Australian Insulin Pump Choices

September 2021 update

Here’s the latest run-down.

There are currently 4-5 pumps that can be purchased new through private health insurance and with reservoirs/infusion sets subsidised through NDSS. This list links short-cuts directly to the relevant sections of this article.

There’s another pump that is not supported by private health insurance or NDSS. But is available:

There are also some older pumps in use, such as:

As usual I’ll run through them all with brief descriptions. Then I’ll mention other pumps we’re aware of which are not available at this point.

780G, DANA-i, EOFlow, Insight, Medtrum, Kaleido, t:sport, iLet, Terumo, DIA:CONN, Sigi.

A note about “closed-loop” systems referred to below: those are systems which use your CGM data to dynamically adjust your pump’s delivery of insulin. These are not the mythical complete “artificial pancreas” replacement, but they do add a lot of automation to help you manage your diabetes. For information about the open protocol closed-loop systems, see my separate page on the Australian options.


The hurdles for pumps to be sold in Australia

For new pumps to be available in Australia, the first hurdle they need to pass is registration with the Therapeutic Goods Administration (TGA), after which doctors and suppliers are legally allowed to talk about them.

The next hurdle is generally getting listing on the Federal Department of Health’s Prostheses List so they’re eligible for supply by health insurance. The Prostheses List was last updated in July 2021. The next update is expected in November.

Subsidised pumps available new in Australia

The following pumps are available new. Usually they’re bought through private health insurance, where they’re classified as prosthetic devices.  Not all private health policies cover 100% of the cost: check with your own insurer as to coverage. But if they cover “insulin pumps” then they’ll cover all of these.


Accu-Chek Solo

This tubeless patch pump has multiple components, starting with a cannula patch onto which the pump clips. The cannula is 90˚ teflon with two length options. There’s a disposable 200U reservoir (which includes the battery for the pump body).

The pump body nominally lasts 4 months. The Aviva Solo handset has an integrated BG meter (although you can enter corrections using a BG value you’ve retrieved from another meter or CGM). Because the pump body lasts for 4 months, when you buy the pump each year you will receive three bodies. Plus if it’s the first year you’ll receive a handset.

The Solo has buttons each side, which can be pressed together in patterns to administer simple boluses even without the handset.

Insulin delivery

Hourly basal rates: 0.1-5.0 U/hr in 0.01 increments, 0.1 U/hr increments above that.
Boluses: 0.2 U minimum, 0.05 U increment.
Bolus speed: varies between 1-2.5 U/min.

Consumables

The 9mm and 6mm teflon cannulas, and 200U reservoirs (which contain the battery that powers the pump) are available through NDSS. A dedicated inserter device for the infusion sets is supplied with the pump.

Waterproof?

The Solo pump is not waterproof: you are expected to remove it (leaving the cannula patch in place) for swimming and showers. This is primarily because the tiny battery has to use a “zinc-air” chemistry to get enough capacity, and without access to air the battery stops working. There’s a small vent on the outside of the pump, that if you covered with tape would kill the pump.

The pump’s ingress-protection rating is only IP22!

Closed loop?

Support for the Solo is on the cards for the Diabeloop commercial closed-loop system in Europe, but that is not accessible in Australia.

More info

Official info: Accu-Chek
Peer support (via FB): Accuchek Solo Pumpers Australia


Tandem t:slim X2

This pump is a small pump with a touchscreen interface. The aluminium case is very robust, and gives it a slight heft in your hand. The internal battery is recharged by USB (typically topped up at least every few days).

Note that Apidra insulin is not compatible with the Tandem reservoirs (it’s not officially listed for pump use in Australia, but is sometimes used in other pumps). Apidra fails catastrophically in this pump.
Fiasp is officially not supported in the t:slim either, although some people apparently do use THAT successfully.

Insulin delivery

Basal rates in up to 16 arbitrary blocks (don’t have to be hourly): starting at 0.100 U/hr, with 0.001 increments above that.
Bolus speed: varies between 1.43-2.97 U/min.

However, the minimum basal rate is 0.100 U/hr (or 0), and this can cause issues for some paediatric use as this minimum also applies to temporary basal rates. Note that even if your basal rate is 0.6 U/hr, that minimum 0.1 still applies to any temp basal. Thus the lowest TBR you’d be able to apply would be 17%. Not 10%. If your basal rate was 0.3 U/hr you’d only be able to drop to 34%.

