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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.
The twiist AID system was cleared by the FDA for use with CGMs that have received FDA designation as integrated continuous glucose monitors (iCGMs). As the twiist AID system gets closer to commercial availability, Sequel Med Tech will publicize the list of compatible CGM
*Recently FDA approved for people with type 1 diabetes ages 6 and up.
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.
twiist : Pump
Pump can be worn with a pump clip, adhesive patch or in a pocket.
twiist : Controller
Pump is controlled by the twiist app on an iPhone. Data from both the pump and CGM are viewable on the twiist app Home Screen.
Twiist : 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 delivery according to continuous glucose monitor (CGM) readings and predicted blood sugar levels. It is the first FDA-approved AID system with Apple Watch compatibility.
Affordability and Access
$$$$
Supplies can be covered for Omnipod or Medtronic pumps and Dexcom. Price range; $0-$8,574 to start and 0-$300/month. iPhone, app, and Riley link are not covered and must be set up independently. Riley link price range; $135-$165.
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
Data Monitoring Options
Data View Options
Yes
Data can be viewed on an iPhone.
Yes
Data is stored and can be viewed directly from the twiist app on the mobile device (iPhone), and can be linked to an Apple Watch for viewing data as well.
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 10-day sensor
Sensors last 10 days, and transmitters last 90 and work at 50ºF – 108ºF. The reservoir holds 300 units and is disposable, and the pump can be used for up to 3 years.
Vision / Auditory / Dexterity
NO text to speech
YES vibration alerts
A LOT of dexterity needed
YES 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.
Waterproof. The pump, when connected to the cassette, has a rating of IP28, indicating protection from continuous immersion in water. The pump can tolerate immersion to depths of up to 12 feet (3.7 m) for 1 hour.
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.
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
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 with an adhesive design that prevents the pump from catching on other objects.
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.
Customizable. Can bolus from phone, smartwatch, or directly from the device without needing to be attached to your phone. The device also directly measures the volume (amount) and flow (speed) of insulin delivered with every micro-dose
Easy to Use
Difficult set-up but easy to use. Software makes most dosing decisions. Requires many parts. Can be difficult to set up.
Watch compatible. The twiist AID system is the first FDA-approved AID system that can be directly controlled from an Apple Watch.
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. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)