The Wall Street Journal recently featured a story that explains why and how more U.S. diabetes patients are using continuous glucose monitors (CGM) to track their blood sugar. Almost 840,000 patients in the U.S. used the devices as of March 31, more than double the 389,000 using them at the end of 2017, according to Seagrove Partners LLC, a health-care research and consulting firm. The Journal's article has a great diagram showing how CGM works and talks about the importance of this technology to improve quality of life for many people with diabetes.
Medtronic's next-gen hybrid closed loop system will be the Minimed 780G, designed to help patients enjoy greater freedom and less burdens. Currently, the 780G is being studied in an in-home trial with 350 adult and pediatric patients with type 1 diabetes participating, using the device over a three-month period. The in-home study is estimated to be completed in January of 2020, with the results presented in July, 2020.
What should you expect from the new Medtronic system?
New vertical "modern" look
Automatic correction bolusing
A new algorithm, that according to Medtronic is more accurate and reliable
A function to automatically adjust for missed meals
Adjustable target range, down to 100 mg/dL
Option for remote software updates
Stay tuned for a launch date and other news on the Minimed 780G!
This month has been full of diabetes tech news as many manufacturers revealed product updates and research at the ADA 2019 Conference in San Francisco. For a great summary article from Diabetes Mine, check this out.
At the conference, Dexcom highlighted their upcoming next-gen G7 updates. Being developed with Verily, the next-gen G7 product will:
Have a faster warm-up time than the current G6 startup window
Include extended wear time of 14-15 days
Offer a fully-disposable, all-in-one sensor-transmitter with a smaller on-body footprint
Provide a dramatic cost reduction and more accuracy and reliability
Allow direct Bluetooth-to-smartphone communication
Dexcom's slating this for later 2020 with a limited launch at first, and then rolling it out more broadly across the U.S. and internationally in 2021.
Starting last week, FreeStyle LibreLink is now available for Android phones, as well as compatible iPhones. FreeStyle LibreLink is a mobile app that enables compatible Android and Apple phones to scan a sensor and display glucose data and trends, including:
Current glucose reading
Up to eight hours of glucose history
With a quick scan over the sensor, you will have glucose readings anytime and anywhere. You can download the new Android app here.
Learn more about the FreeStyle Libre continuous glucose monitoring (CGM) system by checking out these previous blogs:
This week at the American Diabetes Association (ADA) Annual Meeting, Medtronic announced real-world data on its Guardian Connect continuous glucose monitoring (CGM) system and Sugar.IQ diabetes assistant app. The Guardian Connect system and Sugar.IQ app empower people using multiple daily injections (MDI) to more proactively manage their diabetes with meaningful, personalized insights. The real-world data was recorded by users of the Guardian Connect CGM paired with the Sugar.IQ.
Sugar.IQ diabetes assistant is a separate app that continually analyzes how an individual's glucose levels respond to food intake, insulin dosages, daily routines, and other factors. The Sugar.IQ app combines data from the Guardian Connect CGM system with artificial intelligence technology from IBM Watson Health to detect important patterns and trends for people with diabetes and help them make more informed decisions on how to better manage glucose levels and stay within target range.
The data showed that people using the Guardian Connect system with the Sugar.IQ app experienced 4.1% more Time in Range (63.4%) compared to Guardian Connect alone (59.3%), which represents about one extra hour per day. And those who also used the optional Glycemic Assist feature to review their response to specific foods increased Time in Range by an additional 4% compared to those not using that feature.
Learn more from the official Medtronic press release.
The diabetes community is excited about positive results from two Tandem studies that were announced earlier this week. Data from the studies has demonstrated that Tandem's advanced hybrid closed-loop system has achieved the primary outcome of increasing time in range (70-180 mg/dL) without any severe hypoglycemic events for both adult and pediatric age groups.
Tandem's t:slim X2 insulin pump with Control-IQ technology utilizes Dexcom G6 continuous glucose monitoring (CGM) sensor values to predict glucose levels and adjust insulin delivery to prevent highs and lows, while still allowing the user to manually bolus for meals. The system also automates correction boluses, a feature not commercially available today on automated insulin delivery devices.
Read the entire press release for many more details on the studies and outcomes. This news supports Tandem as the company moves toward a future FDA approval on their closed loop system, expected later this year.