Consumables

The Tandem reservoirs are compatible only with the Tandem t:lock infusion sets. The older reservoirs that could be used with any luer-lock infusion set have been discontinued. The Tandem infusion sets are:

  • VariSoft 30 (teflon, angled: same as Medtronic Silhouette, Accu-Chek TenderLink)
  • AutoSoft 30 (teflon, angled)
  • AutoSoft 90 (teflon: same as Medtronic Mio, YpsoPump Inset)
  • TruSteel (steel: same as Medtronic Sure-T)

These are all available through NDSS.

Waterproof?

The t:slim X2 is rated as IP67 waterproof, which is not quite as robust as the IPX8 rating of most other current pumps. See this article for a discussion of waterproof ratings. Mind you, the IP67 rating does still allow for short-term immersion in water up to a metre deep.

Note that the rubber door that covers the USB port is not actually part of the waterproofing: don’t panic if it doesn’t close or breaks off.

Tandem updates

A touted feature of this pump is the ability to update its firmware at home via USB without having to have the whole pump replaced/serviced, and this has already been used to add features to the pump at no direct cost during its 4-year warranty period. Yes, “free” upgrades (although there may be costs involved in getting doctors to sign off on it).

Apart from any minor updates, there are three major revisions we’re aware of:

1. Dexcom G5

The initial version of the pump acted as a Dexcom G5 CGM receiver. This seems to be the version that resulted in the December 2020-April 2021 suspension of its TGA registration. This version is no longer available new. And once you update your pump to a later version, you cannot go back.

2. Basal-IQ

This version changed the CGM to use the Dexcom G6, and won’t connect to G5. It uses this to not just auto-populate the bolus advisor as with G5, but also to implement low-glucose suspend.

This is the version of the firmware currently supplied with the t:slim X2. It was released in the US in August 2018, so there’s a lot of user experience with it online already. The firmware was updated apparently in response to the TGA suspension.

Basal-IQ suspends basal deliveries if your BG is below 3.9 mmol/L, or predicted to go below 4.4 mmol/L within 30 minutes, and should resume when it knows you’re coming back up.  If it’s been suspended for 2 hours then it will resume for 30 minutes.

Do note that if it suspends basal deliveries it also cancels any current extended bolus. Temporary basal rates can be used instead (they resume) although you need to manually disable them when you no longer need them (extended boluses stop after a specified time).

The current TGA approval for the t:slim X2 specifies that for a pump to be supplied:

  1. The hardware must have a manufacturing date of 1st August 2020 or later
  2. The software must be Basal-IQ 6.4.1 or above (which was an update to address the 2020-2021 suspension).
  3. The registration is under extra scrutiny for adverse events until the end of March 2022.

3. Control-IQ

This is the next version, that at the time of writing isn’t quite here yet. It made it onto the Prostheses List in late 2020 and while the pump’s TGA registration was suspended in early 2021 AMSL went ahead and trained staff and diabetes educators in its use. So we thought we could expect it to be rolled out at some point soon after the suspension was lifted. However the conditions that were placed on the t:slim’s TGA registration in March 2021 (described above) do put some doubt on when Control-IQ will be rolled out in Australia.

Control-IQ implements a closed-loop system where the pump not only decreases insulin supply (not the brute-force suspend used by Basal-IQ) if you’re heading low, but also increases it if you’re running high. It still needs you to manage it, but it does a lot of the moment-to-moment decision making for us. It can also link to the t:connect phone app via Bluetooth, allowing viewing and uploading of pump data (but not yet control of the pump) without getting the pump out of your pocket. That would hopefully become available in Australia at about the same time as Control-IQ.

Control-IQ was released in the US at the end of 2019, so again there’s a lot of user experience with it online.

Closed loop?

The t:slim X2 pump is not compatible with any external closed-loop system. Obviously Control-IQ is its own closed-loop system.

More info

Official info: AMSL Diabetes
Simulator app (for both iOS and Android): in app stores (linked from AMSL).
Peer support (via FB): Tandem TSlim X2 Australia+New Zealand


YpsoPump

The YpsoPump (from Ypsomed) is a tiny unit which links to the Mylife app on your phone via Bluetooth. Currently the app has a one-way connection: it needs the user to use the pump’s touchscreen to issue boluses, but does most of the the rest of the management and connection from the phone (including carb/bolus calculations).

