Insulin Pump Rundown

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Choosing an insulin pump doesn’t have to be an overwhelming process. Should you go with a more traditional pump where you can monitor your insulin levels directly? Are you looking for a model that works with a BGM monitor and allows you to administer insulin via a remote? Maybe you need a pump that offers integration with a CGM system. What about size? Color? To use tubes or not to use tubes? Presenting the options so you can find out what pump best fits your lifestyle is our goal.

So, with several models on the market, let us help you sort through the choices by taking a look at what’s available and breaking down the various features of each. We’ve separated the pumps into four categories: pumps that incorporate or work with a Blood Glucose Monitor (BGM) and offer Continuous Glucose Monitoring (CGM), pumps with just CGM capability, pumps with just a BGM, and standalone pumps that don’t work with a BGM or offer CGM.

Hybrid Closed-Loop System

MiniMed 670G System

Image courtesy of Medtronic 

The 670 G system is the newest member to the Medtronic pump family and the first hybrid closed-loop system. In other ways, it is a like  a “basal modulator” where you have to still bolus but it predicts your basal rate. Every 5 minutes, the auto-mode option (hybrid closed-loop) automatically adjusts basal insulin delivery based on your sugar levels to keep you range. It is excellent at catching lows because it stops your insulin dosage 30 minutes before you reach your pre-selected low limits, then it will automatically restart insulin when your levels recover.

Possible concerns

Excessive alerts and extended menu that needs clearing. Only approved for ages 14+ because it has a total daily dose requirement of at least 8 units a day. Feeling of loss of control of management with closed-loop system.

Update

As of February 26, 2018, The Guardian™ Sensor 3, Medtronic’s CGM for its hybrid closed loop system, the MiniMed™ 670G system, has received FDA approval for use on the upper arm. This expanded indication will provide more flexibility for patients as well as accuracy.

Pumps with BGM and CGM capabilities

Medtronic MiniMed 530g System with Enlite Sensor (US)

MinimedParadigm
Image courtesy of Medtronic

Overall, Medtronic pumps are probably the closest systems to “artificial pancreases” available on the market today. The company has been providing good medical devices for decades, so if you’re looking for a trusted device from a company with a good track record, the MiniMed 530g System is the pump for you — 93% of MiniMed users say this pump lets them feel more secure in treating their diabetes.

The MiniMed is relatively small and comes in a variety of colors, so your aesthetic bases are covered with this pump. Additionally, this is the only system currently available on the market that allows for “threshold suspend,” a feature that can act for you if your glucose level goes beyond a preset limit. If you don’t respond to alerts, it can pause insulin delivery for up to two hours, so this system is great for avoiding nighttime lows and in assisting with a good night’s sleep. However, because this threshold suspend system is relatively new, this pump does have some issues when it comes to measuring CGM, and the nighttime alarms can be difficult to hear on the device.

Possible concerns

While the MiniMed works great with the online CareLink program, that the data is not downloadable to other programs like Unicare. Some users have reported struggling with the quiet alerts given during CGM. There is evidence also that the Enlite sensor is not as accurate as the Dexcom sensor.

Meditronic MiniMed Paradigm Revel Insulin Pump (US)

MedtronicParadigmEnlite
Image courtesy of Medtronic

Steady, real-time information is the main selling point of this pump with built-in CGM technology that uses a sensor to wirelessly transmit continuous glucose readings. The Revel also has a customizable early warning system that can be set to alert you of oncoming lows and highs in your blood sugar, allowing you to stay on top of your levels.

One great benefit of an integrated insulin pump and CGM system is that you only have to deal with one company, eliminating issues of synchronization and communication, and ensuring that you’ll only have to deal with one company should either part of the system start malfunctioning

Possible concerns

The pump is not waterproof, so you’ll have to remove it before showering or bathing. And it doesn’t offer food-tracking options. Finally, like the Meditronic 530g, the Revel also works with CareLink software, which may or may work well for you depending on the health software your caregiver network uses. Same concerns about the Enlite Sensor not being as accurate.

Medtronic MiniMed 640g Insulin Pump System (UK / Australia)

640G
Image courtesy of Medtronic

This European pump system from Medtronic offers a few new features over Medtronics 530g system mentioned earlier. It works with a Guardian 2 link transmitter and Enlite sensor that allows continuous monitoring of your glucose levels. And is packaged with a Contour Next LINK BCM from Bayer that communicates wirelessly with the MiniMed unit and offers the ability for remote bolusing. Like Medtronic’s other products, this pump also shares data via CareLink software. The biggest upgrade is the introduction of “SmartGuard” technology, which will suspend insulin delivery if hypoglycemia is predicted by CGM to occur within 30 minutes). The system automatically resumes insulin delivery once glucose levels start to recover. The MiniMed 530g system lacked this predictive ability, and could only suspend insulin delivery once hypoglycemia was reached.