Insulet's Omnipod DASH is now officially available in the United States. The Omnipod DASH™ System combines a tubeless, waterproof, wearable Pod that provides up to 72 hours of non-stop insulin with an easy-to-use, touch-screen, Bluetooth®-enabled Personal Diabetes Manager (PDM) that looks like a normal smartphone. The Pod can be worn anywhere you would administer an injection. Placement is easy, completed with the touch of a button and without even seeing a needle. The DASH system is available with limited release right now, and Healthy Living anticipates providing the system at the end of this year or early in 2020.
There are two components to the DASH system.
The Pod is a small, waterproof device that you fill with insulin and wear directly on your body.
The Pod includes a small, flexible cannula that inserts automatically with the push of a button.
The Pod communicates wirelessly with the Personal Diabetes Manager (PDM) to program insulin delivery.
The Personal Diabetes Manager (PDM):
Multiple PDM features support how you control your insulin.
The system includes two mobile apps and accompanying widgets.
Compatibility with other systems simplifies the tracking and recording of data.
Beyond Type 1 addresses the updates in the Omnipod DASH system:
What’s New in the DASH™ System?
Updated PDM (Personal Diabetes Manager) – The handheld portion of the Omnipod Insulin Management System got an update and will feature a color touchscreen display.
Bluetooth wireless technology – DASH™ PDM and Pod will communicate via Bluetooth, laying the groundwork for current and future integrations with compatible technology – like meters, CGM, and management apps.
Meter integration – DASH™ will be optimized for use with CONTOUR® NEXT ONE Blood Glucose Meter for the transfer of blood glucose readings to the PDM’s bolus calculator via Bluetooth – The PDM will no longer have a built-in BGM.
Diabetes management app integrations – The Omnipod Display and Omnipod View apps will provide users and their caregivers easy access to their insulin therapy information on their smartphones.
Omnipod DISPLAY allows users to discreetly monitor their PDM data on their smartphones.
Omnipod DISPLAY on a smartphone will include a “Find My PDM” feature.
Omnipod VIEW allows parents and caregivers to monitor their loved ones’ diabetes more easily.
The iOS Today View widget allows users and their care teams to see their or their loved ones’ PDM and continuous glucose monitor (CGM) data on one smartphone screen with one swipe.
New Pods – The DASH™ pods will look and work the same, but have been updated for Bluetooth compatibility with the DASH™ PDM. Old pods will not work with the new PDM.
Rechargeable Battery – The DASH™ PDM will require recharging of its lithium ion battery, replacing the AAA batteries used in current Omnipod PDMs.
Payment Structure – The DASH™ PDM will be offered at no cost with the purchase of Pods.
With the Dexcom G6 and G5 mobile apps, you can know your number with a quick glance at your smart device (no need to carry an extra receiver!). Trend lines show where your glucose levels are heading and how fast they're getting there, so you can take action when needed for better diabetes management. You also have the ability to share your glucose readings with loved ones and caregivers.
If you have a new device or are just getting started with a Dexcom CGM, you may wonder what devices and software are compatible with Dexcom apps. Find out here.
In early April, Medtronic entered into a "value-based outcomes agreement" with Blue Cross Blue Shield of Minnesota, and the two organizations have agreed to use a metric other than the gold standard A1C test to measure members' success using the device. A Medtronic spokeswoman recently told Diabetes Mine that Guardian Connect has become the first-ever stand-alone CGM using "Time in Range" as the key metric. Many advocates and innovators in the diabetes community have been pushing to move "beyond A1C.”
Medtronic's press release about their "Time in Range" metric explains:
"Time in Range (TIR) is a standard measurement in diabetes management that tracks the amount of time a person’s glucose is in their target range with 70-180 mg/dL being the standard range. Spending more Time in Range helps minimize both short- and long-term health complications from going too high or low. Results from an analysis of people who used the predictive alerts feature on the Guardian Connect system showed that they experienced fewer high events 39 percent of the time (vs. 10% without alerts) and fewer low events 60% of the time (vs. 33% without alerts)."
Medtronic also has been promoting their Time in Range infographic:
Diabetes Mine explained how Medtronic's reimbursements will work with Blue Cross Blue Shield:
"With Blue Cross Blue Shield, they are actually tying insurance payments to the amount of time users spend in this healthy glucose range -- an approach known as "value-based payments." So if a Medtronic CGM user does not manage to stay in that ideal 70-180 mg/dL range for a certain amount of time when using the device, then Medtronic will actually pay back the cost to the insurance company."
