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The Latest Blood Glucose Management Tools and Products

Date Posted: Monday, June 27, 2022

New insulin pumps, infusion devices, continuous glucose monitors (CGM) and smartphone apps continue to hit the market. The latest technology offers various options for people living with Type 1 and Type 2 diabetes, depending on needs and preferences. The following information is provided for education purposes only. The content does not represent endorsement of any vendor or product.

Continuous Glucose Monitors (CGM)  

Continuous glucose monitors are constantly improving. The latest technology offers various options and benefits including alarms for highs and lows. Many of our patients, with both Type 1 and Type 2 diabetes, have experienced drastic improvements to their blood glucose control by starting to use a CGM.”

Cheryl Barry, RN, MS, CDCES, Diabetes Education Manager at the UMass Memorial Diabetes Center of Excellence.

Dexcom G6

This patch device gets applied to the skin of the abdomen. It contains a small sensor that continuously measures blood sugars and transmits real-time data every five minutes to most smartphones or to a Dexcom receiver. It doesn't require finger stick calibration, and sounds an alarm when readings go too high or low. The sensor integrates with the t:slim X2 and Omnipod 5 insulin pumps (described below). When integrated with an insulin pump, a decrease in sensor glucose will automatically trigger either a reduction or cessation of basal insulin from the pump. The G6 device should be replaced every 10 days.  

After successful temporary authorization throughout the pandemic, the FDA decided to allow Dexcom G6 CGMs to be used permanently in hospitals to monitor blood sugars.

Coming soon: The Dexcom G7 is awaiting FDA approval.  It will be smaller & disposable and the transmitter will be built into the sensor.

FreeStyle Libre 14 Day System

This 14-day wearable device allows for frequent blood sugar checks without finger sticks. It measures glucose levels every minute. Using most smartphones or the provided reader device, users of the 14-day system swipe/scan over a small sensor worn on the arm. The 14-day sensor is useful for people who prefer not to receive alerts for highs or lows. This CGM is not integrated with an insulin pump.  The smartphone app allows data to be shared with family and care team members. 

FreeStyle Libre 2

The FreeStyle Libre 2 system includes the same features as the FreeStyle Libre 14-day system, plus it offers optional, real-time glucose alarms that prompt the user to scan for a real-time reading. The optional alarms warn about highs, lows and urgent lows of 55 or below.    

Coming soon: The FDA has cleared the FreeStyle Libre 3 system for people with diabetes aged 4 years and older. According to a press release from the manufacturer, Abbott, it will be the smallest and thinnest sensor developed to date with higher accuracy than its predecessors. 

Sugar.IQ Machine-Learning

This downloadable app is a “diabetes assistant” for Medtronic’s stand-alone Guardian Connect CGM, without an insulin pump. It recognizes patterns and provides individualized tips to help users keep blood sugars within target range. Medtronic states it can predict high or low glucose excursions up to 60 minutes in advance.

Insulin Pumps

Some insulin pumps automatically adjust background (basal) insulin based on sensor glucose readings to prevent both hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar).

t:slim X2 Insulin Pump with Basal-IQ or Control-IQ Technology

This touchscreen insulin pump integrates with the Dexcom G6 CGM to predict and help prevent hypoglycemia without finger sticks. Free upgrades are available to download using a personal computer. There may be a charge for some.

Tandem Diabetes describes their Basal-IQ technology as a predictive low glucose suspend feature designed to help reduce the frequency and duration of low blood sugar.

The Control-IQ closed loop feature predicts and automatically adjusts basal rates. It also makes hourly correction boluses to help prevent hyperglycemia.

Tandem's t-connect mobile app currently displays your insulin pump screen on your smartphone, showing current glucose and insulin on board. Data automatically uploads to t-connect so your care team can access it during office visits or if you call with a question.

First FDA Approved Smartphone App to Program Insulin Delivery 

The Food and Drug Administration cleared the t:slim X2 phone app for both iOS and Android to be used to deliver insulin. Users will be able to program or cancel bolus doses of mealtime insulin using a smartphone.  Tandem plans to launch the new bolus delivery update for select users this spring before a wider launch during the summer.

MiniMed 770G Hybrid Closed Loop System

This device is approved for Type 1 diabetics who are seven years and older. The system delivers basal insulin every five minutes and constantly self-adjusts to help avoid highs and lows. It features Medtronic’s SmartGuard technology and the Guardian Sensor 3, their most accurate CGM to date. It connects directly to compatible smartphones allowing users to view blood sugar trends and insulin delivery status. The smartphone app automatically shares data with your care team. Family and friends can also view data using the app.

OmniPod DASH

This tubeless, waterproof wearable pod provides up to 72 hours of non-stop insulin and works with a touch-screen Personal Diabetes Manager (PDM) that looks like a smartphone. It’s now covered by pharmacy benefit with many insurance companies, including Medicare, as opposed to traditional Durable Medical Equipment (DME) coverage.

Omnipod 5

The U.S. Food and Drug Administration (FDA) recently (February 2022) approved the Omnipod 5 Automated Insulin Delivery System for individuals ages six and older with Type 1 diabetes. It integrates with the Dexcom G6 CGM and compatible smartphones to automatically adjust insulin and help protect against highs and lows.

Other Insulin Delivery Devices

InPen by Companion Medical

This “smart insulin pen” is a reusable injector that interacts with smartphones. The ½ unit refillable pen helps to calculate doses and also keeps track of injection data. Based on information input by the user, it calculates dosages based upon insulin-to-carb ratios, meal size or number of servings.

This is an option for people who take multiple daily injections but don't want to wear an insulin pump. It can also be used as a pump backup or by those who want to take a pump break.

Ergonomic Pen Needles by BD

The BD Nano 4mm pen needle was the smallest, thinnest pen needle, designed for comfort. Its improved insulin flow through the needle made it simple to use, even for people with hand-strength challenges. The Nano 2.0 concentrates and distributes force to allow better depth for insulin absorption and less pain. BD says the 2nd generation redesign makes the device even easier to use and provides a more comfortable injection experience.

V-Go Insulin Delivery Device 

A patch pump for people with Type 2 diabetes who require multiple daily injections. Medicare covers the V-Go under Part D, and "disposable patch-like devices" are included in the American Diabetes Association’s Standards of Care for Type 2 diabetes. MannKind Corporation recently acquired V-Go from Zealand Pharma

CeQur Simplicity Patch

A three day wearable patch that delivers injection-free mealtime insulin. One click delivers two units of rapid-acting insulin for on-demand meal dosing and bolus correction. Users must still take basal insulin in addition.

Glucagon Delivery Devices

Glucagon is the standard of care for treating severe hypoglycemia (low blood sugars). A standard mix kit has been the only source of glucagon for decades, but now there are alternative products available. 

Gvoke HypoPen Glucagon Injection 

An EpiPen-style glucagon rescue pen by Xeris Pharmaceuticals. It's available by prescription to treat very low blood sugar (severe hypoglycemia) in adults and children with diabetes ages 2 years and above.  

BAQSIMI Nasal Glucagon

This nasal glucagon by Lilly is another way to treat severe low blood sugar. Dry powder is sprayed into the nose using a portable, single-use, ready-to-use device. It's approved for ages 4 and older.

Zealand Pharma's HypoPal Auto-Injector Glucagon Rescue Pen

Currently available as either an auto-injector (like an EpiPen) or a prefilled syringe as a stable ready-to-use rescue treatment for severe hypoglycemia.

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