Managing diabetes, particularly Type 1 and Type 2, requires constant attention to blood glucose levels. Automated Insulin Delivery (AID) systems have revolutionized this process by combining insulin pumps with Continuous Glucose Monitors (CGMs), allowing for real-time insulin adjustments. Here we have included complete range of Dexcom insulin pumps and Abbott insulin pumps, along with sidewise comparison table.
What Is an Automated Insulin Delivery (AID) System?
An AID system integrates three primary components:
- Insulin Pump: Delivers basal and bolus insulin.
- CGM: Monitors glucose levels continuously.
- Control Algorithm: Adjusts insulin delivery based on CGM data.
These systems aim to maintain glucose levels within a target range, reducing the risk of hypoglycemia and hyperglycemia.
Leading AID Systems in the U.S.
1. Tandem t:slim X2 with Control-IQ Technology
• CGM Compatibility: Dexcom G7 and FreeStyle Libre 2 Plus.
• Features:
- Predicts glucose levels 30 minutes ahead.
- Adjusts insulin delivery every 5 minutes.
- Offers manual bolus options.
- Remote software updates.
- Water-resistant design.
• Suitable For: Type 1 diabetes (ages 6+), Type 2 diabetes (ages 6+).
• Requirements: Requires a smartphone for control.
2. Medtronic MiniMed™ 780G
• CGM Compatibility: Guardian™ 4.
• Features:
- Adjusts insulin delivery every 5 minutes.
- Auto-correction dosing.
- Meal detection technology.
- Water-resistant pump.
• Suitable For: Type 1 diabetes (ages 7+).
• Requirements: Requires a smartphone for control.
3. Omnipod® 5
• CGM Compatibility: Dexcom G7 and FreeStyle Libre 2 Plus.
• Features:
- Tubeless, waterproof design.
- SmartAdjust™ technology for insulin adjustments.
- Controlled via smartphone or provided controller.
- Activity feature for exercise adjustments.
• Suitable For: Type 1 and Type 2 diabetes (ages 6+).
• Requirements: Requires a smartphone for control.
AID Systems Compatibility Table
| Feature | Tandem t:slim X2 | Tandem Mobi | Medtronic MiniMed 780G | Omnipod® 5 |
| CGM Compatibility | Dexcom G6, G7, FreeStyle Libre 2 Plus | Dexcom G6, G7 | Guardian™ 4 & Simplera Sync | Dexcom G6, G7, FreeStyle Libre 2 Plus |
| Units of Insulin Bolus | 300 units | Manual bolus via touchscreen or mobile app | Manual bolus via touchscreen or mobile app | Manual bolus via touchscreen or mobile app |
| Control Algorithm | Control-IQ+ | Control-IQ+ | SmartGuard™ | SmartAdjust™ |
| Manual Bolus Options | Yes (via touchscreen or mobile app) | Yes (via touchscreen or mobile app) | Yes (via touchscreen or mobile app) | Yes (via touchscreen or mobile app) |
| Tube or Tubeless | Tubed | Tubed | Tubed | Tubeless |
| SmartAdjust | Yes | Yes | It includes SmartGuard that can be adjusted & can act just like SmartAdjust | Yes |
| Prior Prediction of Glucose Values | Yes (up to 30 minutes prior) | Yes (up to 30 minutes prior) | Yes (real-time adjustments based on CGM data) or with smartguard | Yes (up to 60 mins prior) |
| Water Resistance | Watertight only upto 3 feet for 30mins (IP27 rated) | Yes (IP28 rated) | Water Proof up to 12 feet for up to 24 hours (IPX8 rated) | Yes |
| Suitability for Type 1 Diabetes | Yes | Yes | Yes | Yes |
| Suitability for Type 2 Diabetes | Yes | Yes | Not studied | Yes |
| Age and Type of Diabetes Requirement | 2 or above for Type 1 and age 18 or above for Type 2 | 2 or above for Type 1 and age 18 or above for Type 2 | 7+ years and above | 2 or above for Type 1 and age 18 or above for Type 2 |
| Predictive Insulin Dosing | Yes (Control-IQ predicts and adjusts insulin delivery) | Yes (Control-IQ+ predicts and adjusts insulin delivery) | Yes (SmartGuard™ predicts and adjusts insulin delivery) | Yes (SmartAdjust™ predicts and adjusts insulin delivery) |
| Insulin Suspension | Yes (when glucose levels are predicted to drop below target) | Yes (when glucose levels are predicted to drop below target) | Yes (when glucose levels are predicted to drop below target) or through smart guard | Yes (when glucose levels are predicted to drop below target) |
| Automated Correction Boluses | Yes | Yes | Yes | Yes |
| Customizable Alerts | Yes (various alerts for insulin delivery, glucose levels, etc.) | Yes (various alerts for insulin delivery, glucose levels, etc.) | Yes (various alerts for insulin delivery, glucose levels, etc.) | Yes (various alerts for insulin delivery, glucose levels, etc.) |
Companies frequently recommend Not to use ’Smart Boluses’ if you are under 2 years of age or require less than 5 units of insulin a day.
Important Usage Instructions for Insulin Pumps
- Regular Calibration: Ensure CGMs are calibrated as per manufacturer guidelines to maintain accuracy.
- Site Rotation: Rotate infusion sites to prevent tissue damage and ensure consistent insulin absorption.
- Battery Management: Regularly check and replace batteries to prevent pump malfunctions.
- Water Exposure: Adhere to the manufacturer’s water resistance guidelines to prevent device damage.
- Software Updates: Keep the pump’s software updated to benefit from the latest features and improvements.
- Emergency Plan: Have a backup plan in case of device failure, including manual insulin delivery methods.
Conclusion
In conclusion, selecting the right AID system involves considering factors like CGM compatibility, lifestyle preferences, and specific diabetes management needs. Consulting with a healthcare provider can help determine the most suitable system for individual requirements.
