Insulin Pump Comparison: Which Pump is Right for You?

With the announcement of Animas Vibe’s FDA approval in the United States and last week’s first shipments of Asante’s new MySnap reaching customers who designed the company’s first customizable pumps (myself included), it’s the perfect time for an insulin pump comparison.  Which pump should you be using in 2015?

I’ve been using an insulin pump since the year 2000 and in those 14 years, have used 10 different pump models from five different pump companies. I consider myself a discerning and skeptical customer. When I approach a pump, I want its rep to be able to explain features beyond the company’s marketing talking points. Yes, it’s tubeless, but how’s the user interface? Okay, so site changes are quick, but what advanced pumping features does it include? Integrated CGM, but what’s it like to press the buttons and program a bolus? I want to know how fast it scrolls, how large a pack mule I’ll need for the supplies, and where they’ve buried the IOB.

Each of the six companies listed below is working hard to provide people with diabetes with innovative devices for pumping insulin. Which you prefer depends on which features matter to you; one man’s pro is another man’s con. We are incredibly fortunate to have choices when shopping for a device we’ll depend on for the next four to five years. I encourage you to explore the offerings below.

Insulin Pump Comparison:

Animas Vibe

Features:

• Reservoir size: 200u
• IPX rating: Fully watertight IPX8, company calls it “waterproof” up to 12 feet for 24 hours
• Integrated with Dexcom G4 Platinum CGM (on screen)
• Bright body color choices
• High-contrast color screen
• Infusion Sets: Accepts any luer lock infusion set
• Accepts all fast-acting U-100 insulins
• Meter: use with any meter
• Software: Uploads to Diasend
• Power: 1 AA battery
• Audio: Personalized audio alerts (vibrate, create your own tune, etc). Non-adjustable safety alert set at 55 mg/dL

Additional Specs:

• Weight: 3.70oz
• Basal increments: .025u
• Max Basal Limit: 10u/hr
• Max Bolus: 35u
• Minimum bolus increment: .05u
• Max Hourly Delivery Limit: 50u over 2-Hour Period
• Duration of Insulin Action Increment: 30min
• Max Number of Basal Profiles/Segments: 4 Profiles/12 Segments each

Changes from Previous Model:

vs Animas Ping

• Integrated with Dexcom G4
• No longer have to dial up to the dose from the bolus calculator
• No remote
• No linked meter (meter agnostic)
• Navigational changes to Menu structure

Considerations:

• Not compatible with Dexcom G4 505 software upgrade
• Not compatible with future Dexcom pipeline (G5, etc)
• Pump does not act on data from CGM reading, does not have Low Glucose Suspend
• 200u only
• Not yet approved for pediatric use in the US
• Meter agnostic, but not CGM agnostic – must be used with Dexcom G4 sensors
• A number of users report that the speed of bolus delivery is too fast and therefore uncomfortable

Pros: Integrated Dexcom CGM, Waterproof, Proven company.

Cons: Loss of remote from previous model. Incompatibility with latest and future Dexcom updates.

Takeaway: Exciting and long-awaited new offering from reliable pump company. Wish US would have had access in 2011 when the technology was new and more relevant.

Medtronic 530g w/ Enlite

 Features:

• Reservoir size: 300u or 180u reservoir models, accepts all fast-acting U-100 insulins
• IPX7 Rating – accidental dunk proof
• Integrated sensor technology with Medtronic’s Enlite sensor
• Low Glucose Suspend feature suspends basal in response to low blood sugar
• Meter: Pairs with Bayer CONTOUR NEXT LINK rechargeable meter
• Software: Easy upload to web-based Carelink program
• Audio: Silent option for discreet bolusing
• Power: 1 AAA alkaline Energizer battery

 Additional Specs:

• Weight of 300u model: 3.66oz. Weight of 180u model: 3.35u
• Basal increments:  0.025u for basal amounts in the range of 0.025 to 0.975u, 0.05u for basal amounts in the range of 1 to 9.95u, 0.1u for basal amounts of 10.0u or larger
• Max Basal Limit: 35u
• Minimum bolus increment:  0.025u for bolus amounts in the range of 0.025 to 0.975u, 0.05u for bolus amounts larger than 0.975u
• Max Bolus: 25u
• Duration of Insulin Action Increment: 1 hour
• Max Number of Basal Profiles/Segments: 3 Profiles/ 48 Segments each

Changes from Previous Model:

vs Medtronic Revel

• Features Low Glucose Suspend
• Enlite sensor technology
• Green colored accent for Activate button

Considerations:

• Proprietary infusion sets
• Duration of Insulin Action in hour increments rather than half hour
• Low resolution screen
• Must be purchased as a system. Very difficult to purchase 530G pump without Enlite.
• A number of users report less than desirable accuracy of Enlite CGMS and awkward insertion device
• A number of users report alarms as difficult to hear overnight

Pros: Integrated Enlite CGM with Low Glucose Suspend puts it on the pathway toward Artificial Pancreas. Proven company. Proven pump.

