Everything That You Need to Know About Insulin Pumps

What is an insulin pump?

An insulin pump is not a cure but a method of insulin delivery. It is a small pager-like device that mechanically pumps set amounts of fast-acting insulin into a person’s body. Insulin pumps require you to set “basal rates”–a rate of background insulin that is always present, and the calculation of insulin to food ratios, or bolus amounts, that are used whenever food is eaten. Before choosing an insulin pump figure out which features you require to fit your lifestyle and then make a list of questions to ask your pump rep when you meet.

An insulin pump uses only rapid-acting insulin

Unlike Multiple Daily Injection therapy (MDI), insulin pump therapy does not involve the use of long-lasting insulin.  Small amounts of fast-acting insulin are delivered regularly throughout the day. This allows the pumper to set very specific amounts of insulin to be delivered at exact times.

For some people with diabetes having no background insulin can create a feeling of unease. The threat of DKA (Diabetic Ketoacidosis) is greater for those on a pump if there is any sort of failure in the device or the delivery of insulin.

Other people feel a sense of freedom as they no longer are forced to follow the clock.  When using an insulin pump you no longer need to be concerned about the peaks of long-lasting NPH insulin or the limitations of a single basal rate offered by insulin glargine.

An insulin pump lets you set a variety of “basal rates” to meet the naturally occurring needs of your body. It further allows you to match insulin to carbohydrate intake rather than having to “feed” your insulin. You can chose to eat, snack or graze when you want and however much you want. 

Who should use an insulin pump?

Anyone with insulin-dependent diabetes can use an insulin pump with proper training and support. That being said, not everyone wants to use an insulin pump.  It is important for you to weigh the pros and cons of using an insulin pump for yourself before making a decision.

Some people do not like to be attached to something 24/7 or have a device attached to their body. For others, the benefits of being able to sleep in and reduce or increase background insulin with the press of a button make it worthwhile.

Read our list of the pros and cons of using an insulin pump.

How much does an insulin pump cost?

A basic insulin pump system currently costs approximately $7200CAD* (contact your insulin pump company for exact pricing) and requires monthly pump supplies. These costs are often, but not always covered by private insurance plans.  In Canada, some provinces recognize the long-term benefits of covering insulin pumps and supplies under their provincial health care policies.

You can learn which provinces offer you coverage. 

What types of insulin pumps currently available?

There are many different types of insulin pumps available throughout the world.  This is a good thing because everyone with diabetes has unique needs and the same person can have unique needs at various times in their lives. Here are the pumps that are currently available in North America.

Medtronic 670G

Features: The Medtronic 670G is considered to be the first self-adjusting insulin pump for people with diabetes.

• Automatically adjusts your basal (background) insulin every five minutes using micro bolusing based on your CGM readings.
• Stops insulin up to 30 minutes before reaching your preset low limits.
• Automatically restarts insulin when your levels recover without any alerts
• Remote bolusing from Contour next meter
• Uses Medtronic patented infusion sets
• Uploads to Careline software
• 300 unit cartridges/reservoirs
• CGM integration shows blood glucose readings on the pump screen
  every five minutes making it easy to spot trends and make adjustments
• You can set this pump to auto mode and the insulin pump will make its own basal adjustments or set to manual to adjust yourself
• Temp basal up to 200% for 30minutes-24 hours
• Bolus Wizard Calculator to assist in figuring out meal boluses
• Waterproof
• Predictive alerts
• Colour screen
• Approved for use in individuals 7 years old and over

MINIMED™ 770G

This insulin pump has been approved for use in North America in the fall of 2020. It has many of the same features of the 670G as well as few new ones including

• Bluetooth connectivity
• Share app
• Guardian™ Link (3) Transmitter

Read more about the MiniMed™ 770G here.

OmniPod

Features: The OmniPod is the only tubeless insulin pump currently available on the North American market.