Mylife Assist

The first of Ypsomed’s major upgrades is supposed to be rolling out soon. Mylife Assist integrates their phone app with the Dexcom G6 CGM. In fact it communicates with the G6 independently of the usual Dexcom G6 app. This is currently being piloted in a few countries (including Germany) and we expect it will reach Australia “soon”.

We’re told to expect the Mylife Dose upgrade in late-2021 (delays in the Assist program have pushed this from mid-2021). It will allow us to bolus directly from the app without needing to lay a hand on the pump. To support this in-warranty pumps will be exchanged for versions with new firmware.

Future updates

Ypsomed are also developing the Mylife Loop system in conjunction with TypeZero (now part of Dexcom) and a date of 2023 has been mentioned. TypeZero are the company behind the algorithm in Tandem’s Control-IQ closed-loop system.

Insulin delivery

Hourly basal rates: 0.02-1.0 U/hr in 0.01 increments. 1.0-2.0 U/hr (0.02 increments), 2.0-5.0 (+0.05), 5-15 U/hr (+0.1), and 0.5 U/hr increments above that.
Boluses: 0.1 U minimum, 0.1 U increment.
Bolus speed: 33.3 U/min.

Consumables

The reservoir holds up to 160U of insulin, and the basal rates can be set to 0.01 U/hr increments in 1-hour blocks. The pump uses three types of infusion set:

  • Orbit soft (teflon)
  • Orbit micro (steel)
  • YpsoPump Inset (same as Medtronic Mio, Tandem AutoSoft 90, and Animas Inset II)

A 2018 article on this site talks about the Orbit infusion sets.

The reservoir is smaller than in some other pumps, although 160U is enough for many people’s requirements. But the reservoirs are quick and easy to swap in, so I think the 160U limit is unlikely to be a problem for most people. Plus the reservoirs are glass (unlike the plastic of other pumps) and as such are approved for longer-term insulin storage. The tested and approved use includes the ability to pre-fill reservoirs and keep them in your fridge for up to 4 weeks.

Of the people I have spoken to who have expressed reservations about the 160U reservoirs, it turns out most of them have an idea of “a reservoir change” based on their experiences with other pumps. Procedures where you need to draw insulin out of a vial and into the reservoir, plus often change the infusion set at the same time. The Ypsomed changes are much simpler than that!

All these consumables are available through NDSS.

Batteries

The YpsoPump uses an Alkaline AAA battery. Lithiums are rejected by the pump (they have a different voltage), but the alkaline cells last about a month and are supplied by Ypsomed, so that doesn’t seem inconvenient to me.

Waterproof?

The YpsoPump is rated at IPX8. The manual describes “immersion to a depth of 1m for up to 60 minutes”, and says that “for water sports that cannot comply with these specifications (e.g. diving)” we should disconnect.

Closed loop?

The YpsoPump cannot currently be used with any external closed-loop system. We will see if that’s true after the MyLife Dose update. A version of the pump with special firmware is being used in some clinical trials of looping (including a current one in Melbourne).

More info

Official info: Ypsomed Australia
Simulator app: YpsoPump Explorer (for both iOS and Android).
Peer support (via FB): YpsoPumpers Australia


Medtronic 770G

The Medtronic 770G is a development from the earlier 670G. It runs a closed-loop algorithm using the Medtronic CGM to try to control both highs and lows.

The looping algorithm is the same as the 670G, with the same fixed 6.7 mmol/L target. But it will be software-upgradeable to the enhanced algorithms of the 780G pump which is in use in Europe.

Note that while the 770G promises to be upgradeable, there have been conflicting reports from Medtronic as to whether the upgrades will be free or not. Luckily my grapevine is telling me they will provide 770G->780G upgrades for free for any pump in warranty. But we haven’t seen anything concrete on that yet.

