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November 2, 2003

Insulin Pumps

Question from Tucson, Arizona, USA:

We are currently researching insulin pumps for our son. Although I can find technical comparisons of the various pumps, I am amazed that there seem to be no independent reviews -- a head-to-head functional comparison of the most popular models. Suppose, for example, that a group of 10 users were each given a pump to use for three months. After that time, they would switch to a different pump and use it for the next three months. This process could be repeated for the four most popular pumps. After one year, it would very clear which pumps were superior and what the significant differences were, from a user view point. The test group should include adults and children. The information gathered from such a study would be extremely valuable for people trying to decide which pump they should purchase. Which of the fancy optional features were actually helpful? Which pump is the easiest to use? Other characteristics that aren't apparent after a two day trial use? Pump manufacturers would probably take notice of the results as well. Are you aware of any such study, planned or in progress?


Whilst I quite see that you would like to read this ‘Consumer Report’ on insulin pumps, it would be very difficult to organise, not to mention unexciting to carry out. It also misses out an important aspect of deciding on a pump which is how close each manufacturer is to FDA approved endorsements of glucose sensor to pump communication with proposed bolus calculation and to the ultimate step of safe and reliable sensor control of the pump itself.

Additional comments from Dr. Alan Schorr:

There are no head to head studies at this time for comparison of the insulin pumps. I do not know of any plans from the companies to consider comparisons. This type of study would be financially “taxing” to any institution without outside sponsorship, and it is unlikely that any of infusion companies would consent.

My recommendations are that all the pumps have their specific features, and I tell my patients that this is an individual choice. I even let my patients try the pumps, if they wish, as I carry models in my office. It is a an interesting idea but has been considered in the past.

Additional comments from Dr. David Schwartz:

Your point is well taken. I am not aware of such a formal study or independent, large review. Some sources, (check this website) do offer mini-reviews of various diabetes management tools, but not head-to- head comparisons, but perhaps your point is also moot.

The purpose of an insulin pump is to provide a continuous, relatively constant, “baseline” infusion of insulin and allow a method to provide “bolus” extra insulin based on food intake. When taking a step back, all insulin pumps do this, and do so pretty well. The differences amongst the various pumps are “the extras” such as volume of insulin held in the reservoir, what type of battery used, ease of programming, appearance, and other “bells and whistles.” I often tell families that a Chevy Corvette is a different from a Chevy Suburban., but in essence, both are simply motorized vehicles to transport you from here to there. What features and add-ons do you want? What would be better for you and your life? If you live on a farm, the Corvette may not have the features that you want. If you’re trying to impress a date, perhaps the Suburban is not quite the car.

I view the various insulin pumps in a similar light. Why don’t you contact Consumers Union (the folks who publish Consumers Reports) and plant an idea for them?

Additional comments from Lois Schmidt Finney, diabetes dietitian:

I know of no such study and cannot quite imagine how one would obtain funding to do such a study in an unbiased manner. I think that by going to support groups to find out their opinion and also asking folks who have pumps what they like and what they do not like would be very helpful.

Your son can always try out a pump for about 30 days and then return it if he/you do not like it. I really think that any of the pumps out there require a learning curve so you can use the pump in your lifestyle to achieve the control you want/need. Even those of us who have worn them for quite a while are still on a learning curve. It is great to see your interest in and support for pump therapy. You will be a great asset to your son, no matter which pump he chooses (do find out from him which one he wants to wear since he maybe has ideas).