The Senseonics Eversense CGM recently received FDA approval and is in the process of launching in the United States (it's already up and running in Europe). It has been designed to be the first ever CGM with an implantable sensor that lasts up to 90 days. The Eversense System consists of a fluorescence-based sensor, a smart transmitter worn over the sensor to facilitate data communication, and a mobile app for displaying glucose values, trends and alerts. While being light, discreet, and comfortable to wear, the system’s smart transmitter interprets glucose data from the sensor and sends it to the system’s mobile application via Bluetooth, so patients can review their glucose data to help them make daily diabetes decisions.
The Eversense Long-Term Continuous Glucose Monitoring (CGM) System offers many new benefits:
No weekly sensor self-insertions: With Eversense, a trained health care provider numbs the area and places the sensor in the upper arm and you’re good to go for up to 3-months.
Quickly detects glucose highs and lows: In clinical studies, the Eversense system detected 95% of hypoglycemic episodes (70 mg/dL) and 99% of hyperglycemic episodes (180 mg/dL) within 15 minutes.
Alerts you can see, feel, and hear: The Eversense CGM System can be configured to provide three types of alerts - visual, auditory, and on-body vibe alerts, which can provide you with an additional safety advantage, even during sleep.
Discreet and flexible: The smart transmitter, with its low profile and flexibility to remove and reattach without wasting a sensor, enables a greater level of discretion.
Learn more here.
Eversense CGM Reviews
Check out this article from Beyond Type 1 with reviews from two people with T1D who have tried out the Eversense. They both have a lot of insight about the nuances of using the Eversense. For example, I learned about the advantages of the adhesive: "The adhesive is by far the main differentiator of the Eversense from their competition – this was easily the best thing for me. Because the sensor is fully below the skin, the transmitter adhesive can be changed as often as you like. Each adhesive patch lasts a day and can be peeled off and stuck right back on multiple times per day. Because the adhesive only has to last a day, it is completely hypoallergenic. Technically, you can stick the transmitter on however you like – while at work once, I ruined my Eversense patch and just stuck the transmitter back using materials from an office first aid kit!"
Definitely check out the article for more practical knowledge about using the Eversense.
Continuous glucose monitoring (CGM) brings many people with diabetes better insight into what is happening with their blood sugar levels in the present and over time, with a lot less hassle. A CGM is a small, wearable device system that tracks glucose throughout the day and night. Some systems notify users of highs and lows so they can take action when needed. All systems substantially minimize the need for fingerpricking.
The top CGM systems on the market right now are the Dexcom G6, the FreeStyle Libre 14-Day System, and the Medtronic Guardian Connect CGM. Each system offers a unique set of benefits, but here are some of the best benefits of CGM overall:
Better insight into blood glucose trends
Small and discreet sensors
Smartphone apps to track blood glucose levels
Alarms and alerts, especially helpful when struggling with nighttime lows
Remote monitoring of CGM data from a smartphone, ideal for pediatrics
Get started with CGM by calling the Healthy Living CGM Therapy Team at 866.779.8512 (Option 2) or texting us at 248.577.9903. We will give you a free benefits check to help you understand your coverage and walk you through the next steps, even contacting your doctor's office for you. From start to finish, a CGM enrollment will take commercial and Medicare members roughly 1-14 days, depending on the turnaround on paperwork from the doctor's office.
Are you thinking about a CGM and looking for more info about different systems? Sysy Morales from Diabetes Daily reviewed the FreeStyle Libre in an article called "Why I'm Loving the FreeStyle Libre 14 Day System." Our blog will include some highlights of her review.
"The FreeStyle Libre 14-Day doesn’t include alarms like the popular Dexcom CGM systems but it is less expensive and so possibly more accessible for many people...For my daughter, I want the system with alarms, of course, and the FreeStyle Libre 14-Day system is not approved for anyone under 18 right now, anyway."
"Being mechanically inept, I got nervous when following the instructions on how to insert the sensor but I managed it successfully…if you’re worried about it sticking I’d get two alcohol swabs and rub, rub, rub, letting the area fully dry before applying."
"What I didn’t realize for about one week is that the graph on the reader shows you what your blood glucose has been in the hours before your last finger stick so you can see what your blood sugar has been doing and if you’re trending up or down or hanging steady."
Nice for those Annoyed by Alarms
"The alarms with the Dexcom G6 were so incredibly helpful for keeping tight glucose management but also a bit jarring during times of stress...[with the Libre] I could check as often as I wanted and look at my graph and feel very much in the know without having something dictating when I would do that."
No Bleeding in Public!