The 770G does have a few extra features over the 670G, such as:

  • It has Bluetooth integrated into the pump. This is used to link the pump to your mobile phone (with the CareLink app uploading to Medtronic’s cloud servers). No longer do we have to choose to either have the CGM connected to the phone or to the pump. We finally get to see it on both!
  • The CGM uses the same Guardian3 sensors, but a new transmitter which uses Bluetooth (like the older Guardian Connect transmitters, but not apparently not identical).
  • The CGM is managed by the pump though, which then reports the results to the phone. This is different to the way the Dexcom CGMs can talk to pump and phone independently. Unfortunately Medtronic does not support displaying the information from the phone app to smartwatches.
  • The pumps are shipped with Accu-Chek Guide Link BG meters (instead of the older Contour Next Link 2.4) which connect to the pump via Bluetooth. The plain Guide meters (not the Link version) will link to the MySugr app on phones.

Insulin delivery

30-minute basal blocks, in 0.025 increments.
Boluses: 0.025 U minimum, 0.025 U increment.
Bolus speed: 1.5 U/min (“Standard”) or 15 U/min (“Quick”).

Consumables

The 770G can use either 300U or 180U reservoirs. Although the manuals only mention the 3ml reservoirs, the 1.8ml ones are still available through NDSS (and are required for some of the older Paradigm pumps).

The infusion sets are common across all the Medtronic pumps in this list. The available sets are:

  • Mio (teflon: same as Tandem AutoSoft 90, YpsoPump Inset)
  • Sure-T (steel: same as Tandem TruSteel)
  • Silhouette (teflon, angled: same as Tandem VariSoft 30, Accu-Chek TenderLink)
  • Quick-set (teflon)

Batteries

The 770G uses an AA battery. Either alkaline, lithium, or at a stretch NiMh rechargeable are supported. The pump does not ask for the battery type.
Note that carbon-zinc batteries (often labelled as “heavy duty”) are not supported.

Waterproof?

The 770G is described as coming from the factory as waterproof, able to be underwater to a depth of 3.6m for up to 24 hours. This is still IPX8. It’s the same rating as the older 640G and 670G pumps, and in fact the design of the pump body is unchanged.

However the manual does note that the waterproofing can be compromised by bumps/scratches and especially cracks in the pump. Many people over the years have reported their Medtronic pumps drowning due to cracks they hadn’t noticed before they got wet. So user beware!

Closed loop?

The 770G cannot be used with any external closed-loop system, but it has its own hybrid closed-loop system built-in.

More info

Official info: Medtronic
Peer support (via Facebook): Medtronic 670g and 770g Support Group Australia


Medtronic 640G

This pump originally integrated with Medtronic’s Guardian2 Link CGM, but also supports the Guardian3 Link that was introduced with the 670G.

However, it’s mainly used these days without CGM. And even for people not planning to pay for CGM Medtronic seems to be pushing everyone towards the 770G (which without CGM doesn’t seem to have much real difference to the 640G). But I gather the 640G might still be supplied in some circumstances.

If a 640G does have CGM connected, it can use that data for “SmartGuard” which is their predictive-low-glucose-suspend (sometimes referred to as a “hypo minimiser”).

The pump is supplied with a “Contour Next Link 2.4” BG meter, which links wirelessly (not using Bluetooth) to the pump.

Consumables

The reservoir, infusion sets, and battery are the same as the 770G/670G/etc.

Waterproof?

The 640G has the same waterproofing as the 770G/670G/etc.

Closed loop?

The 640G is not compatible with any closed-loop system.

More info

Official info: Medtronic


Pumps available in Australia

But not through health insurance

If you have some spare cash on hand, you can now get another pump without involving health insurance.

Insulet OmniPod

This tubeless patch pump was launched in Australia in August 2021. It has been used in Europe and the US for years, so there are plenty of user-experience stories online.

Because it is the pump, reservoir, and infusion site all combined into one disposable unit, there are a few differences in operation from traditional pump.

The internal reservoir is filled with a syringe prior to insertion, and it auto-inserts a teflon cannula after application. There are no cannula options: it’s a very short 6.5mm cannula at an angle. But the pump can be worn during swimming/showering/etc. If the pump detaches, a replacement pump is required. In fact every 3 days a whole new pump is required: the only permanent piece is the PDM (“Personal Diabetes Manager”) handset. Every month a new box of 10 pumps.

This model is completely unlike any other pump on the market, which have a “capital” component of the pump itself (and you buy 4 years of warranty support with it) and a “consumables” component. No compromise funding model has yet been found that would shoehorn the Omnipod into the standard Australian pump funding (that’s split between private health insurance covering the “capital” and NDSS covering the “consumables”). We will find out in November if there’s any change in the next Prostheses List update.