Cons: CGM accuracy.

Takeaway: If you have loved the Medtronic pump for the last two decades, you’ll love and recognize this pump. LGS is a great feature when it works and if you trust their CGM.

Tandem t:slim

Features:

• Reservoir size: 300u cartridge before tubing fill
• IPX7 rating: accidental dunk proof
• Bright, colorful, touchscreen interface on shatter-resistant glass
• Easily see matrix of all settings by time segment
• Carb calculator for multiple carb serving input
• IOB on home screen with time remaining
• Site reminder for infusion set changes
• Infusion Sets: Accepts any luer lock infusion set
• Meter: Can be used with any meter, but ships with One Touch Verio IQ meter (does not pair)
• Software: Uploads to Diasend and Web-based t:connect software
• Audio: Silent options for discreet bolusing
• Power: Powered by rechargeable lithium polymer battery via included microUSB cable – can be charged from outlet, car charger, or computer and full charge lasts up to 1 week

 Additional Specs:

• Weight (full): 3.95oz (heaviest pump)
• Basal increments: 0.001u at programed rates equal to or greater than 0.10u
• Max Basal Limit: 15u
• Minimum bolus increment: 0.01u at volumes greater than 0.05u
• Max Bolus: 25u
• Duration of Insulin Action Increment: 1min
• Max Number of Basal Profiles/Segments: 6 Profiles/16 Segments each

Changes from Previous Model:

N/A

Considerations:

• Aluminum casing means metal detector sensitivity
• Many confirmation screens
• Time-consuming fill process
• Not compatible with Apidra
• Opacity means limited visibility within cartrdige
• No reverse correction
• A number of users report problems with air bubbles in the luer lock
• A number of users report alarms as difficult to hear overnight

Pros: Modern touchscreen interface. Features easy to view and access.

Cons: Touchscreen means more room for user input error despite many confirmation screens. Heavy. Air bubbles a frequent issue. First gen product and new company. Site changes take a lot of time.

Takeaway: A slick, beautiful pump with nice accessories. Will appeal to smartphone users.

Accu-Chek Combo

Features:

• Reservoir size: 315u
• Same IPX8 rating as Animas and Insulet, but they choose to refer to it as “Watertight”
• Meter: Bluetooth linked Accu-Chek Aviva Combo meter/pump remote with full pump programming
• Bright color meter screen
• Infusion sets: Accepts any luer lock infusion set
• Site change reminder
• Software: Uploads to Diasend
• Power: 1 AA battery, accepts non-lithium as well as lithium batteries

Additional Specs:

• Extremely lightweight (empty): 2.8oz
• Basal increments: 0.01u for basal amounts in the range of 0.05 to 1.00u, 0.05u for basal amounts in the range of 1 to 10u, 0.1u for basal amounts in the range of 10.0 to 25.0u
• Max Basal Limit: 25u
• Max Bolus: 25u
• Minimum Bolus Increment: .1u
• Duration of Insulin Action Increment: 15min
• Max Number of Basal Profiles/Segments: 5 Profiles/24 Segments each

Changes from Previous Model:

vs Accu-Chek Spirit

• Bluetooth linked meter serves as fully featured pump remote
• Color now a more discreet black
• Full color on-screen graphs on meter

Considerations:

• Low-resolution screen
• Smallest screen on pump market
• Must use linked meter to program boluses using the bolus calculator algorithm
• May only link 1 meter per pump
• Have to program all 24 basal segments
• Cartridge changes require stopping pump and awkward button press
• No native clip, must use case

Pros: Easy bolusing from meter, Proven company.

Cons: Human factor issues (tiny screen, reliance on meter to use advanced features, difficult cartridge changes).

Takeaway: Solid, reliable pump. Awkward implementation.

Asante MySnap

Features:

• Reservoir size: 300u+ pre-filled Humalog cartridges mean 14 fewer steps to set changes and up to a week’s worth of wear
• IPX5 rating: splashproof, should not be submerged
• Company philosophy includes 30-day free trial and $99 upgrades
• Low upfront cost
• Pump bodies and tubing changed out with each new cartridge for up to 7 days of wear (with cannula changes every 2-3 days)
• Auto-priming of tubing
• Super fast set changes with few steps
• Low incidence of air bubbles due to pre-filled cartridges
• Fast access to bolus calculator w/ 1 button press
• Carb calculator for multiple carb serving input
• Option to return disposables for recycling
• Infusion Sets: specially designed cartridge caps include occlusion detection
• User-defined setting of whether to calculate IOB as correction only vs meal + correction
• Fast new setup with settings stored in pump bodies (insert old body and all settings applied to new controller)
• Alerts to disruptions from a dropped or wet pump body or leaking cartridge
• Temp Basal History

