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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
Good to have. Tried and true. Backup or day to day. Fingersticks required.
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
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
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
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.
Tidepool Loop : Controller
Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via insulin pump.
Device Details
Overview
Good to have. Tried and true. Backup or day to day. Finger-sticks required.
Tidepool Loop is the first fully interoperable automated insulin dosing app that originated as a patient-led initiative.
Affordability and Access
$$$$
Most accessible. Available over the counter at all Pharmacies. Price range; $0-$200/month depending on insurance coverage.
$$$$
Pump and CGM supply information is not yet available. iPhone is not covered and must be set up independently.
Data Monitoring Options
Limited Options
Data is available directly on the device. Some meters may be compatible with the Tidepool data management system.
Yes
Compatible with Tidepool - a web-based diabetes data management system.
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 on an iPhone.
Duration and Storage
Daily
Meters can last several years with battery changes/charging, they're used daily and work between 65ºF-86°F
Pump and CGM information not yet available.
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.
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
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.
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
Comfort
Meter supplies carried and requires visible blood.
Low-profile mobile app. Dosing and other adjustments can be done directly on the mobile app.
Easy Insulin Dosing
Limited features. No info on blood sugar trends.
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
Large display. Device typically has large display numbers for easier readouts, and it's very simple to operate.
Easy dosing. Software makes most dosing decisions easy to do on the fly.
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 give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available.