Diabetes tech users now have more options thanks to recent integrations between insulin pumps and continuous glucose monitors.
Users of the Tandem t: slim X2 can now incorporate the Dexcom G7 or the FreeStyle Libre 2 Plus into their automated insulin delivery system.
The most recent development is the integration of Abbott's FreeStyle Libre 3 Plus with Beta Bionics' iLet Bionic Pancreas system.
Additional iLet Bionic Pancreas option
The iLet Bionic Pancreas, which was approved by the FDA in 2023, works similarly to other AID systems in that it uses software with an adaptive algorithm to connect an insulin pump delivery system to a CGM. But unlike other AID systems, it only needs one piece of information to function, which is the user's body weight. This drastically cuts down on the time users must spend configuring the system.
Abbott's Freestyle Libre 3 Plus
Beta Bionics declared that it has begun integrating the iLet Bionic Pancreas with Abbott's FreeStyle Libre 3 Plus CGM.
The FDA-approved FreeStyle Libre 3 sensor that has been modified to work with AID systems is the FreeStyle Libre 3 Plus sensor, which was introduced in June. The Libre 3 Plus is about the size of two stacked pennies and is recommended for use by users who are at least two years old. Additionally, it has a 15-day wear period.
The FreeStyle Libre 3 Plus CGM is now being used by the iLet Bionic Pancreas, the first insulin pump in the United States. Pharmacies and suppliers of durable medical equipment carry the FreeStyle Libre 3 Plus. (FreeStyle Libre 2 by Abbott).
Dexcom’s G6 and G7
Since its release in May 2023, the Dexcom G6 has been compatible with the iLet Bionic Pancreas. Beta Bionics also announced integration with the Dexcom G7 last December, allowing wearers to choose a significantly reduced sensor warm-up time. Depending on their needs and preferences, iLet users can currently use either the Dexcom G6 or Dexcom G7 continuous glucose monitor, or alternate between the two.
How to utilize the Dexcom G7 with the iLet Bionic Pancreas
A Beta Bionics software update, available for free in the Google Play or Apple app stores, is required for current iLet users who wish to use the Dexcom G7.
Sean Saint, CEO of Beta Bionics, stated, "We want to give our patients options with their CGM technology and be able to update quickly and easily without new hardware or additional costs."
Users of the Bionic Pancreas will have to update their iLet mobile app in order to use the Dexcom G7. When the FreeStyle Libre 3 Plus is released later this year, users will also likely need to update their app.
Along with additional CGM choices, the iLet app has been updated.
More options for the Tandem t:slim X2
The Tandem t:slim X2 now works with Abbott's FreeStyle Libre 2 Plus, a modified version of the FreeStyle Libre 2 that the FDA has approved for use with AID systems.
The G7 continuous glucose monitor from Dexcom or Abbott's FreeStyle Libre 2 Plus are now available to users of the t:slim X2 insulin pump.
Abbott’s Freestyle Libre 2 Plus
The FDA-approved FreeStyle Libre 2 Plus sensor is a modified version of the FreeStyle Libre 2 sensor that can be used with AID systems.
Abbott introduced the FreeStyle Libre 3 Plus in June, claiming it was "the world's smallest CGM sensor with future AID compatibility" and offering a 15-day wear time.
Additionally, Abbott is working to make Tandem's t:slim X2 insulin pump system compatible with its FreeStyle Libre 3 Plus sensor; at this time, Tandem's t:slim X2 insulin pump is only compatible with the FreeStyle Libre 2 Plus sensor.
The G7 Dexcom
Additionally, the G7 offers more customization options for alerts, including the ability to choose glucose values for the quick rise and fall alerts, and better accuracy than the G6.
Regarding the Dexcom G7's U.S. collaboration with Tandem, Dr. Diana Isaacs, director of education and training in diabetes technology at Cleveland Clinic, remarked, "This is the day we have all been waiting for." "We are one step closer to the real goal of giving people more options for their diabetes technology now that we have another CGM option to work with."
The Tandem t:slim X2 now pairs with the Dexcom G7.
Things to consider before combining the Dexcom G7 with the t:slim X2
When Dexcom's G7 integration was implemented in the United States in December 2023, there was a lot of excitement but also a lot of uncertainty. Some users had trouble figuring out which Dexcom G7 version to use with their Tandem AID systems because there were two versions in circulation at the time: one that was compatible with AID and the other that wasn't.
At first, some medical professionals were concerned about how easy the integration would be for diabetics.
"This integration has long been anticipated by everyone," stated Dr. Irl Hirsch, a medical professor at the University of Washington. "Everyone ought to be content, but they're not."
Distributors were "sending the wrong G7 (the one that doesn't talk to the Tandem) to patients," according to Hirsch. Additionally, he warned that some people may find it difficult to tell the difference between the compatible and incompatible Dexcom G7 labels, which could cause confusion for both users and pharmacy technicians.
This shouldn't be as big of a problem going forward because Dexcom has phased out its G7 sensors that don't work with insulin pumps.
If the side of the Dexcom G7 box has a manufacturing date of 2024 or later, along with a white line beneath the LBL number, users will now know that a G7 sensor is compatible with the Tandem t:slim X2 insulin pump (contact Dexcom customer service if a Dexcom G7 sensor is not compatible).
If there is a white line beneath the LBL number and a manufacturing date of 2024 or later on the side of the box, Dexcom's G7 sensor is compatible with the Tandem t:slim X2.
The t:slim X2 pump with Dexcom G7 integration was introduced in South Africa and over ten European countries in January 2024.
The Dexcom G6 or Dexcom G7 CGM will be available to current t:slim X2 pump users for the management of their diabetes. When it's most convenient for them, Dexcom G6 users can switch to the Dexcom G7. Distributors of durable medical equipment (DME) carry Dexcom G7 sensors that work with the t:slim X2 pump.
Everything is covered under warranty. At the time of the rollout, t:slim X2 users in the United States ought to have received an email with instructions for a free software update that integrates the G7. Before being shipped to new clients, new t:slim X2 pumps will come pre-installed with the Dexcom G7 integration.
The updated software offers the following features to t:slim X2 users in addition to granting them access to important G7 features:
A timer for exercise mode that allows for a duration of 30 minutes to 8 hours:
Additional pump alarm and alert tones, including fill tubing notifications, CGM alerts, quick bolus, and bolus.
A screen called "Select Sensor" that allows users to alternate between Dexcom G6 and G7 hardware.
Users of tandem t:slim should also be aware that the Dexcom G7 and G6 have different software requirements:
All Dexcom G6 sensor versions are compatible with the t:slim X2 pump (software version 7.3 or later).
Only specific Dexcom G7 sensor versions—specifically, those with a white line beneath the LBL number at the bottom of the packaging, as seen in the image below—are compatible with the t:slim X2 pump (software version 7.7 or later).
Before starting the software update, you’ll need to complete training. You can find a helpful checklist and preview the update process here.
What these modifications signify for diabetics?
The first step toward more choice and customization in diabetes care is to make insulin pumps compatible with various CGM sensors. Insulet, the manufacturer of the Omnipod 5, announced that it was fully integrated with both the Dexcom G6 and the G7, in addition to Tandem's t:slim and Beta Bionics' iLet.
Experts see a future where individuals with diabetes can select from a variety of CGMs, insulin pumps, and insulin delivery algorithms to control their condition.
"We don't think there is a one-size-fits-all approach to managing diabetes," stated Elizabeth Gasser, Chief Strategy Officer at Tandem. "We are still committed to giving people a variety of options from which to select."
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