There have been two major versions of the Omnipod: “Eros” and “DASH”. The difference between these is the computer chip and the radio used to talk to the handheld PDM (and thus what they’re compatible with).

Eros

The original Eros pumps used 433 MHz radio. These received TGA approval for Australia in 2012, but were never sold here. That TGA approval was dropped in 2020.

DASH

The newer pumps instead use Bluetooth to talk to the PDM (which is actually a locked-down Android device). These received TGA approval for Australia in 2020.

How much?

The Omnipod is not supported by health insurance or NDSS, so you’re stuck buying them in boxes of 10 for an approximate cost of $40 per pod. At more than $4800 per year, that is a lot more expensive than other pumps. Over 4 years it’s on the order of twice as expensive as even buying another pump outright (and including NDSS consumables). But it is something that can be bought on a per-box basis (without committing to 4 years).

Usage

Unlike other pumps (including the Solo patch pump) there are no buttons on the pump itself. The only way to deliver insulin is using the PDM.

Errors occur at times with all pumps. With the OmniPod some can be resolved via the PDM, but some need to you remove the pump. In some error conditions the pump will alarm loudly, and the only recourse is to remove the pump and break the kill-switch panel (which is otherwise against your skin) with a nail/key/pin to silence it.

Insulin delivery

Each pod is filled with 85-200U of insulin, which has to last the 72 hours (3 days). As mentioned, the 6.5mm angled teflon cannula is auto-inserted when you activate the pod.

Up to 24 basal blocks (can be set to 30-minute boundaries) in 0.05 U/hr increments.
Boluses: 0.05 U minimum, 0.05 U increment.
Bolus speed: 1.5 U/min.

Waterproof?

The Omnipod is rated at IP28: down to a depth of 7.6 meters) for up to 60 minutes. You’re supposed to be able to shower, swim, etc without having to remove it.

Closed loop?

The Eros pods can be used with external closed-loop systems (Loop and AndroidAPS) using a RileyLink/EmaLink/OrangeLink radio bridge (these replace the PDM). But Eros will never be supplied in Australia.

As well as operating as a standalone pump, the DASH will be used by Insulet’s future Omnipod 5 closed-loop (which used to be called Horizon) as well as Tidepool’s future commercial closed-loop version of Loop. No sign of either of those for Australia yet (or anywhere in the world in fact).

The DASH is not currently compatible with any external looping system. But hopefully this will changer sooner rather than later.

More info

Official info: Insulet
Peer support (via Facebook): Omnipod Users Australia


Other pumps in use in Australia

While not available new, the following pumps are still in use by many people.

Accu-Chek Combo

This pump is a relatively old design, but it has proven itself as a reliable performer over the years. The last of these was sold in September 2021, with warranty and support promised to continue for 4 years.

The Combo system is comprised of a “Spirit Combo” pump along with a “Performa Combo” BG meter which is used as a remote control so the pump doesn’t have to be brought out of your pocket in normal use.

Mind you, that Performa Combo does insist on a fresh fingerprick for each bolus decision. Although when used with AndroidAPS the meter is replaced by a Bluetooth connection to your phone so the meter’s no longer required.

Insulin delivery

Hourly basal rates: 0.1-1.0 U/hr in 0.01 increments, 1.0-10 U/hr in 0.05 increments, 0.1 U/hr increments above that.
Boluses: 0.1 U minimum, 0.1 U increment.
Bolus speed: 12 U/min.

Consumables

The pump’s reservoir can hold up to 315U of insulin. The pump has a luer-lock connection for its infusion sets, so the currently-available (through NDSS) sets it can be used with are:

  • Accu-Chek FlexLink (teflon)
  • Accu-Chek Rapid-D (steel)
  • Accu-Chek TenderLink (teflon, angled)
  • Medtronic Silhouette (only 17mm version, but same as TenderLink)
  • Medtronic Sure-T (steel)
  • Medtronic Quick-set (teflon)
  • Orbit soft (teflon), micro (steel)
  • Cleo 90 (teflon)

Batteries

The Combo uses an AA battery. Either alkaline, lithium, or NiMh rechargeable are supported. After a new battery is inserted the pump asks for the battery type so it can calibrate the “low battery” indicator.

Waterproof?