• Tubeless
• 200 unit pods
• 2 AAA batteries
• Batteries last 4 weeks
• Automatic inserter with no visible needles
• Pink slide insert window to ensure the cannula has deployed
• Strong adhesive
• Pod has a durable, water-proof exterior shell
• Handheld PDM has built-in FreeStyle blood glucose (BG) meter
• PDM has large color screen with bright light option
• Customizable ID screen
• Test strip port light for low-light conditions
• Suggested bolus calculator
• Downloadable data
• Intuitive prompts
• Reduced upfront costs
• Discreet
• Temporary basal rates from 30minutes to 12 hours

Omnipod DASH™ System

The Omnipod DASH® Insulin Management System is the latest insulin delivery system released by Insulet Corp. Its features include:

• Discreet, tubeless, waterproof Pod
• Holds 200 units of insulin
• Customizable basal insulin profile and bolus calculator
• Intuitive graphical displays
• CalorieKing^® food library
• Rechargeable lithium ion battery
• Optimized for use with the CONTOUR^® NEXT ONE Blood Glucose Meter for wireless transfer of blood glucose readings to the DASH™ PDM
• ability to set a 0 basal rate

Read more about the DASH system in the article linked below.

Tandem t:slimX2 ™ Insulin Pump

Features: The Tandem t:slimX2 ™ is the only insulin pump currently offering DexCom integration

• 38% smaller than other pumps
• 300 unit reservoir/cartridge
• Colour, shatter-resistant, touch screen
• Fastest bolus entry
• Can bolus up to 50 units
• Site-change reminder w/customizable day and time
• Graphic on screen history
• Bolus calculator
• Temp basal up to 250%, 72 hrs
• Can set duration of insulin action in 1-minute increments
• IOB shown on home screen
• Missed bolus reminders
• Warns of high and low insulin temps
• Uses Tandem t-lock infusion sets
• Uses a rechargeable battery
• New Basal-IQ™ Technology with Dexcom G6 available to upload with physician approval
• New Control-IQ ™ Technology with Dexcom G6 available in the US
• remote software upgrades

Read why we were excited to see the t:slimX2 come to Canada.

Ypsomed Diabetes Care YpsoPump®

Features: The YpsoPump® is marketed as an “easy to learn” insulin pump offering the “essential features”. 

• measures 7.8 cm × 4.6 cm × 1.6 cm and weighs 83 g (including battery and filled cartridge)
• 4.1 × 1.6 cm, OLED touch screen that uses icons to help you navigate the insulin pump features
• Pre-filled, 1.6mL (160 unit) glass cartridges that will last for 7 days in the insulin pump or up to 30 days if filled and kept in the refrigerator
• Waterproof rating of IPX8 (immersion to a depth of 1 m for up to 60 minutes)
• Bolus delivery in increments of 0.1, 0.5, 1 or 2 units
• 2 custom basal patterns set in increments of .01 units by the hour
• Temporary basal patterns that can be set at 0%-200% for 15 min to up 24 hours.  They must be set in 10% increments.
• Uses one AAA alkaline battery that lasts for 30 days
• Mylife mobile app for smartphones that sync with the YpsoPump® via Bluetooth® technology.
• Uses 90degree Orbit steel infusion sets

You can read more about the YpsoPump® on our blog.

How to choose the best pump for you?

Choosing an insulin pump should be a personal experience.  Consult your diabetes team and ask the diabetes community their opinion but ultimately make sure that the pump fits your lifestyle. You will have it for at least 5 years.  Even though most manufacturers do have a return policy, you want to be happy with your choice.

• Do you want a tubed insulin pump or a patch pump?
• How much insulin will you use in a day?
• What sort of infusion set do you prefer?
• Do you want a pump that can speak to your continuous glucose monitor?

Read 10 Things to know before shopping for an insulin pump for other things to consider.

You can also get our pumping ebook. It has a list of questions to help you decide what features you require and questions to ask your insulin pump rep when you meet.

What is an insulin pump infusion set?

All tubed insulin pumps require the use of an infusion set. An infusion set is how the insulin goes from the pump into your body. A set is composed of the site (the piece that attaches to the body) and the tubing which attaches to the pump.

Sites can be manually inserted or inserted with the help of a built-in or separate insertion device.  A person with diabetes will change out their infusion set every 2-4 days. Learning how to properly attach an infusion set to your body is part of your introductory pump training.

What types of infusion sets are there?

Infusion sets come in three basic options…90 degree sets, 30 degree sets and steel cannulas.  Consider your weight, activity level, dexterity, and where you are planning on placing an infusion set before you decide which infusion set to use.

