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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
Inhalable regular human insulin. Cartridges come in three doses: 4, 8, and 12-unit doses.
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
Afrezza : Inhaler
Small refillable inhaler contains a compartment for powdered insulin containing cartridges.
Afrezza : Cartridge
Cartridges come in three doses: 4, 8, and 12-unit doses. All color coded.
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
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
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
An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.
Device Details
Overview
Nothing on the body when not in use. Visible when dosing.
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
$$$$
Widely covered. Price range; 0-$99/month, depending on insurance coverage. $35/month for medicare and commercial insurance plans.
$$$$
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
No 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.
Data View Options
No 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).
Duration and Storage
10 Days
Open cartridges last up to 10 days. Sealed cartridges may be stored in a refrigerator at 36°F - 46°F until the expiration date.
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
LITTLE dexterity needed
NO text to speech
YES vibration alerts
A LOT of dexterity needed
Patient Considerations
Active Lifestyle
Body free of devices. Does not remain attached to the body.
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
Very short-acting. Absorbs quickly through the lungs to correct high blood sugar but requires attention to prevent 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
Many components. Have to carry multiple cartridges that can be bulky.
Low profile. Low profile/low maintenance sensor. Small tubed pump with the most infusion sets to pick from.
Easy Insulin Dosing
Less precise but easy dosing. Dosing may be less precise due to the inhaled method of dosing, but color-coded cartridges make dosing easier. Dosing can also be done based on small, medium, or large meals and can be administered 1-2 hours post meals.
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
Simple design. Whistle-like device for inhaling insulin.
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 finger-sticks are required.
Factory-calibrated sensor. Fingersticks needed for backup only.
Privacy
Hideable. Small, discreet, and portable device that's not as noticeable as injections.
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.