The Spirit Combo has an IPX8 waterproof rating. Some people do take it swimming, although the manual’s official advice is quite conservative:

Avoid contact with water. Check daily that your Accu-Chek Spirit Combo insulin pump is not chipped, cracked or damaged in any way, and that the battery cover and the adapter are correctly closed. If the pump is chipped or cracked, water, dust, insulin, or other substances may enter your pump and lead to malfunction. Before any contact with water, disconnect and take off your pump.

Disconnect and remove your pump before taking a bath, or going into a whirlpool, shower, or swimming pool. Avoid exposing your pump to high humidity, such as in a sauna, as this could result in damage.

I have spent years using the Combo. It’s been a very reliable pump for me. I’ve always taken the cautious line that I take the pump off before I head into water, but have faith that it will probably survive if I fall overboard when working around water.

Closed loop?

The Combo can be used with the AndroidAPS closed-loop system. This is not actively supported by Accu-Chek, but I’m sure most of Accu-Chek’s recent sales have been due to this compatibility.

More info

Official info: Accu-Chek
Peer support (via FB): AndroidAPS users, AussieLooping


Medtronic 670G

The 670G pump was Medtronic’s first closed-loop system. The pump acts as the receiver for the Guardian3 Link CGM, which it needs for the closed-loop functionality.

The pump is supplied with the same linked BG meter as the 640G. The meter, pump, and CGM sensors communicate via a radio protocol which is not Bluetooth.

The Guardian3 CGM has sensors that last for 7 days, and require calibration within every 12 hours.

Insulin delivery characteristics are the same as for the 770G.

Consumables

The reservoir, infusion sets, and battery are the same as the 770G/670G/etc.

Closed loop?

The 670G cannot be used with any external closed-loop system, but it has its own hybrid closed-loop system built-in.

With its CGM the 670G is able to have the same SmartGuard function as the 640G, as well as having “auto mode” which is their closed-loop system. Note that it is a first-generation looping system and lacks many of the configuration options and features of the open protocol loop systems (such as the inability to customise the target BG level) although it is approved by the regulators and available without you having to assemble it yourself.

More info

Peer support (via Facebook): Medtronic 670g and 770g Support Group Australia


Medtronic Paradigm

These were Medtronic’s earlier generation of pumps. The consumables (reservoirs and infusion sets) are still used with the current 770G.

The “Veo” 554 and 754 pumps were the last versions of these, but the earlier 522, 515, 722, and 715 look very similar.

The reservoir in the 554 can hold up to 180U of insulin, and the 754 can hold up to 300U (or use the 180U option).

The Veo pumps support Medtronic’s old “Enlite” CGM system (uses the same sensors as the Guardian2 CGM, but a different “MiniLink” transmitter) and they have a primitive low-glucose-suspend function (which suspends when you get to the boundary point, not when the pump predicts you’re soon going to get there).

These pumps were originally rated with IP67 dust/waterproofing, but especially given their age I would not regard any of them as waterproof today.

Insulin delivery

30-minute basal blocks, in 0.025 increments.
Boluses: 0.025 U minimum, 0.025 U increment.
Bolus speed: 1.5 U/min. The “Veo” models halve that speed for boluses <1 U.

Consumables

The reservoir and infusion sets are the same as the Medtronic 770G, and are available through NDSS.

Batteries

Officially the only batteries supported were alkaline AAAs. The on-screen battery-level indicator is calibrated for these. However many loopers are using lithium AAAs which last a lot longer (but if you rely on the LCD battery indicator drop from full to empty very quickly, which I think is why Medtronic originally said these were not supported). The looping software has its own recalibrated indicator. I personally used lithium AAAs in these batteries for a long time.

Closed loop?

The latest firmware versions of these pumps are not compatible with any external closed-loop systems. Older versions with firmware up to 2.7A are “loopable” and work with all three opensource closed-loop systems (OpenAPS, Loop, and AndroidAPS).

The 512/712 models are only compatible OpenAPS and AndroidAPS (not Loop), but the Paradigm 515/522/554 and 715/722/754 models work with all three.


DANA R and RS

The DANA R and RS pumps look almost identical. The main differences are the R’s use of Bluetooth 2 rather than the lower-power Bluetooth LE of the RS, and a correspondingly-worse battery life (approximately a third of the lifespan). The pumps have a 300U insulin reservoir.

