Diabetes Technology Update

Diabetes Technology Update

Since the last newsletter both the Omnipod 5 automated insulin delivery (AID) system and Abbott Freestlye Libre 3 continuous glucose monitor (CGM) have become available, and the FDA just approved the Dexcom G7 on December 8th. The Dexcom G7 is a smaller CGM version of the current G6 model that provides continuous readings, and alarms. It could take a while before the device makes it through the supply chain and connect with any AID pumps (Tandem or Omnipod). The G7 currently connects with multiple AID systems in other countries and Dexcom is working to make the connection as quickly as possible. The Freestyle Libre 2 doesn’t currently connect with a pump, and the Libre 3 has struck the first deal to work with a pump made by Ypsomed in Germany. The smaller Libre 3 sensor has continuous reading and alarms, and the Libre 2 needs to be scanned to show a reading. A good caparison of currently available sensors and other diabetes apps and technology can be found at the danatech website.

 

The tubeless Insulet Omipod 5 is the main competition to the Tandem t:slim X2 Control-IQ AID system. Both use the Dexcom G6 sensor and both have published data that shows improvements in glucose control in people with type 1 diabetes. The choice is a lifestyle one—some people prefer the tubeless Omnipod to the tethered Tandem pump. However, the Omnipod control algorithm does not provide auto-correct bolus doses while the Tandem system does. Therefore, talk with your diabetologist before deciding on a system—there are pros and cons to each. The best site to learn about the system is the PANTHER Program from the Barbara Davis Center in Colorado.

 

Another AID system, the MiniMed 780G system is available in more than 60 countries, and was recently approved in Canada, but the launch is still delayed in the US. It has an even better algorithm for delivering insulin, but still only works with a Medtronic sensor, which has its issues (although the sensor is reported to be better than prior).

 

What is new and available from Medtronic is an extended 7-day infusion set for their MiniMed 600 and 700 series pumps. The extended set includes a new inserter, tubing, connector, and a larger insulin reservoir that will lower medical waste. It is also estimated to save up to 25% of insulin cost due to reduced wastage due to set changes. In the clinical trial there was a 77.8% survival rate of the infusion sets with unchanged glucose control and a higher satisfaction rate of the extended infusion set over the standard 3-day set. Infusion sets have long been the Achilles heel of insulin pumps and it will be interesting to see how well this new system works in real life.