Additional Specs:

• Extremely lightweight: 2.9oz
• Basal increments: .05u
• Max Basal Limit: 4u
• Minimum bolus increment: .05u
• Max Bolus: 25u
• Duration of Insulin Action Increment: 15min
• Max Number of Basal Profiles/Segments: 4 Profiles/10 Segments each

Changes from Previous Model:

vs original Snap (1.0)

• New high resolution color screen replaces original Snap’s low-res screen
• Customizable colors and accents for faceplate, frame, and buttons
• IOB visible on home screen
• Faster scrolling
• Longer flashlight timeout
• On-screen color customization for highlighting menu choices
• Option for Quick 1-button access to Temp Basal for lefthand button

Considerations:

• Humalog only
• No patient upload software, currently has clinical Diasend support only
• Righthand 1-button access button can be either bolus calculator or audio bolus, but user must choose which
• No vibrate-only option for discreet bolus delivery
• Not waterproof, IPX7 rating for splashproof
• Meter and CGM agnostic – not integrated or paired
• Proprietary infusion sets due to specially designed cartridge cap
• No missed meal bolus alerts or pre-set temp basal rates
• Longest length pump on market
• Disposable pumps not available to Medicare/Medicaid
• Disposables must be returned to company for recycling for small fee
• No native clip, accessories lacking

Pros: Feature rich pump in customizable color. Free 30-day trial and $99 upgrades. Very fast set changes.

Cons: No integration with meter/CGM. No patient software yet. Not waterproof. New company to market.

Takeaway: Definitely worth saving this new kid a seat at the lunch table. Company is patient-centered and pump is reliable and simple to operate.

Insulet Omnipod (UST400)

Features:

• Reservoir size: 200u
• IPX8 rating: Pod portion is fully waterproof, PDM is not
• Low upfront cost
• Tubeless
• Auto-cannula insertion
• Bright color screen on PDM
• Food library
• Accepts all fast-acting U-100 insulins
• Temp basal and carb bolus presets for frequently used inputs
• Option to return disposables for recycling
• Reverse correction for bolusing when BG is below 70
• Meter: Integrated Freestyle meter in PDM (Personal Diabetes Manager)
• Software: Uploads to Diasend and CoPilot software
• Audio: Silent options for discreet BG testing and bolusing
• Power: PDM powered by 2 AAA batteries, Pod powered by 3 357 cell batteries that do not need to be replaced

Additional Specs:

• Pod weight (empty): .88oz, PDM weight: 4.4oz
• Basal increments: .05u
• Max Basal Limit: 30u/hr
• Minimum bolus increment: .05u
• Max Bolus: 30u
• Duration of Insulin Action Increment: 30min
• Max Number of Basal Profiles/Segments: 7 Profiles/ 24 Segments each

Changes from Previous Model:

vs Omnipod UST200

• Slimmer pods
• Black PDM replaces blue
• Additional confirmation screens
• Personalization screen with user-defined color and user’s name
• IOB visible on  home screen

Considerations:

• 200u capacity
• 80 hour expiration
• 80 unit fill minimum
• Potential wasted insulin if following protocol of disposing of failed pod without withdrawing unused insulin
• Basal does not resume after suspend duration unless reactivated by User. User should choose Temp Basal “Off” for short term suspension.
• A number of users report high Pod Error and Occlusion rates
• Disposable pumps not available to Medicare/Medicaid
• Disposables must be returned to company for recycling for small fee
• If PDM lost or forgotten, pump delivers basal program but no bolus functions available

Pros: Tubeless. Waterproof.

Cons: High alarm/failure rate.

Takeaway: As the only tubeless option on the market, it’s just right for users wary of tubing. When it works, it works great. When it doesn’t, it can be a frustrating user experience.

Melissa Lee

-Melissa Lee was diagnosed with type 1 diabetes at the age of 10 in 1990. Having spent her first 18 years post-diagnosis feeling very alone with the disease and hoping to achieve the control required for a healthy pregnancy with diabetes, Melissa discovered the diabetes online community in 2008 and found her advocacy voice, as well as the glucose control she needed to birth two healthy children.

Melissa Lee

+Melissa Lee was diagnosed with type 1 diabetes at the age of 10 in 1990. Having spent her first 18 years post-diagnosis feeling very alone with the disease and hoping to achieve the control required for a healthy pregnancy with diabetes, Melissa discovered the diabetes online community in 2008 and found her advocacy voice, as well as the glucose control she needed to birth two healthy children. link