90 degree infusion sets

90 degree infusion sets are what the name implies, they are infusion sets with sites that can be inserted straight into the body. They are available in either steel or teflon (clear)  cannula.

AutoSoft™ 90

For those looking for a softer, teflon cannula, you can order this infusion set to be manually inserter or order the ones that have a built-in inserter. It has a small, flat infusion set design.  You can insert them with one-hand when using the inserter.  The inserter has a hidden introducer needle which can be helpful for people who are needle phobic. The site is connected to the tubing at the body with this infusion set. It has a convenient needle protector after use.  These sets are safe to carry without compromising sterility. They come in 23 and 43 inch tubing and a 27 gauge introducer needle with 6 and 9mm cannulas.

TruSteel™

If you have had issues with tissue damage or are prone to kinked cannulas, steel infusion sets could be a great option for you. These infusion sets are manually inserted at a 90-degree angle. You must change them out every 2-3 days.

Cleo

The Cleo infusion set is distributed by Smith Medical®  and has a built-in, automated injector for people using luer lock connections.

Orbit

The Orbit infusion set rotates 360°, has skin-friendly and reliable tape, comes with tan and semi-transparent tape for more discreteness and is currently available in both soft and steel cannulas available

30 degree sites

Like the 90-degree sites, 30-degree sites can be manually inserted or placed with the help of a built-in insertion device. You insert these sets at an angle of up to 30 degrees.  They are good for active, thin, or muscular individuals.

Using sites with a built-in inserter makes one-handed insertion easy. It has a well-protected introducer needle which makes it perfect for those who are needle phobic.  For those who prefer to manually control the speed at which the inserter needle enters the body, a manual version of this site also exists.

The transparent window on 30-degree sites makes it easy to view the skin below.

With this infusion set, you disconnect and connect the tubing at the site on the body.

Download our free infusion set comparison to help you decide which set is best to optimize your insulin pump experience.

Where do you place an infusion set?

Just like when using injection therapy, insulin infusion sites must be rotated.  Sitemaps like this one may help to keep
track of insertion sites and reduce the chance of hypertrophy.

You can place an infusion set in any of a number of places on your body.  Any area that you used for injections may also be used for infusion sets.  Here are just some examples…

Do I need a Continuous Glucose Monitor with my insulin pump?

A continous glucose monitor (CGM) can be a part of an insulin pump. These pumps are known as “sensor-augmented pumps”. A  CGM can also be stand-alone device used by both pumpers and those on multiple daily injections.

There are currently four different devices available that you can view on our CGM page.

Read a few more things to consider if you are wondering if a continuous glucose monitor or flash monitor is right for you.

Where do you put your insulin pump?

This is a question that a lot of people struggle with. They wonder what to do with their pump in their daily lives, at night and during intimate times.  It is all a matter of personal preference.  You can use pump pouches, clips, pockets, and some people will simply place them in an old sock pinned to the body. Do what works for you but here are a few options.

Pump clips…

 Okay, we admit that this isn’t the traditional way a pump clip is worn!

Pump Pouches

 Spibelt

How do you travel with an insulin pump?

Insulin will lose its potency if repeatedly exposed to x-ray machines.

Do NOT allow insulin or insulin pumps to go through the x-ray and full-body scanners at the airport. Do not disconnect at any time. If there is a problem, ask for the wand to be used. Putting the pump through such a process can damage internal programming.

Read our full page of tips on traveling with an insulin pump here.

What to do if your pump fails?

Insulin pumps are machines. They can breakdown. If they do, contact your pump company immediately for guidance.

Make sure that you have written down all of your pump settings in case of any failure. Have your basal rates, corrections factors, and insulin to carb ratios noted in a safe place should your pump completely shutdown.

If your pump failure is at a level where it is unsafe to wear contact your diabetes team on back-up protocols such as injecting with a long-acting insulin or injecting a set amount of rapid-acting insulin every four hours to cover your basals.

More information on Insulin Pump Therapy…

• Insulin pump coverage
• Pumping tips
• Questions to consider when purchasing an insulin pump

     Get help finding the right insulin pump for your lifestyle. 

*price may vary.