The supplier (Managing Diabetes) ceased sales of the RS (apparently largely due to their exhorbitant costs for importing the special Lithium batteries in today’s economy) but is still supporting current users with consumables via NDSS.

Insulin delivery

Hourly basal blocks: minimum 0.04 U/hr, with 0.01 increments.
Boluses: 0.05 U minimum, 0.05 U increment.
Bolus speeds. R: 5 U/min. RS: 4, 2, or 1 U/min.

Consumables

For a long time the DANA pumps have mainly been used with the Soft Release O infusion sets. These were made by Ypsomed and equivalent to the Orbit Soft set. The Orbit micro steel cannulae (available on NDSS without tubing) can be used with the DANA tubing if you needed to use those. However the Soft Release O has been discontinued. As of August 2021 only one version of it is available through NDSS: a 9mm cannula with 80cm tubing. We don’t know how much longer that will be available for, but for now this tubing can be used with all the Orbit versions available from Ypsomed (through NDSS).

But as of July 2021 there was a new infusion set added to NDSS. This is the “DANA Inset II“, which has a DANA connector but is otherwise identical to the Medtronic MioTandem AutoSoft 90Animas Inset II, and YpsoPump Inset.

Batteries

The special batteries for the pump are still supplied in each box of reservoirs.

The upcoming DANA-i (see below) looks like it will be their replacement product, but there’s no sign of it yet. If that does reach Australia, there might be some reorganisation of how batteries for the RS are supplied. The DANA-i uses the same reservoirs, but will not need these special batteries included in the reservoir box.

Closed loop?

Both the R and RS pumps are compatible with the AndroidAPS closed-loop system.


V-Go: a non-T1D pump

The V-Go is available in Australia, but is designed for use in Type 2 diabetes, not Type 1. It is a simple mechanical (spring-driven) device for 1-per-day use, with a fixed infusion rate. I have previously written about the V-Go.


Other insulin pumps

That’s it for the current Australian pump options, but there are some other pumps around the world which Australian folk keep asking about.

Medtronic 780G

This is Medtronic’s touted next closed-loop pump. It’s still being trialled at some locations around the world, but in fact it’s hit the market in Europe. It apparently has Bluetooth for connecting to your phone, but the thing most people talk about is a more-advanced closed-loop algorithm than the 770G. The 770G pump seems to effectively be an early release of the hardware for it.

Some features include a new CGM which only needs calibration on the first day of a sensor, and a BG target adjustable between 5.6-6.7 mmol/L.


DANA-i

This is the next pump from SOOIL. It has TGA approval for supply in Australia, but did not reach the July 2021 update to the Prostheses List, so can’t yet be funded by private health insurance.

It uses the same reservoirs and infusion sets as the DANA RS, but uses a standard AAA battery (alkaline or lithium). It is a bit bigger (“chunkier”) than the RS pump though. The pump does also have a few technical advances over the RS other than just a new battery, such as a new Bluetooth module with increased range.

The DANA-i has apparently begun delivery to some customers in Europe and in NZ already, but it’s a waiting game for all the pieces to fall into place for Australia.

In Europe this pump is supported by the commercial CamAPS FX looping system and by Diabeloop. But there’s no sign of these systems for Australia yet. It seems likely that Android APS will be compatible with the DANA-i in an upcoming release, although timing is currently unknown.


EOFlow

This patch pump from Korea got some press in March 2019 when it got “Breakthrough Device” designation from the US FDA. It is apparently reaching the South Korean market now, but it’s a long way from other markets.

Apparently research and testing is continuing with a version that integrates a CGM sensor as well as infusion cannula into a single unit for closed-loop operations.


Accu-Chek Insight

This pump is used in Europe, but not available here (although it was registered with the TGA back in 2015, as well as added to the Prostheses List). Like the other Accu-Chek pumps it has a remote handset/meter which links to it via Bluetooth.

The pump needs its own collection of Accu-Chek infusion sets (the end of the pump is actually part of the infusion set tubing).

It uses the same cartridges as the YpsoPump, but the pre-filled NovoRapid/Fiasp “PumpCart”s used for it in Europe are not yet available in Australia. Accu-Chek originally planned self-filled reservoirs for the Insight (and the pump asks you if you’re using self-filled or pre-filled) but the self-filled ones never reached production. The YpsoPump’s reservoirs can be used in the Insight (they are standard PumpCart format).

