libre2 tslim device
Screen Shot 2021 12 15 at 3.47.47 PM

Summary

This system is the first automated insulin delivery system that combines the Tandem t:slim x2 with the Freestyle Libre 2 Plus 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. 

The OmniPod is the only tubeless pump option. A Personal Diabetes Manager (PDM) is used to give insulin doses to the pod, which remains attached to the body. This pump is one of few that is completely waterproof. 

Components

Control IQ with Freestyle Libre  : Pump

Control IQ with Freestyle Libre : Pump

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

Control IQ with Freestyle Libre  : Sensor

Control IQ with Freestyle Libre : 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 Freestyle Libre  : Controller

Control IQ with Freestyle Libre : 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 control insulin delivery using the t:connect app.

Control IQ with Freestyle Libre  : Infusion Set

Control IQ with Freestyle Libre : Infusion Set

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

Omnipod : Pump

Omnipod : Pump

Pods come with reservoirs and directions for application. They can be applied anywhere on the body that is comfortable.

Omnipod : Reservoir

Omnipod : Reservoir

Fill reservoir is enclosed with the Pod and used to manually fill the Pod with insulin.

Omnipod : Controller

Omnipod : Controller

Personal Diabetes Manager (PDM) is used to give insulin doses to the pod.

Device Details

Overview

This system automatically adjusts insulin levels from the Tandem t:slim X2 pump based on the Libre 2 Plus readings for more time in range.

This is a discreet pump option without tubing but will require a controller to dose. 

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.

$$$$
Widely covered for insulin-dependent type 1 and 2. Pump can be provided by pharmacy or DME. Price range; 0-$200/month.

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
Pump data can be accessed by clinicians on Diasend by Glooko.

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).

No Options 

Duration and Storage

3-day pump 15-day sensor
Sensors last 14 days, and transmitters last 90 and work at 50ºF - 113ºF. 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. 

3 Days
Pod can be worn for up to 72 hours and work from 41ºF – 104ºF.

Vision / Auditory / Dexterity

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

NO text to speech
NO 
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. 

Waterproof. Wear the Pod in the shower, in the pool, or in the ocean. The PDM is not waterproof and must be charged daily. 

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.

Personalized dosing. Pods can deliver personalized doses of rapid-acting insulin based on the rates programmed into the Personal Diabetes Manager (PDM) device. The ability to set zero basal rates is not available. 

Comfort

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

Free of tubing. Pods do not have tubes like traditional insulin pumps, allowing for more freedom of movement.

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 dosing. Basal and Bolus in 0.05 increments. No interruption in insulin delivery (pods stay on during bathing and swimming). 

Easy to Use

Modern & no scanning required. Rechargeable and touchscreen pump. Sensor does not require scanning and sends minute-by-minute readings directly to the pump.

Fewer parts. The PDM has button navigation. Pod has fewer parts than tubed pumps.

Fewer Fingersticks

Factory-calibrated sensor. Fingersticks needed for backup only.

Frequent finger-sticks are required. 

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. CGM has a built-in hypoglycemia safety alarm that alerts users when glucose is below 55 mg/dl and is always on. 

Somewhat discreet. The pod attaches directly to the body with no tubing, but the pod is bigger than an infusion set. Pod does not have vibrate option.