libre2 tslim device
stelo sensor

Summary

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. 

Dexcom Stelo is the first over-the-counter low-profile, all-in-one glucose sensor/transmitter. This sensor lasts for up to 15 days and sends real-time glucose readings to a compatible smartphone app. No finger pricks or scanning is needed. 

*Recently FDA approved for people 18 years or older with type 2 diabetes. Expected availability is summer 2024.  

MARD of 9.2% 

Components

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.

N/A

Device Details

Overview

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.

Small all-in-one sensor/transmitter with a quick warm-up period and can be worn in multiple areas.

Affordability and Access

$$$$
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.

$$$$
No insurance coverage data. Pricing is to be announced in summer 2024. Price expected to be low to allow for over the counter distribution. 

Data Monitoring Options

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.

To Be Announced 

Data View Options

Yes
Data can be viewed directly on the pump screen or on the t:connect mobile app (available for both iOS and Android devices).

To Be Announced 

Duration and Storage

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. 

15 Days
Sensors last 15 days. They are purchased over the counter. Works at 50ºF – 108ºF

Vision / Auditory / Dexterity

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

YES text-to-speech
YES vibration alerts
3 sound sources
A LOT of dexterity needed

Patient Considerations

Active Lifestyle

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. 

Waterproof when submerged in 2.4 meters of water and must be within 20 (unobstructed) feet of the receiver or mobile device. This device is intended to help people with non-insulin requiring type 2 diabetes better understand their blood sugar numbers. 

Avoiding 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.

Very limited alerts. This device does not provide alarms and alerts for high, low, and rise/fall rates. This device is intended to track and understand the effects of food on blood sugar for people with type 2 diabetes.

Comfort

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

Low profile and low maintenance sensor application.

Easy Insulin Dosing

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.

No options. Stelo is intended for use by people with type 2 diabetes who do not require insulin to manage their blood sugar levels. 

Easy to Use

Modern & no scanning required. Rechargeable and touchscreen pump. Sensor does not require scanning and sends minute-by-minute readings directly to the pump.

Real-time data and alerts make dose adjustment easier.

Fewer Fingersticks

Factory-calibrated sensor. Fingersticks needed for backup only.

Factory-calibrated sensor. Finger sticks needed for backup only.

Privacy

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. 

Small sensor. Discreet and thin sensor that is easy to hide under clothing.