The Insight is compatible with the AndroidAPS closed-loop software, as well as the commercial Diabeloop.

All the signs are that Accu-Chek will be ceasing new sales of the Insight in Europe by 2022.


Medtrum A6

This tubeless patch pump from China has had TGA registration for some time, but does not seem to be on anyone’s marketing plans. Note the approval covers the pump itself, not their associated CGM system. Reports from overseas users characterise it as a relatively primitive device (especially its controller device).

Currently I do not expect to see the Medtrum reach the Australian market.


Kaleido

A patch pump from the Netherlands, Kaleido has a similar form factor to the now-defunct Cellnovo system, but also allows you to use longer tubing for flexibility in how you wear it. It’s the pump Diabeloop in France initially chose for their DBLG1 closed-loop system.

Currently I do not expect to see Kaleido reach Australia.


Tandem t:sport

This is not an actual pump yet, just a planned product that occasionally gets mentioned online. All we’ve seen are various prototype mock-ups. Here one is shown alongside the t:slim X2.

It apparently has a traditional “piston style” reservoir holding 200U, and no screen. It’s built to be controlled from Tandem’s t:connect app via Bluetooth. It would have the Control-IQ loop software inside it, and talk to the Dexcom G6 CGM. It would use the same infusion sets as the t:slim, and presumably new options with super-short tubing will be introduced. It’s designed to be small enough to be stuck to your skin beside the infusion site (see the image above of the similar Kaleido pump).

The latest rumours are of Tandem possibly introducing this in the US in late 2021 or into 2022. After it finally appears in the US we’ll eventually find out if there are any plans for the rest of the world.


BetaBionics iLet

This is another not-an-actual-pump-yet. BetaBionics have been working for years on a “bionic pancreas” closed-loop system, and have conducted a number of trials in the US.

There have been two basic designs investigated: an insulin-only pump, and a “dual-hormone” (glucagon and insulin fed to two infusion sites). Insulin to push your BG down, and glucagon to bring it up: just like an actual pancreas.

BetaBionics did a lot of work with Zealand Pharma who developed dasiglucagon, an artificial glucagon which is stable in liquid form (unlike the regular glucagon in injection kits). Dasiglucagon has also recently reached the US market in a ready-to-inject emergency pen form.

Of course in the years all this dual-hormone development work has been going on, other single-hormone closed-loop systems have developed too. While iLet trial participants have commented about how easy the system is to use, I haven’t yet seen clinical results any better than achieved by today’s single-hormone systems. But maybe the advantage is the self-tuning nature of the system.

There are no signs yet of when an iLet product might actually appear, and trials are ongoing.


MEDISAFE WITH

Terumo (a brand many people associate with syringes and needles) also has an insulin pump, but only within Japan.

The “MEDISAFE WITH” is a patch pump, and will be used with the Diabeloop closed-loop system.

I’m not aware of any plans for this pump outside Japan.


DIA:CONN G8

This Bluetooth-connected pump is from South Korea. I’m not yet aware of what countries (if any) outside Korea and China it will be marketed in.

It’s advertised as coming with a phone app which is cloud-connected for sharing data with HCPs. It takes a single AA battery, holds up to 300U, and has a bolus increment of 0.05U. The delivery speed is selectable from 1-8 U/hr (in 1 U/min increments).


Sigi

This Swiss patch pump was shown at the 2021 ATTD (Advanced Technologies and Treatments for Diabetes) conference, although it has apparently not yet been commercialised into a product. Well, it looks ready but it seems Sigi are looking for commercial partners.

It has some novel features:

  • Users receive two USB-rechargeable pumps to alternate between.
  • Clips into and out of a cannula “plate” (which has an angled cannula).
  • Uses the same PumpCart insulin vials as the YpsoPump and the Accu-Chek Insight.
  • It uses Bluetooth and is designed to integrate with future loop systems.
  • It administers insulin via a dual mechanism, with the PumpCart reservoir pressurising the delivery mechanism which essentially then squashes and expands a tiny section of tubing to deliver tiny parcels of insulin for accurate dosing.

Due to the compression engine I do expect that Apidra would not do well in that pump (but that’s not available in pre-filled PumpCarts anyway).


That’s it for now

But I’m sure this page will get updated again in the coming months…