Minimed Veo Insulin Pump System (Canada, Australia)

medtronicEnliteParadigm
Image courtesy of Medtronic

This pump is essentially the non-U.S. version of the MiniMed Revel. It offers the same combination of real-time information via a linked BGM and an integrated CGM sensor. It is not waterproof, doesn’t offer food-tracking options, and works with CareLink software.

Pumps with CGM capability

Animas Vibe Insulin Pump (UK / Europe)

*Note: This pump has been discontinued in the United States.

AnimasVibe
Image courtesy of Animas

The Animas Vibe pump provides real-time, intuitive blood glucose insights so users can closely monitor their highs and lows. Additionally, its display interface is showcased in full color which makes it easier to see where your glucose levels are heading — when you see red, you intuitively know that you’ve got to get your levels down which can be more helpful than seeing those levels displayed on a more traditional green-and-black screen. It’s a little bulkier than some of the other pump systems we reviewed, but that can be a positive element when it comes to a child’s ability to navigate this interface; this is the only CGM system approved for monitoring children as young as 2 and can help a child learn to independently monitor glucose levels.

The Animas Vibe is waterproof and has customizable alarms to help you monitor your glucose levels, and there is also a built-in, non-adjustable hypoglycemia safety alert set at 55mg/dl so that if you miss an alert, this pump will still have you covered.

Possible concerns: This newest model does have a few technological glitches to work out—it’s not compatible with Dexcom’s latest G5 upgrade, and it won’t be compatible with Dexcom’s future platforms—but ideally, future models will be more compatible with Dexcom upgrades. With a reservoir capacity of 200 insulin units, the pump holds fewer doses than some other models.

Pumps with BGM capability

Insulet OmniPod UST400 (US / UK / Canada)

Omnipod Image courtesy of Insulet Corp.

The OmniPod is the only tubeless system available in the United States currently, freeing it of the complications of tube injections. A small “pod” attaches to your skin via adhesive. This pod contains a small, automated cannula and up to 200 units of insulin that the user injects immediately prior to insertion of the pod. A hand-held “personal diabetes monitor” controls your injections, displays your levels and data, allows you to set warnings, and has a built in BGM from FreeStyle.

As the only tubeless system available on the market, this is a great option for those users who are put off by the notion of tubing. However, because of the lack of tubes, there is more room for a margin of error and can result in having to dispose of the pod early, wasting insulin, and having to go through several pods before the correct insulin and glucose monitoring levels are achieved.

Additionally, the OmniPod is waterproof and can be worn while swimming or bathing without disrupting insulin delivery

Possible concerns

While convenient, users have said that the pod doesn’t always stay adhered when wet and have reported occlusion error rates and wasted insulin when disposing of the pod if the recommended protocol for insulin withdrawal is not followed exactly. The unit also lacks CGM integration.

Animas OneTouch Ping Insulin Pump and remote (US / Canada)

Image courtesy of Animas
Image courtesy of Animas

The main selling point of the Ping is its ease of use. The pump and the meter remote share information wirelessly, allowing you to give yourself an insulin dose without ever touching your pump. Both the pump itself and the remote can control nearly all functions, from delivering a bolus, to monitoring your stats, to setting alerts and warnings. This pump also excels at tracking nutritional data. The meter can store the nutritional values of up to 500 foods it taps into through the CalorieKing database.
Animas says the meter remote works from up to 10 feet away. And the pump is waterproof up to 12 feet in depth for as long as 24 hours, eliminating the need to disconnect while swimming or bathing. Eight different pump and remote “skins” are available to help you customize your look.

Possible concerns

One draw back of the Ping, however, is that it doesn’t offer interaction with a CGM, like the Animas Vibe. So if constant glucose monitoring is what works for you, you’ll have to invest in a second device. With a reservoir capacity of 200 insulin units, the pump holds fewer doses than some other models.

Accu-Chek Spirit Insulin Pump (US)

Accu-Chek Spirit Combo Insulin Pump (US

AccuCombo
Image courtesy of Roche

The Spirit is a bare-bones, silver, stand-alone pump with a reversible, backlit display that’s relatively easy to read. It essentially looks like a small pager. While it lacks some of the features of Accu-Chek’s Spirit Combo Pump, the Spirit holds 315 units of insulin and enough memory to store 30 days of daily readings.

The Spirit Combo looks like a small dark gray cell phone. This combination pump and BGM holds 315 unit of insulin and uses a Bluetooth connection to communicate, allowing you to control your pump activity from your meter. The remote can deliver insulin from as far as 6.5 feet away.

The full-color, on-screen blood sugar and bolus data are easy to read and make tracking your information simple and convenient. The unit holds daily data for up to 90 days. The pump can also be used independently of the meter if you choose to.

Possible concerns

Neither of the two Accu-Chek units are water proof or water resistant, meaning you’ll have to remove the pumps when bathing or swimming. Neither are fully CGM integrated either. Lastly, while the Spirit Combo has higher insulin capacity than the Animas Ping (the other meter remote pump combination option on the market), the Ping has a greater range of insulin administration at 10 feet. That might not seem like a great difference, but for parents who are administering insulin to children, that extra three and a half feet could be helpful.

