Meter
libre2 tslim device

Summary

Good to have. Tried and true. Backup or day to day. Fingersticks required.

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

Generic Meter : Lancets

Generic Meter : Lancets

Tiny needle called a lancet is used to poke the skin (on a finger or on your arm) to get a small sample of blood. The lancing device is packaged with the glucometer.

Generic Meter : Test Strips

Generic Meter : Test Strips

The strips work with the glucose meters to “read” blood sugar levels. One box of test trips usually contains between 25-50 single use strips.

Meter : Glucometer

Meter : Glucometer

The meter measures the amount of sugar in the small sample of blood that is placed on the disposable test strip. Most CGMs require testing blood sugar with a meter to calibrate the CGM device daily.

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.

Device Details

Overview

Good to have. Tried and true. Backup or day to day. Finger-sticks required.

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

$$$$
Most accessible. Available over the counter at all Pharmacies. Price range; $0-$200/month depending on insurance coverage.

$$$$
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

Limited Options
Data is available directly on the device. Some meters may be compatible with the Tidepool 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 may be viewed directly on the device. Some meters contain a built-in USB connection that allows information to be uploaded to a data management system. 

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

Daily
Meters can last several years with battery changes/charging, they're used daily and work between 65ºF-86°F

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
NO 
vibration alerts
A LOT of dexterity needed

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

Patient Considerations

Active Lifestyle

Must pause activity to check blood sugar.

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

Less data. Meters don't give as much blood sugar data as sensors do and require a high level of engagement and effort to avoid 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.

Comfort

Meter supplies carried and requires visible blood.

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

Easy Insulin Dosing

Limited features. No info on blood sugar trends.

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

Large display. Device typically has large display numbers for easier readouts, and it's very simple to operate.

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

Frequent fingersticks are unavoidable.

Factory-calibrated sensor. Fingersticks needed for backup only.

Privacy

No attached device for blood glucose monitoring. 

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.