Is there a better SQLite update / insert pattern than this?
The second code block is the clunky one, it has repetition which the first one doesn't. If you wanted to refactor the first example you would need to go higher up and do the check for existing record before you make the call to save or update then have a method for save and one for update, but this would lead to some duplicate code.

From what you have posted I'd stick with the first one.