Which insulin pump is the best?

How do you know which insulin pump is the best insulin pump?

Diabetes, whether it is Type 1 or Type 2, is a chronic condition, but you can still manage diabetes successfully with the help of a healthy lifestyle and proper medical care. Some patients will need insulin injections at a certain point in their diabetes management. However, for those who are too busy or squeamish to deal with an injection, a useful tool that they can use is an insulin pump.

Since you are reading this article you probably are asking the question "Which insulin pump is the best". There is no "the best insulin pump" for everyone. But, there is "the best insulin pump for you" out there. After reading this article you will decide which pump best suits you.

If you wish to learn about our online diabetes doctors and our telehealth diabetes care center, contact us after you finish reading the article, and remember to share with other people who may benefit from the information.

What is an insulin pump and How does an insulin pump work?

Insulin pumps are small medical devices that work by delivering insulin automatically. It does that in a calculated, steady, and continuous fashion (referred to as the basal insulin). It also allows giving a bolus dose close to mealtime for rapid-acting insulin delivery. So the best insulin pump or average insulin pump all do the same thing when it comes to how it works.

The pump is a small device, much like a pager or iPod, and is usually worn on your body. The pump has a thin catheter that is connected to a cannula. The cannula is inserted into the fatty tissue of the body to deliver insulin doses straight into the bloodstream.

The entire pump is fastened to your body with the help of an adhesive patch. This is commonly positioned around the stomach area, but based on your preferences, it can also be fastened to the thighs, upper arms, hips, or even the buttocks.

Many people love using the pump because it is small, discreet, and easy to use. You also don’t have to deal with constant reminders about using it as you would with an insulin injection. Before you buy an insulin pump, it is always recommended that you consult with your endocrinologist or seek help from knowledgeable specialists such as the ones at SugarMDs. This will help you determine the best insulin pump for "you".

With their help, it is easier to understand how you can use the insulin pumps, monitor blood sugar levels, and manage your condition successfully. If you’ve never used an insulin pump, we’re here to help you out. Any pump can turn into the best insulin pump if you know the bells and whistles associated with it.

Is the Insulin Pump Right for Me?

Many people with diabetes use insulin pumps because they prefer a system with flexible and frequently adjustable insulin delivery. Some people use pumps to avoid taking injections. Choosing between injections vs insulin pump options usually hinges on a person’s preferences. However,  you should seriously consider an insulin pump if you:

• Frequently suffers from very low ( below 70 mg/dl) or very high( >200) blood glucose frequently.
• Have an active lifestyle and will benefit more from having changes in your basal rates ( Basal insulin need can change depending on the activity status)
• Want flexibility in your diet and like precision in insulin dosing? Using the bolus calculator in the pump helps for better precision in your doses (allows flexibility in insulin dosing based on what you eat. Also  gives you freedom of food choices)
• You have gastroparesis – a condition where the stomach is unable to empty itself in a normal manner ( feeling full too quickly, nausea, sometimes vomiting)

Is the insulin pump difficult to use?

Most people are intimidated by the word insulin pump. On the other hand, very few patients have a hard time using insulin pumps once they start using them. If you can use a smartphone you can use an insulin pump. Insulin pump nurses and specially trained coaches help you a few times to get you started and the rest is a piece of cake. The learning curve is not steep. And, once you master you reap the benefits.

How Does an Insulin Pump Help?

If you’re still contemplating the idea of whether you should use an insulin pump or not, here are some reasons that can help you decide.

More Flexibility

With an insulin pump, you can continue to live an active lifestyle without any issues. You don’t have to find a special area to inject insulin into your body. Any area where you normally would inject insulin will work for the pump infusion site.

Preventing the Risk of Low Blood Sugar

Insulin pumps have a CGM readings system incorporated in them. Medtronic 670 G and tandem control IQ systems are the best examples. This ensures that they monitor your blood sugar levels and automatically shut down or inject more insulin based on your blood sugar levels. It’s a safe, easy, and healthier way to consume insulin.

Accuracy in Insulin Delivery

Insulin delivery can be set as needed. You have the freedom to set the dosage amount for the insulin. Even if you’re new, this is not a hard feature to master and will ensure that you don’t accidentally have too little or too much insulin.

