Ask the following questions when making your insulin pump selection:
Will the pump hold enough insulin to last you at least three days?
Some pumps hold as little as 176 units of insulin, while others hold as much as 315 units. Since most pump users change their infusion set every three days, it is important to have enough insulin in the reservoir to last that long. To estimate your three-day insulin requirements, take the total daily insulin you take now by injection (including short-acting and long-acting), and multiply by three. Presently, the Medtronic pumps hold either 176 or 300 units (depending on the model), the Animas OneTouch Ping and OmniPod each hold 200 units (although the OmniPod has no tubing to prime, thus saving 10–20 units), the Roche Accu-Chek Combo hold 315 units, and the Sooil Dana Diabecare IIS, Tandem t:slim, and Asante Snap hold 300 units, .
Can you see the screen reasonably well?
Unless you have somebody who can help you perform all of your daily pump programming, it is important that you be able to read the pump’s screen clearly. Check the screen contrast and the size of the characters, with and without the backlight, to make sure you can see them well enough to perform all necessary programming.
Will the bolus dose amounts work for you?
If you require very large or very small mealtime doses, be careful. Presently, the maximum bolus on the Medtronic, Roche, Tandem, and Asante pumps is 25 units, on OmniPod, it’s 30 units, on Animas, it’s 35 units, and on Sooil it’s 10 units. If you are extremely sensitive to insulin, look for a pump that delivers boluses in extremely small increments (less than a tenth of a unit).
Will the “bolus calculator” meet your needs?
One of the best features of modern pumps is the built-in bolus calculator. All of the pumps ask for your blood glucose level and the grams of carbohydrate you plan to eat in determining your dose. They then deduct insulin that is still “active” or “unused” from the last bolus given. When setting up the bolus calculator, some pumps allow you to enter your insulin-to-carbohydrate ratio in very precise proportions, while others round to whole numbers such as 1 unit of insulin per 4 grams of carbohydrate, 1 unit per 6 grams of carbohydrate, and so on. Some will not allow a ratio of less than 1 unit per 2 grams of carbohydrate or 3 grams of carbohydrate. While this is not a problem for the majority of pump users, it can be limiting for people who are on very large doses of insulin.
Likewise, the time intervals used when setting insulin-to-carbohydrate ratios are highly flexible in some pumps and less flexible in others, and when making adjustments for “active” or “unused” insulin, different pumps handle the data in different ways.
Can you hear or feel the alarms?
This is something you have to try out for yourself. The pump will alert you if there is a problem, but if you’re not aware of the alert, what good is it? All pumps, with the exception of the OmniPod, allow you to adjust the beep volume or switch to a vibrate mode.
Do you require a pump that is fully waterproof?
All pumps are “splash resistant.” Perspiration and rainwater are not typically a problem, so this is only an issue if you plan to submerge or drench your pump. And the fact is, most pump users simply disconnect at the infusion set housing before bathing or going into the water. But if you do a lot of swimming or spend a lot of time boating, rafting, or canoeing, it is a good idea to have a fully waterproof pump.
Do you desire a pump that links with a blood glucose meter or continuous glucose sensor?
This is kind of like playing the futures market. Clearly, the future of diabetes management and pump therapy involves a continuous glucose monitor feeding data about your glucose levels to a pump, which then determines how much insulin to deliver automatically. However, we are not at this point yet.