Select Device Freestyle Lingo Freestyle Libre 3 Freestyle Libre 2 Freestyle Libre 14 Day Dexcom G7 Dexcom G6 Dexcom Stelo Guardian Connect Medtronic Simplera Eversense Meter Omnipod Omnipod Dash Medtronic 780G Medtronic 630G Tandem t:slim X2 Bigfoot Unity Medtronic InPen Tempo Pen NovoPen 6/NovoPen Echo Insulin Pen Afrezza CeQur Simplicity Patch V-Go Patch Omnipod GO Patch Syringe and Vial Beta Bionics iLet Pancreas Control IQ with Dexcom Control IQ with Freestyle Libre Medtronic 780G with Smart Guard Omnipod 5 Tandem Mobi Tidepool Loop twiist DIY Loop Apple Series 6/7/8/9/10/SE (2nd Generation) Garmin vívosmart 5™ Garmin Venu Sq 2 Garmin Venu 3 Garmin vivoactive 5 Garmin Fenix 8 Garmin vivofit jr 3 Garmin Forerunner 165/265/965 Garmin epix (Gen 2) Garmin Enduro 3 Fitbit Ace LTE Fitbit Charge 6 Fitbit Inspire 3 Fitbit Versa/Versa 2/4/Versa Lite Fitbit Sense 2 Fitbit Luxe Google Pixel 2/3 Samsung Galaxy 4/5 Xiaomi Mi Band 9 Oura Ring Whoop 4.0 Withings ScanWatch 2 Withings ScanWatch Lite Pedometer 3D Pedometer
Select Device Freestyle Lingo Freestyle Libre 3 Freestyle Libre 2 Freestyle Libre 14 Day Dexcom G7 Dexcom G6 Dexcom Stelo Guardian Connect Medtronic Simplera Eversense Meter Omnipod Omnipod Dash Medtronic 780G Medtronic 630G Tandem t:slim X2 Bigfoot Unity Medtronic InPen Tempo Pen NovoPen 6/NovoPen Echo Insulin Pen Afrezza CeQur Simplicity Patch V-Go Patch Omnipod GO Patch Syringe and Vial Beta Bionics iLet Pancreas Control IQ with Dexcom Control IQ with Freestyle Libre Medtronic 780G with Smart Guard Omnipod 5 Tandem Mobi Tidepool Loop twiist DIY Loop Apple Series 6/7/8/9/10/SE (2nd Generation) Garmin vívosmart 5™ Garmin Venu Sq 2 Garmin Venu 3 Garmin vivoactive 5 Garmin Fenix 8 Garmin vivofit jr 3 Garmin Forerunner 165/265/965 Garmin epix (Gen 2) Garmin Enduro 3 Fitbit Ace LTE Fitbit Charge 6 Fitbit Inspire 3 Fitbit Versa/Versa 2/4/Versa Lite Fitbit Sense 2 Fitbit Luxe Google Pixel 2/3 Samsung Galaxy 4/5 Xiaomi Mi Band 9 Oura Ring Whoop 4.0 Withings ScanWatch 2 Withings ScanWatch Lite Pedometer 3D Pedometer
Summary
Loop is a DIY (do-it-yourself) system. It takes some work to set up but allows people to think about diabetes less by automating basal insulin delivery based on predicted glucose levels. This system can be used with the Dexcom G6 and the Omnipod or Medtronic pumps. Information about DIY Loop can be found on the Loop or Riley Link websites.
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.
Components
Loop : Pump
The system is compatible with Omnipod (left) or Medtronic (right) pumps. Both options can be applied anywhere on the body that is comfortable.
Loop : Sensor
Automatic applicator inserts sensor just under the surface of the skin and can be applied to many places on the body.
DIY Loop : Transmitter
RileyLink allows the pump and sensor to communicate. It is only required if a Medtronic pump is used.
Loop : Controller
Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via an Omnipod or Medtronic 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
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
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
An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.
Device Details
Overview
This is a DIY (do-it-yourself) system that needs significant setup. It has the most flexibility in settings and device options. It also depends on a third device called a "Riley Link" to communicate between sensor, phone, and pump.
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.
Affordability and Access
$$$$
Supplies can be covered for Omnipod or Medtronic pumps and Dexcom. Price range; $0-$8,574 to start and 0-$300/month. iPhone, app, and Riley link are not covered and must be set up independently. Riley link price range; $135-$165.
$$$$
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.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
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.
Data View Options
Yes
Data can be viewed on an iPhone.
Yes
Data can be viewed directly on the pump screen or on the t:connect mobile app (available for both iOS and Android devices).
Duration and Storage
3-day pump 10-day sensor
Sensors last 10 days and transmitters last 90, and work at 50ºF – 108ºF. Pods or pump reservoirs last for up to 72 hrs and work from 40ºF – 104ºF.
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.
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
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. *Medtronic option is not waterproof. Omnipod option is fully waterproof.
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.
Avoiding Highs and Lows
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
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.
Comfort
Low-profile but extra device. Low profile/low maintenance sensor. The RileyLink is an extra device that must be carried.
Low profile. Low profile/low maintenance sensor. Small tubed pump with the most infusion sets to pick from.
Easy Insulin Dosing
All settings are completely customizable. Can bolus from phone or smartwatch. Can operate “open-loop” where the user must enact insulin delivery based on recommendations or “closed-loop” where modifications to insulin delivery are automatically delivered.
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.
Easy to Use
Difficult set-up but easy to use. Software makes most dosing decisions. Requires many parts. Can be difficult to set up.
Modern & no scanning required. Rechargeable and touchscreen pump. Sensor does not require scanning and sends minute-by-minute readings directly to the pump.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
Factory-calibrated sensor. Fingersticks needed for backup only.
Privacy
Discreet. Ability to give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available. *Medtronic pump has tubing. Omnipod is most hideable pump option (no tubes or separate controller needed).
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.