Insulin pump choice

Why is it good to have a choice of insulin pumps?

There is no evidence to suggest that any make of insulin pump is better than another when it comes to managing your type 1 – they all work just as effectively as each other. However, if you would have difficulty seeing the screen or refilling the make of pump offered by your clinic, a choice of pump could be considered a clinical need.

What’s important is that you’re happy and comfortable with the pump you use, especially as you will wear it every day. Think about what matters to you. Do you want to be able to remove the pump for short periods of time, for example when you go swimming? Would you feel more comfortable with the pump attached to you or in your pocket? You might not have these answers straight away – it might take time to find what’s right for you.

Choosing an insulin pump that works for you

Here are some things to consider when you’re choosing a pump:

Tubing or no tubing

There are two types of pumps – tethered pumps or patch pumps (also known as micro pumps). Patch pumps are stuck directly onto the skin and use a short fine tube that goes into the skin to deliver insulin, and tethered pumps use a longer fine tube to connect a cannula under the skin to a pump, which can be kept in your pocket or clipped to a belt or clothing.

Some people prefer a patch or micro pump because they feel self-conscious about the tubing that’s used with a tethered pump. However, some people think that a pump with tubing actually gives you more choice about where to keep your pump – in your pocket, on your waistband or even a special lycra garter around your thigh (you can find these online). The cannula that stays on you when you disconnect a tethered pump is much smaller than a patch or micro pump, which you have to keep attached to you for three days at a time.

Some people may feel self-conscious about wearing something new, like you might do with new glasses, contact lenses or a wristwatch. Many people who use tethered pumps feel uncomfortable at first, but with time get used to wearing one. In fact, after a while, many people feel strange without their pump.

Waterproof pumps

All pumps are splashproof and you can buy waterproof cases. Many people remove their tethered pump when they get in the shower, go swimming or do water sports. Activity usually means you need less insulin so you can re-attach a tethered pump after about an hour.

CGMs – integrated or separate?

Some insulin pumps, like the Medtronic MiniMed 630G System offer an integrated CGM. One advantage of this is that your insulin pump and CGM reader are combined into just one device (the sensor is still separate).

You may find some advantages keeping your CGM separate. For example, having a separate CGM means you can check your glucose levels without having to get your pump out from your clothing. If you’re a parent of a child with type 1, you won’t have to fish the pump out of bedding or stop your child playing to check their glucose levels.

Having a separate CGM means you keep the option of updating your device from time to time. If you have an integrated pump and CGM, you won’t have this option unless the manufacturer releases an upgrade that you can access under the terms of your pump warranty.

Getting the pump you want from your clinic

Will my clinic offer a choice of pumps?

Not every clinic offers insulin pump choice so check with them. If your clinic only offers one option, it’s usually for one of two reasons; either clinic staff have only been trained on one type of pump or the hospital has an exclusive contract with one pump supplier.

What to do if there is a lack of choice at your clinic

If your clinic can’t give you the choice you would like, find out their reason for only offering one type of pump. If the staff haven’t been trained on the make you’d prefer, they might be willing to get training. But bear in mind it may take some time for this training to happen.

If your need for a pump is more urgent, you can ask your GP to refer you to another clinic that offers the pump you want. You can ask the company that makes the pump where their pumps are used. Visit our insulin pumps page for a list of manufacturers.

What to do if there is a lack of choice at your hospital

If there’s a lack of choice at your hospital, the best thing to do is to change hospitals. This is because it can take a long time – months or even over a year – for a contract situation to change at a hospital.

You can ask your GP to refer you to the clinic you want to attend, regardless of the distance from your home. If you need help or your GP refuses to refer you contact us at outreach@jdrf.org.uk

What to do if the lack of choice at your hospital is restricted by its integrated care boards

It might be that the hospital is restricted by its Integrated Care Board (ICB), in which case changing hospitals won’t help (because the same decisions will apply for all hospitals in your area). If this is the case you can make an Individual Funding Request (IFR) through your Diabetes Healthcare Team. You can find this by searching online for your local ICB and their IFR process.