Hi Tom,
I've had both the small and large Medtronic pumps. There's really very little difference in terms of pump size, the larger one just has a slightly more rounded shape where the reservoir goes in and the reservoir sticks up above the rest of the pump slightly. You can use the smaller sized reservoirs in the larger pump anyway.
I picked the smaller 180u one first, as I used around 60 units per day so could change reservoir and set every 3 days as required (leaving the set in longer increases risks of infection, and starts to create scar tissue around the insertion site).
I switched to the larger 270u one as I was planning pregnancy and last time I ended up having to change my reservoir every 30 hours or so. It works just as well, only I don't fill the reservoir completely so I still change both when I need to change the set.