Comparison of Insulin Pumps

By Beth Michaels, in-house Dietitian

In this article we’re going to do a comparison of insulin pumps and provide information to help you make a decision about what might work best for you.

Insulin pumps are small computerized devices that serve to deliver short or rapid acting insulin to the body incrementally throughout the day. They work through an infusion set, which is changed every 3 days or so, in which a catheter is inserted under the skin and left covered and sealed.

This catheter then extends through a tubing, which is connected with a reservoir of insulin that is released according to the pumps programming. The reservoir has a sort of plunger or ‘pump’ that must be told what to do by the wearer.

For example, if a person consumes 15 grams of carbohydrates, the pump doesn’t ‘know’ this unless the person enters that information or the amount of insulin they require based on that information.

Insulin Pumps: Factors to Consider

There are many different kinds of insulin pumps available and just like when choosing a house, a vehicle, or clothing items, there is no one ‘best kind’ for everyone as they all have different advantages and disadvantages. Some of these are more important to certain people than others, so it’s important to consider the factors that are most important to you.

Here are some variations to compare as you consider the pump that will be best for you:

Cost

Health insurance may cover much of the cost, but there are often co-pays and deductibles.

Size, weight, appearance

No pump-wearer is trying to make a fashion statement, but for some, having a bulky or obvious pump is more troublesome than a small, discreet or even cool-looking pump.

Ease of use

Some features make pumps more user-friendly than others. Playing around with buttons, screens, menu items and so forth, can give you a better feel for simplicity in day-to-day use.

Battery type and life

Pumps have different charging options and duration between charges.

Infusion sets and tubing

Most pumps have tubing that connects the reservoir to the pump. Patches or pods are tubeless and offer a tangle free option and stay stuck to the site until it is changed.

Reservoir size

Those who are highly insulin resistant or use more than 60 units/day will want to ensure they have sufficient reservoirs to avoid having to change cartridges on a daily basis.

Flexible dosing

The ability to set multiple dosing and variable rates is very beneficial, especially in those who use large amounts of insulin and are more ‘brittle.’

Basal range, delivery, and increment

People who are extremely sensitive to insulin may require doses of less than 1 full unit.

CGM and meter integration

If a pump integrates data from glucose meters or CGMs this eliminates the need to manually enter glucose values and ensures a correct reading. Some pumps have meters integrated into the remote controls that program the pump.

Alarms

Pumps have alarm systems for obstruction, over-delivery, near-delivery, and many other factors. Volume and intensity of vibrations are points of consideration.

Warranty

Sometimes it’s hard to know whether your pump is right for you until you’ve actually used it for a time. Many pump manufacturers offer a 30 day money-back guarantee, but check before purchasing.

Memory and reporting

All meters have different data managing systems and generated reports–some are more helpful and understandable than others; most are compatible with Windows and Mac.

Special features (colors, software download, waterproof etc)

Several other bells and whistles offered by pumps should be taken into consideration when making a decision based on what is most important.

Realistically, most people end up with the pump their insurance company covers.

5 Popular Insulin Pumps

While there are far too many pumps and features to cover in a single article, five of the most popular pumps and highlighted features are as follows:

Medtronic

ADVANTAGES	DRAWBACKS
Long-established, large reputable company	Not water tight
Industry leader	Low contrast LCD screen
Integrated Enlite CGM system (data display on pump screen)	CGM system must be purchased with pump ($)
Connect feature for sharing CGM data (even on smartphones)	On-board insulin only subtracted from correction bolus
Quick and easy bolus programming	Slow bolus delivery
Easily downloadable to online program	Customer service complaints
Very specific Insulin to Carb ratios (.1 g increments)	No food database available
Generates insulin/carb/BG statistics	Alerts difficult to hear

Animas Vibe

ADVANTAGES	DRAWBACKS
Syncs with Dexcom G4 (CGM) integrates with web-based software	No data averages or statistics generated on screen
Water-tight	Re-priming with battery change
Very bright full color screen; easy to read	Insulin to carb ratios whole numbers only
Highly customizable	200 unit cartridge limit
AA Batteries; last 6-8 weeks	Cursor screen complicated
Cartridges easy to fill	Extra button presses when programming
No air bubbles	Does not sync to meter
Strong metal clip	On-board insulin not subtracted from bolus

Omnipod

 

ADVANTAGES	DRAWBACKS
Reduced up-front costs	Bulky programmer and pod ‘bulge’ on skin
Discrete size (smaller than other pumps)	Cannot program while bolus is delivering
No tubing (more freedom to move around, no ‘lost’ insulin)	Cannot enter boluses or make setting changes without programmer
Fully watertight	Max reservoir 200 u
Temp basal and boluses can be customized	Dislodged cannula or disconnection requires complete reservoir replacement
Freestyle meter built into programmer	Not covered by 3rd party payers
Large color screen with full-sentence text	Insulin to carb ratios whole numbers only
Graphing/charting capability	Only one cannula type
Automated cannula insertion minimizes pain and lipodystrophy	Must suspend when changing basal settings

Tandem (t-slim)

ADVANTAGES	DRAWBACKS
Bright full color TOUCH screen	Small buttons…difficult to navigate
Modern, “techy” appearance; compact	Unlock procedure required to perform programming
Graphic on-screen history display	No integrated clip
Carb counting calculator	Tubing connector unattractive
Web-based downloadable software	No meter link option
Calculate bolus up to 50-60 units	New manufacturer
Cartridges hold 300-480 units	Charging required 1-2x/week
Highly customizable	No in-warranty upgrade policy

Roche Accu-Chek Combo

 

ADVANTAGES	DRAWBACKS
Full pump programming via linked meter/remote via bluetooth	Must use linked meter to check BG and perform bolus calculations (cannot enter manually)
Bolus adjustments in percentages	Need computer software to change certain temp basal parameters
Bright full color meter screen	Bulky
Smart scrolling speeds	No clip (must use case)
3 programming options (based on user capability)	Cartridges challenging to fill without bubbles
Holds 315 units insulin	Must stop pump to change cartridge
Sensitive occlusion detection	Can only link 1 meter per pump
History displayed as graphic reports on meter screen	Bolus calculations complicated to set up
Can use rechargeable batteries	Must enter cartridge fill amount manually

You can also find a more detailed side by side comparison here.

One last point–word of mouth may be one of your best assets.

If you know anyone who has a pump or has had one, or even better, has tried multiple types, set a date to meet up with them and ask some questions.

To provide a comparison of insulin pumps, much of the information available is from the manufacturer, which is obviously a bit biased. We all know some things look better ‘on paper’ than they are able to deliver ‘in practice.’

Your doctor and/or diabetes educator likely has experience with patients using several of these as well so be sure to ask them too!