I have used a Medtronic 670G hybrid closed-looped insulin pump since March 2018. My initial experiences with the "fast-tracked-by-the-FDA" device were not pleasant but improved after Medtronic updated the G3 CGM sensor and predictive blood glucose algorithm. The updated system was more reliable, and most patients on the hybrid closed-loop system showed improved outcomes over regular pump users. When a friend recently asked for recommendations for insulin pumps for his friend, I recommended the Medtronic 670G system.
In a hybrid closed-loop system, an insulin pump communicates with a continuous glucose monitor (CGM) which feeds blood glucose information into a continuous feedback loop control algorithm that works with the insulin pump to keep blood glucose levels within a specified range. The hybrid closed-loop system automatically increases and decreases basal insulin as glucose levels rise and fall. The patient still needs to input carbohydrates and make adjustments for exercise, as well as make occasional corrections for high and low glucose levels.
But after sending my friend my initial recommendation, I dug around the DOC (diabetes online community). I realised that there was another option, one that I think is better than the Medtronic 670G.
In 2018, Medtronic’s 670G was the only closed-loop system on the market. However, in the fall of 2019, the best CGM sensor manufacturer (I formerly user a G4 sensor), San Diego’s Dexcom, teamed up with another San Diego based insulin pump maker Tandem, to create a hybrid “closed-loop" insulin pump system.
Available to t:slim X2 insulin pump users with Dexcom G6 CGM integration, Basal-IQ™ technology is a predictive low-glucose suspend feature that predicts and helps prevent lows with zero fingersticks.
If I were choosing today, I would choose the t:slim X2 insulin pump users with Dexcom G6 CGM integration. Why?
- The t:slim X2 insulin pump can be updated with new features during its warranty period.
- It has a separate smartphone-style touch screen from which the user can quickly and easily access pump functions.
- The t:connect® mobile app serves as a secondary display for the t:slim X2 insulin pump. The user can have alerts appear on a smartphone or sent to a spouse’s smartphone.
- The Dexcom G6 can send alerts to smartphones and smartwatches including Apple iPhones and Watches.
After reading up on the t:slim X2 and Dexcom G6, my Medtronic 670G feels and looks like a BlackBerry pager in comparison. The Medtronic 670G has toggle switches and scroll buttons. Neither the Medtronic 670G nor Medtronic G3 CGM transmitter connects to a smartphone or smartphone.
I don't know if this matters, but Dexcom and Tandem are American owned companies. In these uncertain times, the supply chain for your medical devices is something to be considered.
The t:slim X2 and Dexcom G6 are newer and I won't know what the growing pains are for a while. But I am excited that when my pump warranty runs out in eighteen months, I will have something new to try.
Submitted as part of the 100DaysToOffload project.