medtronic receiver v2
tidepool loop device

Summary

The Medtronic Guardian Connect is a continuous glucose monitoring (CGM) system that provides real-time glucose data on a compatible smartphone. The system offers optional low and high blood sugar notifications and can be inserted on the abdomen or back of the upper arm.

 

MARD of 9.6%

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

Guardian Connect : Sensor

Guardian Connect : Sensor

Sensor is inserted underneath the skin, either on the abdomen or arm. Push buttons applicator allows sensor to be placed on the body in one step.

Guardian Connect : Transmitter

Guardian Connect : Transmitter

Seashell-shaped with built-in Bluetooth capability that allows it to send glucose data directly to a smartphone every 5 minutes.

Guardian Connect : Receiver

Guardian Connect : Receiver

Trends and alerts are viewed directly on a mobile device. Available for both iOS and Android devices.

Tidepool Loop  : Controller

Tidepool Loop : Controller

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

Device Details

Overview

One of the larger sensors, may be cumbersome to wear on some parts of the body under clothes.

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

Affordability and Access

$$$$
Sometimes covered. The costs vary depending on individual insurance coverage and how insurance classifies CGMs. Price range $0-$600/month.

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

Data Monitoring Options

Yes
CGM data can be linked to a CareLink account and shared with the user's health care team. 

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

Data View Options

Yes
The Guardian Connect mobile app allows users to view glucose levels, trends, create customizable alerts, and share blood glucose data with family and friends. 

Yes
Data can be viewed on an iPhone. 

Duration and Storage

7 Days
Sensors last 7 days, and transmitter battery needs weekly charging and replacement once a year. Both can be stored between 36°F - 86°F.

Pump and CGM information not yet available. 

Vision / Auditory / Dexterity

YES 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

Waterproof transmitter when submerged in up to 2.5 meters of water for 30 minutes and must be within 20 feet of a connected mobile device.  

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

Measures sensor glucose 24/7 and sends alerts when a high or low is detected. Trend arrows show the direction glucose is heading, with the rate of change. 

Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.

Comfort

More tape is needed for Medtronic sensors.

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

Easy Insulin Dosing

Sensor trends can be used for dose adjustment.

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

Rechargeable sensor transmitter but has the most steps to change sensor.

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

Fewer Fingersticks

2 daily finger-sticks are needed to calibrate the sensor.

Factory-calibrated sensor. Fingersticks needed for backup only.

Privacy

Somewhat discreet. Ability to see sugar on watch or phone. Sensor requires regular meter use.

Discreet. Ability to give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available.