The Latest Blood Glucose Management Tools and Products
Date Posted: Wednesday, February 01, 2023
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 during the pandemic, the FDA now permanently allows Dexcom G6 CGMs to monitor blood sugars in hospitals.
Coming soon: The G7 has been cleared by the FDA and will soon become commercially available. It's 60% smaller than the G6, promises greater accuracy and easier insertion.
FreeStyle Libre 2
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 swipe/scan over a small sensor worn on the arm. It gives the option to turn on alerts for high and low glucose levels. It has an alarm for urgent lows (55) that cannot be turned off. This CGM is not integrated with an insulin pump. The smartphone app allows data to be shared with family and/or care team members.
FreeStyle Libre 3
This 14-day sensor is available for ages 4 and older. It’s smaller, easier to set up and more accurate compared to past models. The Libre 3 offers real time readings and can only be used with a smartphone app. It does not have a separate receiver. Medicare does not cover this device.
Eversense 3
This sensor gets implanted into the upper arm by a physician. It must be changed every 180 days. The system includes the implantable sensor, a transmitter worn above where the sensor is implanted, and a phone app. The transmitter needs to be charged daily and must be calibrated with a fingerstick. It’s approved for ages 18 and older.
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 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 upgrades.
The Control-IQ closed loop feature predicts glucose levels 30 minutes ahead (using the Dexcom G6) and automatically adjusts basal rates to prevent both hyper and hypoglycemia. It can also give an automatic micro correction bolus every hour.
Tandem's t-connect mobile app displays your insulin pump screen on your smartphone, showing current glucose and insulin on board. The updated version allows you to administer a bolus from your phone. 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.
MiniMed 770G Hybrid Closed Loop System
This device is approved for people with type 1 diabetes 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.
Coming soon: Medtronic’s 780G has been filed with the FDA but is not yet approved.
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 covered by pharmacy benefit with many insurance companies, including Medicare, as opposed to traditional Durable Medical Equipment (DME) coverage.
Omnipod 5
This tubeless automated insulin delivery system is approved for ages two and up with type 1 diabetes. The pump integrates with the Dexcom G6 CGM and compatible smartphones to automatically adjust insulin based upon a predicted glucose level in 60 minutes and helps protect against highs and lows. The pump is controlled by either a separate controller device or select smartphones.
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.
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). Lilly’s standard mix kit was the only source of glucagon for decades, but is no longer available. It has been replaced by the following products.
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 and up.
BAQSIMI Nasal Glucagon
This nasal glucagon by Lilly treat severe low blood sugar by spraying dry powder into the nose using a portable, single-use, ready-to-use device. It's approved for ages 4 and up.