"I’m still sensitive to how I come off to others despite how hard I’ve worked at this over the years. Doing a finger stick check in front of people in a public setting, while I’ve done it thousands of times, still makes me uncomfortable...I also hate checking in places that gross me out, too."
"I got the ‘check blood glucose’ symbol about 5 times over the two-week period so I checked my blood sugar those times. My blood sugar was within 30-40 points of what I was getting from the FreeStyle Libre 14-Day system. I also checked a few other times with a finger stick just to assess accuracy. Those times my blood sugar reading was always within 10 points of the FreeStyle Libre 14-Day system. So I felt comfortable dosing off of it but did pay attention and look out for the symbol indicating a finger stick was needed."
Easy to Wear
"While I didn’t have problems with the size and weight of the Dexcom G6 sensor, I found the FreeStyle Libre 14-Day sensor even easier to wear. It’s pretty flat and while heavy, the smooth, circular shape, in my opinion, helps keep it on and feeling balanced. I forgot I had it on."
For Morales's entire review, click here.
To find out more about getting started with a FreeStyle Libre or other CGM system, including a free benefits check, contact our CGM Therapy Team at 866.779.8512 (Option 2) or 248.577.9903 (text).
Researching your pump options? Here are some helpful tools from Tandem and Medtronic to help you understand the benefits of different insulin pumps on the market.
t:simulator App from Tandem
With the App, you can experience the touchscreen interface of the Tandem t:slim X2 Insulin Pump with Basal-IQ Technology using a smartphone or tablet. You can also enable "Tool Tips" for a tour of the pump's key features. The App provides info about the pump's technical specifications and access to a glossary of common terms for better understanding.
Download the t:simulator App at the bottom of this page.
MiniMed 670G System Simulator from Medtronic
This application provides step-by-step instructions on the different features of the 670G and 630G insulin pumps. There are training resources for both systems and the capability to explore the insulin pump through different functionality scenarios. You will find device feature videos that give more info about the Auto Mode and Suspend Before Low features.
Download the MiniMed System Simulator through Google Play or on the Apple App Store.
This year, Dexcom (founded in 1999) celebrates its 20th birthday! Over 20 years, Dexcom has brought us groundbreaking technology, and there are many changes, including growth and expansion, on the horizon. Read more at the Diabetes Mine blog "Dexcom Hits 20-Year Birthday with Exciting New Tech, Corporate Restructuring." According to the Diabetes Mine article, these are the...
Six New Changes to the Dexcom G6 App for Apple
Siri Assist – You can now ask Siri to read Dexcom G6 glucose readings aloud and display graphs directly on the lock screen.
More Followers – With an expanded Dexcom SHARE function, you can now share glucose readings with up to 10 people (in the past the max was five).
24-hour Sensor Expiration Reminder – The app now offers an automatic 24-hour reminder before it’s time to replace a sensor, in addition to the existing 2-hour and 6-hour reminders.
CLARITY App at Your Fingertips – You can now launch the Dexcom CLARITY app directly from the Dexcom G6 app for more retrospective glucose reports, rather than having to exit the G6 app and go into the separate CLARITY app.
Extra Integration – They've also added a feature allowing Google Fit to display Dexcom G6 data on a three-hour delay (this lag is a regulatory hurdle being discussed with FDA).
Apple Watch Feature – Users can also add an icon to check their glucose level when customizing the face of their Apple Watch Series 4. Unfortunately, Dexcom doesn't yet allow for direct-to-watch functionality; you still need the smartphone as the middleman between the CGM and Apple Watch.
When we learn more and dig a little deeper, we often come out with better understanding and more compassion. Jennifer, a business development team member with Healthy Living, is trying out the Freestyle Libre CGM for 14 days to help all of us better understand the technology and the patient experience using the sensor and reader. This is similar to the Healthy Living Wear-a-Pump Challenge from a couple of years ago when several team members lived life using an insulin pump for a week! We are excited to hear what Jen will learn from her firsthand experience with the Freestyle Libre CGM system. Learn more about the Freestyle Libre and how to get started.
Many more choices for insulin pumps and CGM are becoming available to Medicare members as diabetes technologies continue to progress. And even more exciting, many companies are starting to work together more closely to integrate their separate insulin pump and CGM systems to create even greater advancements. In today's post, we want to point out the benefits of combining the Tandem t:slim X2 insulin pump with Dexcom continuous glucose monitoring (CGM) for better diabetes management.
The t:slim X2 pump can be upgraded when new technologies and features become available.
