When helping a patient make a pump selection it is imperative to consider:

Insulin Reservoir Volume – will they be able to go the full 3 days on one site? Are they willing to change more frequently?

Screen Readability – will they be able to see the screen on the pump devices? Are magnification aides or brightness options available?

Bolus Maximums & Increments will the pump’s dosage limitations meet patient needs?

Bolus Calculator Flexibility does the pump bolus calculator allow for overrides? Flat dosing for meals if needed?

Alarm Distinction will the patient be able to hear or feel notification alarms for safety?

Water-Tightness does the patient need to be able to continue pumping while in water or will they be able to disconnect? If they frequent hot tubs or saunas they will have to disconnect to protect insulin integrity

Some further considerations for management include:

Link w/Meter or CGM – does the pump meet their technology use goals?

Convenience Factors (tubing, clip)

Infusion Set Options

Aesthetics

Out-Of-Pocket Costs -- tubed pumps have a far higher starting cost while the omnipod has a lower starting cost, but over the full 4-year life of a pump warrantee those prices even out. But this may be an important consideration when starting with a new pump.

Are they near a plan out-of-pocket maximum? This could be a great time to invest in a pump. If they have a high deductible health plan, waiting for their contract to expire and selecting a plan with better device coverage may be of benefit.

Will their pump and cgm supplies be covered as diabetes supplies, durable medical equipment, or under their pharmacy benefits? This varies by plan and by pump manufacturer.

Insulin pumps now have automated insulin delivery features including:

The ability to suspend insulin delivery to prevent hypoglycemia

Suspend and alert users for hypoglycemia

The following features are now offered in closed-loop systems:

Infusion Set Selection and Use:

As mentioned earlier, infusion sets come in many lengths and styles. Consider the following for your patient:

Appropriate depth for body type – for instance, leaner individuals benefit from shorter and angled canulas.

Select the correct priming amount.

Site preparation technique.

Frequency of change-outs. For instance, ≤ 3-days (steel needle sets are recommended for 2-day set changes).

Proper site rotation – not reusing a site until the underlying tissue has had time to fully heal.

Summary

Choosing the right insulin pump and set can mean the difference between a patient with a controlled, stable blood glucose level who enjoys a high level of satisfaction, or a patient who is forever making dosing mistakes and suffering physically and mentally from poorly controlled blood sugar levels. Insulin pumps provide the easiest way to mimic the insulin delivery of the human pancreas, perfectly meeting the needs of the patient, thereby providing a more carefree lifestyle.