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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
Insulin pens make insulin delivery more convenient than traditional vial/syringe options. Pens are small, portable, and more discrete to use in public.
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
Insulin Pen : Bolus Insulin
Bolus (fast-acting) insulin pen for meal time or high blood sugar correction.
Insulin Pen : Basal Insulin
Basal (long-acting) insulin pen for steady release of insulin that helps control blood sugar between meals, and overnight.
Insulin Pen : Needles
Disposable needle attaches to insulin pen for daily injections.
Tidepool Loop : Controller
Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via insulin pump.
Device Details
Overview
Nothing on the body when not in use. Noticeable when dosing.
Tidepool Loop is the first fully interoperable automated insulin dosing app that originated as a patient-led initiative.
Affordability and Access
$$$$
Widely covered for insulin-dependent type 1 and 2. Price range; 0-$1260/month depending on insurance coverage.
$$$$
Pump and CGM supply information is not yet available. iPhone is not covered and must be set up independently.
Data Monitoring Options
No Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
Data View Options
No Options
Yes
Data can be viewed on an iPhone.
Duration and Storage
28 Days
Can be kept at room temperature (not above 80º F) when in use for 28 days. Unopened insulin pens should be stored in the refrigerator (36ºF - 46ºF).
Pump and CGM information not yet available.
Vision / Auditory / Dexterity
NO text to speech
NO vibration alerts
A LOT of dexterity needed
NO text to speech
YES vibration alerts
A LOT of dexterity needed
Patient Considerations
Active Lifestyle
No attachments to the body. Insulin pens are easy to use and do not remain attached to the body, allowing for a flexible and 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.
Avoiding Highs and Lows
Limited customizability. Pens require manual dose adjustment and limit the ability to adjust basal insulin throughout the day.
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
Comfort
Many components. Have to carry pen and pen needles but nothing attached to the body.
Low-profile mobile app. Dosing and other adjustments can be done directly on the mobile app.
Easy Insulin Dosing
More precise than syringes. Ability to measure doses using a dial, increasing accuracy.
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
Simple but many steps. Attach a new needle, dial the correct dose, inject, and dispose of needle.
Easy dosing. Software makes most dosing decisions easy to do on the fly.
Fewer Fingersticks
Frequent finger-sticks are required.
Factory-calibrated sensor. Fingersticks needed for backup only.
Privacy
Hideable. Pens can be hidden when not in use but visible when in use. Frequent injections are unavoidable.
Discreet. Ability to give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available.