Pumping: Ease Of Use Matters

By Gary Scheiner

These days, insulin pumps have sooooooo many features, it’s hard to pinpoint which one is truly best. Each pump has its share of strengths and weaknesses – for details, see the pump comparisons on our website.

Since I switch pumps on a regular basis in order to stay fresh and current on each one, I’ve come to appreciate certain features more than others. One feature in particular that I’m drawn to is the ease of use of the pump’s bolus calculator. Given that 80-90% of all interaction we have with our pumps involves boluses, this seems like a feature that is worthy of extra consideration. So, keeping with our practice’s policy of keeping an open mind and offering up objective, practical information, we decided to put each pump’s bolus entry mechanism to the test.

We defined “ease of use” to be: (1) the time it took, and (2) the number of button pushes required to program and initiate delivery of a normal bolus. To be fair, we entered a fixed number of carbs (45grams) and a fixed blood glucose (160 mg/dl, or 8.9 mmol/l) into each pump. When a bolus “shortcut” button was available, it was utilized. All glucose values were entered manually rather than using the linked glucose meters.   Our experience has shown that the majority of pump users do not use the meter that links with their pump due to insurance coverage issues, preference for a different type of meter, or opting to use glucose data from a CGM. The only exception is with the Accu-Chek Combo pump which does not allow manual glucose entry into the Aviva Combo meter (which calculates the bolus dose), so we had to perform fingersticks on the Accu-Chek meter during the bolus time trials.

For each pump, three separate bolus entries were performed, and the results were averaged to provide the data below. Occasionally, when “scrolling” was required, there was overshooting or undershooting of the desired entries, which added to the time and number of button pushes. We felt that the effects of mis-scrolling were mitigated by averaging three test results for each pump.

(For information on each pump, click the Pump brand to visit the website)

Here’s what we found:

In rank order, from fastest to slowest bolus programming:

1. Tandem T:Slim
2. Asante Snap
3. Insulet OmniPod
4. Medtronic 530G
5. Animas Ping
6. Accu-Chek Combo

In rank-order, from fewest to most button pushes:

1. Asante Snap
2. Accu-Chek Combo
3. Medtronic 530G
4. Insulet OmniPod
5. Tandem T:Slim
6. Animas Ping

Clearly, despite the fact that I’m the fastest finger-pricker in the East, the Accu-Chek Combo’s time was affected by the need to perform a fingerstick each time a bolus is calculated. Also, the Tandem T:Slim’s number of button pushes was inflated by the fact that numeric values are typed in rather than scrolled in. However, our overall ratings for ease of bolusing looks like this:

Asante Snap – 5 Stars

Tandem T:Slim  – 4 Stars

Medtronic 530G   – 3 Stars

Insulet OmniPod – 3 Stars

Accu-Chek Combo – 2 Stars

Animas Ping – 1 Star

Of course, you’re free to disagree. Everyone is entitled to their opinion, and I’m sure there are elements of bolusing that we haven’t included in this comparison. I, for one, really like the ability to program my boluses quickly. Time adds up: Just 10 fewer seconds per bolus, six times per day, comes to 6 hours per year I can spend doing things I’d rather be doing.

Feel free to post your thoughts on our facebook page (Integrated Diabetes Services)