Accu-Chek Insight Insulin Pump System

AccuAviva

Image courtesy of Roche

The Insight (presently available only in the United Kingdom) is Accu-Chek’s newest offering. It builds on the framework set down by the Spirit Combo. Like the Spirit Combo, the Insight is a remote-operated pump. The pump features a more modern color display and touchscreen technology. It holds 200 units of insulin, and, like the Spirit and Spirit combo, is not CGM integrated or waterproof.

Standalone Pumps (no BGM or CGM support)

Tandem t:flex Insulin Pump for Type 2 Diabetes (US)

Tandem t:slim Insulin Pump (US)

tslim-tflex

Image Courtesy of Tandem Diabetes Care

Tandem offers three pumps with varying features. All three sport a sleek, black look, with a bright color touch screen and compact, thin dimensions (the t:slim models are slightly less bulky than the t:flex, though all are still the smallest available smart pumps). The units also offer carb-counting options and work with T-Connect Diabetes Management Application, Tandem’s web-based tracking software.

The t:flex is the largest-capacity insulin pump on the market. With a cartridge reservoir that holds up to 480 units (the two t:slim models hold 300), it’s designed for people who require more than 100 units of insulin a day. It can calculate blouses up to 60 units at a time (25 for the Slim models), and missed bolus reminders can be customized by the day of the week.

Possible concerns

The t:flex does not offer BGM or CGM interaction, but the t:slim G4 and the t:slim X2 does. All three pumps are also waterproof for a shorter duration than some other pumps. Tandem says its units are watertight up to three feet in depth for 30 minutes — so while it might be okay to leave these pumps on while bathing, swimming could pose a risk of damage. Some users report difficulty in hearing the alarms at night, and the aluminum casing around the pump, while adding to its sleek look, can set off metal detectors.

Standalone Pumps (CGM support)

Tandem t:slim G4 Insulin Pump with Dexcom G4 Platinum CGM (US)

tslimg4

 

 

Image Courtesy of Tandem Diabetes Care

Tandem offers three pumps with varying features. All three sport a sleek, black look, with a bright color touch screen and compact, thin dimensions (the t:slim models are slightly less bulky than the t:flex). The units also offer carb-counting options and work with T-Connect Diabetes Management Application, Tandem’s web-based tracking software.

The t:slim G4 is the only Tandem model that offers CGM. The unit comes equipped and paired with the popular Dexcom G4 Platinum CGM. The system is not integrated with Dexcoms latest G5 system. The cartridge reservoir holds up to 300 units of insulin,

Possible concerns

The t:flex and t:slim do not offer BGM or CGM interaction, and while the t:slim G4 does, the CGM is made by a different company. All three pumps are also waterproof for a shorter duration than some other pumps. Tandem says its units are watertight up to three feet in depth for 30 minutes—so while it might be okay to leave these pumps on while bathing, swimming could pose a risk of damage. Some users report difficulty in hearing the alarms at night, and the aluminum casing around the pump, while adding to its sleek look, can set off metal detectors.

Animas 2020 Insulin Pump (Europe) has been phased out.

MedtronicMinimed630G

MiniMed 630G System

A part of the Medtronic pump family. This system includes a new pump designed with many consumer oriented features such as customizable alerts and alarms, additional waterproofing, and the ability to remotely bolus from the meter. The MiniMed 6530 utilizes SmartGuard technology which takes action to reduce the risk of Diabetes Complications by notifying you 30 minutes before you trend low or high and will pause insulin delivery up to 2 hours if you are trending low. Also, the meter automatically sends BG reading to the pump as it is connected through blue tooth.

Possible concerns

You have to be at least 16 years old to use it. You must use the Contour Next Link 2.4 meter, It’s only available in the US. Similar systems such as the 640G is available in Europe and Australia.

Future of CGMs

Many believe that the next step for insulin pump technology is closed-loop insulin delivery systems, sometimes referred to as an artificial pancreas. The closed-loop insulin delivery system is a combination of an insulin pump, CGM, and an algorithm that manages blood glucose levels. Instead of the user deciding how much insulin to dose, the technology would decide for them, using all of the information that it is gathering in real time. Many different companies are racing to come out with a viable closed-loop insulin delivery system, including Medtronic, Insulet, and Tandem, and Animas. Medtronic has been the first to release the 670G, the first closed-loop insulin delivery system to receive FDA approval.  

One of the problems that a closed-loop insulin delivery systems face is the fact that injected insulin will always lag as compared to a normal, functional pancreas because it takes time for injected insulin to take effect. A potential solution to this is also incorporating glucagon into the equation, which is a hormone that facilitates quick release of glucose into the bloodstream for hypoglycemia. This technology is not currently on the market, but Beta Bionics is working on creating this product, called a hybrid or fully closed-loop insulin delivery system.

 


Read the Blood Glucose Meter Rundown or our Tools and How-to Guides.