Any type of programmable infusion pump can function as a cortisol pump (VGo patch pumps are NOT suitable for cortisol pumping). The main functions cortisol pumpers need are programmable basal and bolus features. The most common insulin pumps also make great cortisol pumps.
Common Pump Manufacturers
Manufacturers such as Medtronic, Tandem, and Insulet (OmniPod) make up the three most commonly used infusion pumps for cortisol pumping. Some medical providers may already have a preferred manufacturer. The activities, priorities and finances of the individual wanting the pump should also be taken into consideration when selecting an infusion pump.
Medtronic and Tandem are traditional “tubed” pumps. This means they have a length of tubing connecting the subcutaneous infusion set to the device. The exact length of tubing often is between 23 or 46 inches, depending on pumper’s preference.
Things to Consider for Pump Types
There are many different factors to consider when looking for a cortisol pump. These include things such as resistance around water, size of reservoir for medication, tubed or tubeless delivery, and overall cost of the system. Each one of these topics will be discussed in greater detail below.
- The most current models of insulin pumps are all waterproof to some degree.
The Medtronic 630, 640, and 670g are IPX8 rated. This means they are fully submersible to at least 1 meter in depth, usually up to 3 meters (Longman 2019). They can be worn for showering, bathing, and most swimming situations.
Tandem pumps are IPX7 rated. This means they can be immersed in water up to 1 meter for 30 minutes (Longman 2019). However, as this rating can only be guaranteed when the pump is brand-new out of the box, Tandem recommends pumpers keep their pump away from water completely.
Omnipod also has an IPX8 rating. It has been tested up to 25 feet of depth for 60 minutes. The Omnipod PDM (remote), however, is not waterproof and should be protected from water (FAQ’s Omnipod.com).
- Tandem T-slim and Medtronic pumps both hold up to 300 units of medication. The tandem T-flex boasts the largest capacity at 480 units. Omnipods hold 200 units.
Tandem pumps boast a user friendly touch screen and are rechargeable, requiring no batteries. They have a slightly slimmer profile than Medtronic pumps, making them a little easier to hide under clothing.
Medtronic is the largest insulin pump manufacturer. Their newest line of 600 series pumps is still very simple to use despite not having a touch screen like tandem. Their button layout has similar functionality to that of android smart phones and interface should be intuitive for those that are familiar with such technology.
- Inset Options
- Tubed pumps such as Medtronic and tandem offer a variety of inset options. Cannulas can be angled or straight, they can be Teflon or steel and come in different cannula lengths based on the patient’s needs and preference.
Leaner body types may require an angled inset, such as a 30 degree inset, for better absorption and less bruising potential. Straight, 90 degree insets tend to work with a variety of body types. 6mm cannula length is a good starting place for most patients. 9mm may be used for patients with more subcutaneous tissue.
Steel cannulas tend to be used for patients that encounter frequent site issues with Teflon cannulas, such as irritation, or leaking. The variety of cannula options make tubed pumps ideal for patients that have never used an infusion pump. If a particular cannula does not work well for the patient, it is simple to order another type.
Omnipod comes with only one cannula type. It is a 45 degree angled Teflon inset. If this inset type does not work for the patient, there are no other cannula alternatives for this system. If the patient can reliably use the Omnipod cannula, the tubeless system is well liked by patients. There are no tubes to be snagged and its easy to wear with any clothing. It is ideal for athletes and swimmers.
- Omnipod compared to the tubed pumps has the lowest start up cost. This is not to say the system is inexpensive, but the initial investment in the PDM is much lower than the cost of a new tubed pump.
However, tubed pumps have less monthly cost. Its important to check the patient’s insurance benefits to see what kind, if any, pump can be covered.
Find out more:
Frequently Asked Questions. (n.d.). Retrieved from https://www.myomnipod.com/podder-support/faq.
Longman, J. (2019, August 29). IPX Ratings Explained. Retrieved from https://www.audioreputation.com/ipx-ratings-explained/.
Summer-Friendly Tandem Pump Features. (n.d.). Retrieved from https://www.tandemdiabetes.com/blog/post/general/2017/07/13/summer-friendly-tandem-pump-features.