The Major Components of a Pump

We’ve previously mentioned what an insulin pump is but let’s a closer look at its components. The following are the three major components you can find in a traditional insulin pump:

The Pump

This is the main body of the insulin pump. This is computerized and battery-powered with an insulin reservoir and a built-in pumping system. They can either have a touch screen or buttons that can be used to deliver insulin into your bloodstream. The best insulin pump or a regular insulin pump, regardless they all have a pump system.

The Infusion Set

The cannula and tubing together make up the infusion set. They can either be made of steel or Teflon. Patients fasten the infusion set to the skin with the help of an adhesive tape. The good news is that there are different types of infusion sets available for you to choose from.

However, if you’re not sure about which one is right for you, consult with a diabetes care team like SugarMDs. They can help you pick one that not only matches your lifestyle but your body’s needs, too.

The Tubing

The tubing is a thin and flexible plastic funnel taped to your skin. It has a small needle inserted catheter which transfers insulin to your body. Tubing lengths vary and you can pick one according to your preferences.

If you want to wear your pump at a distance from the infusion set, you can always choose tubing that is longer. Omipod maybe the best insulin pump for you since there is no infusion set or tubing involved.

Various Kinds of Infusion Sets  are Available

There are also different types of infusion sets available. This makes it easy for different people and lifestyles. The following are the ones you can pick and choose from:

Straight Sets

Patients insert straight sets at a 90-degree angle in the skin. They have shorter needles. They are more suitable for use on the arms or the buttocks. Additionally, you can use an insertion device with this set which hides the needle. This is especially handy if you are afraid of needles.

Angled Sets

Patients insert angled sets at a 30-45-degree angle into the skin. They also have longer cannulas than straight sets. This makes them more suitable for use by pregnant women, athletes, muscular people, and children. Due to the angle, you can view the needle and monitor the insertion area as well.

If you’re not sure which set is right for you, ask your endocrinologist for help. They will be able to guide you when it comes to which type of set you should choose.

(Diabetes Education Online, UCSF)

Various Types of Insulin Pumps

Traditionally, insulin pumps are commonly found in two forms, such as tethered pumps and patch pumps. However, today, there are more pump types available, including the closed-loop insulin pump. Let’s briefly look at each of these types here.

Pumps that use tubing (Medtronic, tandem)

Tethered pumps come with flexible tubing which is tethered between the pump and the cannula. The pump also has various feature controls and is portable in nature.  Some pumps with tubing also come with a separate handset for controls. Patients can use this remote as a blood glucose monitor. Do you want to know the best insulin pump between Medtronic and tandem? Watch the video below.

Patch Pump (Omnipod)

A patch pump is a simple pump that the Patient attaches or sticks to the skin. The controls of the pump are on a separate remote control. Much unlike the tubed pump, this remote can also serve as a blood glucose meter.

The biggest benefit of using patch pumps is that there are no other tubes to fasten on handles. However, you need to be very careful about accidentally knocking the pump. Also, a lot of people report sensitive skin and rashes due to the adhesive patch.

Closed-Loop Pumps (Medtronic 670G, tandem control IQ)

Also known as an artificial pancreas, closed-loop insulin pumps work completely automatically. They respond to readings CGM device takes continuously through the glucose monitor. It’s easy to wear it throughout the day, and it is perfect when it comes to monitoring the blood sugar levels of your body. You will still have to give boluses for the food however the pump will compensate for the patient calculation errors that can cause higher or lower blood sugars than the specified target blood sugars.

Medtronic 670 G has its own CGM (guardian).  Tandem control IQ works with Dexcom.

The Best Insulin Pump Brands to Choose From

Now that you’re ready to pick an insulin pump, we’re listing down the top ones from renowned insulin pump brands. To help you make up your mind, we’re sharing the pros and cons associated with these devices as well. This can allow you to choose a device that meets your needs and gives safe and continuous insulin delivery.

Tandem pumps

Tandem insulin pumps are of two types - the t: slim X2 and the t-flex. Both these pumps rely on basal IQ technology to deliver insulin based on the glucose readings. Most recently tandem came up with a control IQ system in early 2020.

