Tandem Device Image Mobile Bolus copy v2
tidepool loop device

Summary

This system combines the Tandem t:slim x2 with the Dexcom G6 or G7 continuous glucose monitor (CGM) to automatically adjust insulin delivery in response to glucose trends. It's easy to use and allows bolus dosing directly from a compatible iOS or Android smartphone. 

Tidepool Loop is the first fully interoperable automated insulin dosing app that originated as a patient-led initiative.

Background: A diabetes non-profit called Tidepool decided in 2018 to officially support Loop and shepherd it through the FDA process. Tidepool Loop was cleared by the FDA in January 2023 with plans to launch with Dexcom and other alternate controller-enabled (ACE) pump partners (RileyLink will no longer be necessary).

2023 Updates from Tidepool:

  • Medtronic and Tidepool have decided to discontinue the development of a Medtronic insulin pump system compatible with Tidepool Loop.
  • As Omnipod 5 is now commercially available, Insulet is devoting all available resources to their Omnipod products, including the global launch and further development of Omnipod 5.
  • Future ACE Pumps that will be commercially compatible with Tidepool Loop will need to be FDA-cleared for use with third-party interoperable automated glycemic (iAGC) controllers.

Components

Control IQ with Dexcom : Pump

Control IQ with Dexcom : Pump

Touch screen pump connects tubing to a small patch called an infusion set that attaches to the body.

Control IQ : Sensor

Control IQ : Sensor

Automatic applicator inserts sensor just under the surface of the skin and can be applied to many places on the body.

Control IQ with Dexcom : Controller

Control IQ with Dexcom : Controller

t:slim pump receives CGM readings to automatically adjust basal insulin delivery via an infusion set. Compatible smartphone can be used to view and administer boluses via the t:connect app.

Control IQ : Infusion Set

Control IQ : Infusion Set

An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.

Tidepool Loop  : Controller

Tidepool Loop : Controller

Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via insulin pump.

Device Details

Overview

The system automatically adjusts insulin levels from the Tandem t:slim X2 pump based on the Dexcom G6 or G7 readings for more time in range. 

Tidepool Loop is the first fully interoperable automated insulin dosing app that originated as a patient-led initiative.

Affordability and Access

$$$$
Widely covered for insulin-dependent type 1 and 2. Supplies for Pump and Sensor provided by DME suppliers. Price range; $5-$6,995 to start and $0-$200/month.

$$$$
Pump and CGM supply information is not yet available. iPhone is not covered and must be set up independently.

Data Monitoring Options

Yes
The t:connect mobile app for the t:slim X2 pump wirelessly uploads pump and CGM data to the cloud-based t:connect web application.

Yes
Compatible with Tidepool - a web-based diabetes data management system. 

Data View Options

Yes
Data can be viewed directly on the pump screen or on the t:connect mobile app (available for both iOS and Android devices).

Yes
Data can be viewed on an iPhone. 

Duration and Storage

3-day pump 10-day sensor
Sensors last 10 days and transmitters last 90 and work at 50ºF – 108ºF. Pump can be used for up to 72 hrs, battery life lasts five days with the use of CGM, and work between 40°F - 99°F. 

*CGM transmitter is only required for the Dexcom G6 model. 

Pump and CGM information not yet available. 

Vision / Auditory / Dexterity

NO text to speech
YES 
vibration alerts
A LOT
of dexterity needed

NO text to speech
YES 
vibration alerts
A LOT 
of dexterity needed

Patient Considerations

Active Lifestyle

Exercise Activity. Can manually increase target range to 140-160 mg/dl. Insulin decreases when Control IQ predicts CGM ≤140 mg/dl and increases when ≥ 160 mg/dl within 30 minutes. Autocorrections will still occur. Pump is not waterproof. CGM is waterproof. 

Automatic responses. Can set custom blood sugar targets and insulin and carb sensitivities based on type of activity. App automatically responds to blood sugar changes during activity.

Avoiding Highs and Lows

Auto basal and bolus insulin. Responds to CGM data by increasing or decreasing basal insulin delivery to prevent highs and lows and maintain a target blood glucose of 110 mg/dl. Auto-bolus is available once per hour to correct blood sugar above 180 mg/dl.

Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.

Comfort

Low profile. Low profile/low maintenance sensor. Small tubed pump with the most infusion sets to pick from.

Low-profile mobile app. Dosing and other adjustments can be done directly on the mobile app. 

Easy Insulin Dosing

Automatically adjusts dosing. Sensor integration allows for the pump to automatically adjust insulin doses. More customizable dosing than pens or syringes. Basal in 0.001 increments, bolus in 0.01 increments. Extended bolus available.

Customizable. Can bolus from phone or smartwatch and all settings are expected to be customizable. More information on modifications to insulin delivery will be available soon. 

Easy to Use

Modern & flexible. Rechargeable and touchscreen pump. Sensor integrated with multiple devices in case you change up what you're using. 

Easy dosing. Software makes most dosing decisions easy to do on the fly.

Fewer Fingersticks

Factory-calibrated sensor. Fingersticks needed for backup only.

Factory-calibrated sensor. Fingersticks needed for backup only.

Privacy

Discreet. Ability to check blood sugar on phone or watch. Ability to bolus on a compatible smartphone. Pump has tubing but can be clipped to clothing or placed in a pocket to be discreet when needed. Dexcom's built-in hypoglycemia safety alarm alerts users when glucose is below 55 mg/dl and is always on.

Discreet. Ability to give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available.