Go Ahead, Pick Your Pump
Which Pump Is Right for You?

Are there specific safety features that you will need?
While all pumps have basic safety features to prevent accidental over-delivery of insulin and optional nonspecific reminders (such as a daily alert at a certain time), other safety features may be desirable for enhancing your pump experience and preventing potential problems. For example, alarms can be set to detect possible missed meal or snack boluses. Both the Deltec and OmniPod pumps let you set up time intervals during which boluses must be programmed, or else an alarm will go off. And since it is very important to change the pump’s infusion set on a consistent schedule, it can be very helpful to have a customizable site-change reminder. Currently, only the Deltec pump offers this feature. The OmniPod must be changed every 72 hours or less, so a default alarm will occur before the Pod expires.

Are the size and appearance pleasing to you?
For most people, size and image do matter. Your choice may depend on how big you are, your desire to conceal the pump, and how or where you intend to wear it. In general, smaller is usually better. The OmniPod is by far the smallest pump, and the lack of tubing makes it very discreet. However, a programmer the size of a Palm Pilot must be carried along with it. Animas is the smallest traditional pump, followed closely by the smaller of the Medtronic Paradigm pumps (the 176-unit model). The Deltec pump has a compact height and width, but it is a few millimeters thicker than the others. The 300-unit Paradigm pump is slightly larger than the other pumps.

Are loaner pumps easy to get and inexpensive?
If you plan to do a great deal of traveling, camping, etc., you may want to have access to loaner pumps to bring as backup. This is not usually an issue for those who are upgrading their pumps (because they have their old pump to use as a backup), but it can be important for first-time pump users. Both Animas and Deltec provide loaner pumps to their customers free of charge. Medtronic charges for loaner pumps, but having a good relationship with your local rep may help you to get around the charges. OmniPods are provided in bulk quantities, so having a backup should not be an issue. However, Insulet, the maker of OmniPods, only provides one pump programmer, and a backup costs several hundred dollars.

Will your insurance pay for a particular model?
Given the cost of pumps, perhaps this should be the first thing you check into. Most major insurance companies will cover any pump you prefer, but some offer preferred pricing (lower copayments) for certain pumps, and some (including Medicare) will only cover pumps manufactured by companies with whom they have direct contracts. If you have difficulty getting answers on your own, each pump company has an insurance billing department that will gladly help you to determine whether their pump will be covered by your insurance.

When you still can’t decide
Of course, after listening to everything I have to say about the pros and cons of the various pumps, some of my clients just throw their hands in the air and ask me which pump I now wear (as if that magically makes it the best pump in the universe). Keep in mind that I’ve had only one wife for the past 16 years, but I’m on my 11th insulin pump! So this may not be the best way to make a decision. OK, fine, I’ll tell you anyway. After much research and deliberation, the pump I have chosen to wear at my side is none other than…

Editor’s note: The author’s printer ran out of ink just as the last sentence was printing. We apologize for any inconvenience this may cause. Please direct your questions (or complaints) to Gary Scheiner.