The following are the pros and cons associated with their usage:

Pros

• Recent improvements with control IQ system to prevent highs and lows. It also increases time in range (Keep glucose as close to normal as possible)
• They have a full-color, bright touchscreen
• Chargeable batteries
• Waterproof; can be used while swimming and showering
• High-quality, compact design
• Integrates with smart devices like smartphones and CGM through Bluetooth
• No fingerstick blood sugar calibration is necessary. Integrated with Dexcom G6.

Cons

• With smaller buttons, the screen may go blank if the Patients miss the buttons while pushing in order.
• The tubing connector may snag on your clothes
• The unlock procedure is not simple and may cause a hassle
• Both basal and bolus settings are in the same time slot, which can be time-consuming to adjust
• Has a weak vibration system
• Patients have to charge the pump 1-2 times per week

Medtronic Insulin Pumps

These pumps use SmartGuard technology to suspend insulin delivery in case the blood sugar reaches an alarmingly low limit. They’re simple to use and are available in two different types. The following are the pros and cons associated with their usage:

MiniMed 670G System

Pros

• Great customer support. A large support team with the nurses and technical team.
• A hybrid closed-loop pump with SmartGuard technology allows flexible levels of insulin delivery. Similar to tandem control IQ it helps to keep blood sugar close to normal as much as possible.
• An auto-mode feature adjusts insulin delivery according to a CGM sensor(As of 2020 requires calibration twice a day with fingersticks)
• A waterproof screen in full-color
• Choice of both fast and slow bolus delivery
• Patients can use the integrated meter as a remote control for bolusing (the contour next meter is subject to insurance coverage and the pump remote bolus feature has to be turned on)

Cons

• Airplane mode option for CGM requires extra finger-sticks for safety checks and calibration
• Has a high learning curve to operate the pump in Auto mode
• Frequent alerts from Auto mode can be disruptive
• If the patient does not do a calibration pump will take the patient off of auto mode. When not in auto mode insulin pump will not adjust the insulin delivery.
• Too many menus that are complicated.
• The Carelink program Is the only way to download data

MiniMed 630G System

Pros

• Full-color screen
• Waterproof pump that can also sustain itself under 12ft of water for up to 24 hours
• Suitable for adults and children aged 16 and above
• A hybrid closed-loop basal adjustment that relies on predictive algorithms and CGM readings
• Bluetooth handset that delivers blood sugar levels to the machine
• Generates insulin statistics

Cons

• Airplane Mode option for CGM accuracy may not be on par with other insulin pump brands
• You will have to pay for backup pumps
• Small screen and text which makes readability poor
• Complicated programming with lots of button-pushing

Omnipod

Omnipod insulin pumps are the only single-standing “tube-less” pumps in the market. They are pre-filled with insulin. The following are the pros and cons associated with these devices:

Pros

• Portable and travel-friendly with no tubing required
• Can easily program through thick clothing a few feet away
• Less costly than other insulin pumps on the market
• Automated cannula insertion
• Water-tight pump
• Large and clear color screen with big readings

Cons

• There is no integration with Dexcom as of 2020. They do not have they are own CGM either. 
• There is no automatic adjustment of insulin, unlike the Medtronic or tandem pumps. 
• Complicated programming with lots of button-pushing
• The hybrid closed-loop feature is still in development
• Pod might create a bump on the skin and stop working after 72 hours
• Supports only one cannula length
• No vibration option

With the help of these details, you can not only understand insulin pumps better but also improve your condition easily. If you have any doubts, you can always consult one of our endocrinologists at SugarMDs. We offer you remote monitoring services, and helpful medical advice to use insulin pumps safely. Get in touch with us now!

Author: Ahmet Ergin, MD, FACE, CDCES, ECNU
About the author: Dr. Ergin operates a large diabetes practice mostly in Jupiter, FL, and yet can see diabetic patients across the entire state of Florida via a unique telehealth platform which also allows him and his team to track patient progress and be available at all times.

The Best Insulin Pump Brands to Choose From

Now that you’re ready to pick an insulin pump, we’re listing down the top ones from renowned insulin pump brands. To help you make up your mind, we’re sharing the pros and cons associated with these devices as well. This can allow you to choose a device that meets your needs and gives safe and continuous insulin delivery.

