What’s the Best Insulin Pump for Me?

What’s the Best Insulin Pump for Me?

How to find the best insulin pump for your diabetes, your needs and your lifestyle.

If you’re finding it difficult to control your diabetes, you’re having regular highs and lows, or you just want more flexibility around your meals and lifestyle, an insulin pump can help. Insulin pumps can help you control your diabetes, stabilise your blood sugar and reduce complications like severe hypos and diabetic ketoacidosis. But then comes the question, ‘what’s the best pump for me?’

Types of insulin pump

There are fifteen different types of insulin pumps available in the UK. Most pumps are either tethered or patch pumps:

 

  • Tethered pumps: Tethered pumps are connected to your body via a narrow tube and cannula. You carry the pump in a pocket or bag
  • Patch pumps: Patch pumps attach directly onto your skin; they deliver insulin to your body through a fine cannula
  • Insulin pumps with integrated CGMs: Integrated pumps communicate with a continuous glucose monitor
  • Closed-loop systems: Also known as an artificial pancreas, these use an app to automatically adjust the dose on your insulin pump according to the readings from an implanted glucose monitor
  • Implanted insulin pump (IIP): IIPs are only available in France at the moment but are a promising new development in pump technology

How to choose an insulin pump

When trying to decide the best insulin pump for you, there are lots of questions to consider:

Do I want a pump that is attached to my skin or connected via a tube?

Tethered pumps connect to your body via an infusion set consisting of a fine tube and a cannula. You carry the pump in a pocket, bag or bum-bag. Some people find the line tethering the cannula to the pump awkward and are worried about snagging and pulling.

Do I want a waterproof device that I can wear while swimming or doing water sports?

The OmniPod pump insulin delivery system is waterproof up to 7.5 metres for one hour. You should remove other devices when you are showering, bathing or swimming.

Do I mind if the pump can be seen under my clothing?

Patch pumps are slightly smaller than a pack of cards. They attach directly to your body and may bulge under clothing, particularly in children or people who are petite. You may prefer a tethered pump that you hide in a pocket.

Do I want my pump to integrate with a continuous glucose monitor?

Some smart pumps communicate with your CGM, receiving information about your glucose readings around the clock.

Do I need my pump to automatically stop supplying insulin if I have a dangerously low hypo?

A couple of insulin pumps can integrate with your CGM and directly respond to low glucose readings by stopping the insulin supply; This is beneficial for people who have severe hypos overnight. Pumps that integrate with CGM technology include the Medtronic MiniMed 640G and the Medtronic MiniMed Paradigm Veo.

Will I get my pump on the NHS or pay privately?

Not everyone can get an insulin pump on the NHS. The National Institute for Health and Care Excellence (NICE) recommends that you may be eligible for an insulin pump if you have frequent hypos or hypers without prior warning or your HbA1c is 69mmol/mol despite actively managing your diabetes. You will also need to show that you regularly inject insulin, check your blood glucose at least four times a day and understand how to count carbs.

What is my pump budget?

Pumps vary in price, with some of the latest high tech devices costing more. Private pumps cost £2,000 – £3,000 and should last 4-8 years. Patch pumps, in which you replace the device every three days, can prove more expensive. You should receive your insulin free of charge on prescription, even if your pump is bought privately.

Does the pump software work with your smartphone?

Some pumps work with a smartphone app; others are programmed using a dedicated remote control.

How big do you need the insulin reservoir to be?

If you have high insulin requirements, it’s sensible to choose a device with a big reservoir so that you don’t have to change it too often.

Can the pump deliver small doses of insulin?

If you’re looking for a pump for a child or are sensitive to insulin, you may want a pump that can administer tiny amounts.

Insulin pump risks and benefits

Before deciding whether an insulin pump is the right choice for you, it can help to weigh the risks and benefits of insulin pumps. The insulin pump pros and cons include:

Pros of insulin pumps:

  • Better diabetes control
  • More flexibility with meals and exercise
  • Less frequent hypos and hypers
  • Fewer diabetes complications and DKA
  • Steady supply of insulin day and night
  • Easy to add a bolus of insulin at meals
  • Fewer injections
  • Helps control early morning hypers

Cons of insulin pumps:

  • Cost
  • You need to carb count
  • You may not like wearing a device on your body
  • You will need training to use the pump effectively
  • It can be challenging to learn how to programme and control the pump

Sources:

https://www.healthline.com/diabetesmine/an-insulin-pump-guide-diabetesmine

https://sugarmds.com/the-best-insulin-pump-sign-up-now-to-improve-your-diabetes/

https://www.diabetesselfmanagement.com/diabetes-resources/tools-tech/how-to-pick-an-insulin-pump-or-cgm/

https://integrateddiabetes.com/updated-insulin-pump-comparisons-and-reviews/

https://www.webmd.com/diabetes/insulin-pump

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Carol Willis - Diabetes Clinic Facilitator

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