Insulin pump access in the U.S. is changing fast. As more companies move away from traditional durable medical equipment (DME) contracts and toward pharmacy benefits, people with diabetes can start or switch pumps with far fewer barriers. Long contracts and large upfront costs are fading, giving users more flexibility and choice.

That flexibility comes with new challenges. Modern insulin pumps are no longer interchangeable, and today’s automated insulin delivery (AID) systems use very different algorithms and controls. Settings that work well on one pump can behave very differently on another, increasing the risk of highs, lows, or users not fully benefiting from automation.

Healthcare providers are increasingly seeing confusion during pump transitions. Some users copy settings without realizing they may be interpreted differently or not used at all, while others miss key features like activity modes or automated corrections. At the same time, clinicians and diabetes educators are under growing pressure to stay current across multiple systems, frequent updates, and increasingly complex pump behavior.

We break all of this down with Diana Isaacs, PharmD, CDCES, who works with patients navigating these transitions every day. She explains why switching pumps isn’t as simple as copying settings, how different AID algorithms behave in very different ways, and where things often go wrong when users aren’t fully supported. She also shares practical steps for safer transitions, including recalculating settings and prioritizing proper training. Listen to the episode above or watch the full conversation in video below.

Disclaimer: Diabetech content is not medical advice—it’s for educational purposes only. Always consult with a physician before making changes to your healthcare.