For example, Medicare members who qualify can currently access the Dexcom G5 CGM system, and we anticipate the more advanced Dexcom G6 system will be available to Medicare members on April 1st. If a patient is currently using the t:slim pump with a G5 system and upgrades to using the G6 system, all the patient will need to do is update his or her t:slim X2 pump with the latest software OR if they already have the t:slim pump with Basal IQ, they can integrate their Dexcom G6 after viewing a brief online training video. This ability to upgrade the insulin pump's software is unique to Tandem systems.
Medicare members are eligible for a new pump every five years, and in that time span there can be many advancements in diabetes technologies that can potentially leave a user behind on newer, beneficial improvements.
As we mentioned, with the Tandem t:slim pump, a Medicare member can easily update the pump to keep it current with the latest technology. This will soon prove a great benefit as we anticipate Tandem to release their "Control iQ" feature within the year. This will allow the pump, when paired with the Dexcom G6 system, to autonomously deliver more insulin when blood glucose levels are high.
The Tandem t:slim is an easy-to-read, color touchscreen pump - and it is super easy to use.
Want to try it out for yourself? Tandem offers a free simulator app for Medicare members to install on iPhone or Android devices right now. This simulator app provides users with the opportunity to test the experience of using the pump along with the Dexcom G6 system before deciding to make the purchase.
Learn more about the Dexcom G6 CGM system here.
The Tandem t:slim X2 has been approved by the U.S. FDA as an "interoperable" insulin pump. An interoperable pump can be used with different components that make up diabetes therapy systems, allowing patients to tailor their diabetes management to their individual device preferences, which opens up huge future possibilities for closed-loop systems and other management technologies. In 2018, the Dexcom G6 was designated the first interoperable continuous glucose monitor by the FDA.
Read the full press release from the FDA here.
The Future of Tandem
In November, Diatribe wrote a fantastic article about what's on the horizon for Tandem, including the Control-IQ hybrid closed loop, the "interoperable" pump designation, the t:connect mobile app, and the t:sport patch pump with hybrid wear.
Significantly lower cost - for greater accessibility
Fully disposable with no separate transmitter - after sensor wear is complete, the entire piece is thrown out and replaced
No fingersticks - like the Dexcom G6
Extended wear - approximately 14 days
Sends data straight to Smartphone - via Bluetooth
This information came from the diaTribe blog. According to diaTribe, "This sensor will be made widely available to people with diabetes who are on intensive insulin therapy (pumps or multiple daily injections) and those with type 2 diabetes on pills or no medication."
This is an exciting technology to look forward to for better diabetes management for more people. We'll keep you in the loop as more news emerges from Dexcom. To learn more about CGM options available today, call us at 866.779.8512, Option 2.
This sounds stupidly easy. But it’s so effective. And looking at my pump, I can see how many times it kicks Basal IQ into action so I can continue to exercise, or snuggle my kid, or drive my car, or sleep. You know, basic stuff that humans do. – Kerri, six until me
Tandem Basal-IQ Technology is wowing all around. Available as part of the t:slim X2 Insulin Pump and integrated with the new Dexcom G6 CGM, Basal-IQ Technology predicts and helps prevent lows, suspending insulin delivery before they happen. Expect less time low: there was a 31% relative reduction overall in sensor time below 70 mg/dL when clinical study participants used Basal-IQ Technology. Zero fingersticks are required for mealtime dosing or calibration when using Dexcom G6 Continuous Glucose Monitoring.
The X2 pump is discreet and easy to use. It features a large, color touchscreen interface for carb counting, bolusing, and viewing blood glucose trends – and it’s the smallest available pump. The Tandem t:slim X2 also offers upgradeable software, so when new features become available, the pump can be updated using a personal computer. You can also share blood glucose information with family members and other key members of the support team via Dexcom share app.
Check out the Tandem video or try out the system via the simulator app. Contact the Healthy Living Insulin Pump & CGM Therapy Team to find out more about getting started at 866.779.8512, Option 2 (phone) or 248.577.9903 (text).
It's an excellent time time of year to go on an insulin pump, upgrade an out-of-warranty pump, or start using CGM...or at least investigate your options! For many people on commercial health insurance plans, deductibles are satisfied and reset on January 1st of the new year. Reach out to the Healthy Living Insulin Pump & CGM Therapy Team for a no-cost insurance verification to find out more about your coverage and costs. Reach us at 866.779.8512, Option 2 (phone), 248.577.9903 (text), or via chat at myhlms.com.
To find out more about the benefits of these technologies and the products that we offer, visit: