tidepool loop device
loop device v4

Summary

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.

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.

Components

Tidepool Loop  : Controller

Tidepool Loop : Controller

Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via insulin pump.

Loop : Pump

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

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

DIY Loop : Transmitter

RileyLink allows the pump and sensor to communicate. It is only required if a Medtronic pump is used.

Loop : Controller

Loop : Controller

Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via an Omnipod or Medtronic pump.

Device Details

Overview

Tidepool Loop is the first fully interoperable automated insulin dosing app that originated as a patient-led initiative.

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. 

Affordability and Access

$$$$
Pump and CGM supply information is not yet available. iPhone is not covered and must be set up independently.

$$$$
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.

Data Monitoring Options

Yes
Compatible with Tidepool - a web-based diabetes data management system. 

Yes
Compatible with Tidepool - a web-based diabetes data management system. 

Data View Options

Yes
Data can be viewed on an iPhone. 

Yes
Data can be viewed on an iPhone. 

Duration and Storage

Pump and CGM information not yet available. 

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.

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.

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. 

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 mobile app. Dosing and other adjustments can be done directly on the mobile app. 

Low-profile but extra device. Low profile/low maintenance sensor. The RileyLink is an extra device that must be carried.

Easy Insulin Dosing

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. 

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.

Easy to Use

Easy dosing. Software makes most dosing decisions easy to do on the fly.

Difficult set-up but easy to use. Software makes most dosing decisions. Requires many parts. Can be difficult to set up. 

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.

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).