Tandem pumps

Tandem insulin pumps are of two types - the t: slim X2 and the t-flex. Both these pumps rely on basal IQ technology to deliver insulin based on the glucose readings. Most recently tandem came up with a control IQ system in early 2020.

The following are the pros and cons associated with their usage:

Pros

• Recent improvements with control IQ system to prevent highs and lows. It also increases time in range (Keep glucose as close to normal as possible)
• They have a full-color, bright touchscreen
• Chargeable batteries
• Waterproof; can be used while swimming and showering
• High-quality, compact design
• Integrates with smart devices like smartphones and CGM through Bluetooth
• No fingerstick blood sugar calibration is necessary. Integrated with Dexcom G6.

Cons

• With smaller buttons, the screen may go blank if the Patients miss the buttons while pushing in order.
• The tubing connector may snag on your clothes
• The unlock procedure is not simple and may cause a hassle
• Both basal and bolus settings are in the same time slot, which can be time-consuming to adjust
• Has a weak vibration system
• Patients have to charge the pump 1-2 times per week

Medtronic Insulin Pumps

These pumps use SmartGuard technology to suspend insulin delivery in case the blood sugar reaches an alarmingly low limit. They’re simple to use and are available in two different types. The following are the pros and cons associated with their usage:

MiniMed 670G System

Pros

• Great customer support. A large support team with the nurses and technical team.
• A hybrid closed-loop pump with SmartGuard technology allows flexible levels of insulin delivery. Similar to tandem control IQ it helps to keep blood sugar close to normal as much as possible.
• An auto-mode feature adjusts insulin delivery according to a CGM sensor(As of 2020 requires calibration twice a day with fingersticks)
• A waterproof screen in full-color
• Choice of both fast and slow bolus delivery
• Patients can use the integrated meter as a remote control for bolusing (the contour next meter is subject to insurance coverage and the pump remote bolus feature has to be turned on)

Cons

• Airplane mode option for CGM requires extra finger-sticks for safety checks and calibration
• Has a high learning curve to operate the pump in Auto mode
• Frequent alerts from Auto mode can be disruptive
• If the patient does not do a calibration pump will take the patient off of auto mode. When not in auto mode insulin pump will not adjust the insulin delivery.
• Too many menus that are complicated.
• The Carelink program Is the only way to download data

MiniMed 630G System

Pros

• Full-color screen
• Waterproof pump that can also sustain itself under 12ft of water for up to 24 hours
• Suitable for adults and children aged 16 and above
• A hybrid closed-loop basal adjustment that relies on predictive algorithms and CGM readings
• Bluetooth handset that delivers blood sugar levels to the machine
• Generates insulin statistics

Cons

• Airplane Mode option for CGM accuracy may not be on par with other insulin pump brands
• You will have to pay for backup pumps
• Small screen and text which makes readability poor
• Complicated programming with lots of button-pushing

Omnipod

Omnipod insulin pumps are the only single-standing “tube-less” pumps in the market. They are pre-filled with insulin. The following are the pros and cons associated with these devices:

Pros

• Portable and travel-friendly with no tubing required
• Can easily program through thick clothing a few feet away
• Less costly than other insulin pumps on the market
• Automated cannula insertion
• Water-tight pump
• Large and clear color screen with big readings

Cons

• There is no integration with Dexcom as of 2020. They do not have they are own CGM either. 
• There is no automatic adjustment of insulin, unlike the Medtronic or tandem pumps. 
• Complicated programming with lots of button-pushing
• The hybrid closed-loop feature is still in development
• Pod might create a bump on the skin and stop working after 72 hours
• Supports only one cannula length
• No vibration option

With the help of these details, you can not only understand insulin pumps better but also improve your condition easily. If you have any doubts, you can always consult one of our endocrinologists at SugarMDs. We offer you remote monitoring services, and helpful medical advice to use insulin pumps safely. Get in touch with us now!

Author: Ahmet Ergin, MD, FACE, CDCES, ECNU
About the author: Dr. Ergin operates a large diabetes practice mostly in Jupiter, FL, and yet can see diabetic patients across the entire state of Florida via a unique telehealth platform which also allows him and his team to track patient progress and be available at all times.