Diabetes Technology

Insulin Pumps

These small devices deliver insulin continuously under the skin. The reservoir inside the pump holds up to 200-300 units of insulin. Insulin is pumped through thin, plastic tubing, ending in a thin catheter under the skin (OmniPod®, however, is tubeless since it is attached in its entirety to the skin and gets disposed of every 3 days). These external pumps (in the U.S. marketed by MiniMed/Medtronic, OmniPod/Insulet, T-slim/Tandem) cannot read sugar levels. Thus, the patient still has to monitor his or her own sugars either with fingersticks or by a continuous glucose monitor to be able to adjust insulin infusion rates (“basal” rates and mealtime “boluses”). The MiniMed/Medtronic 670G, 770G and Tandem T-slim X2 systems are “hybrid” closed-loop device, the first step toward an “artificial pancreas”. These pumps are wirelessly integrated with a continuous glucose sensor which directs the pump to deliver the needed amount of insulin to keep blood sugar at a safe level.

V-Go is a disposable insulin delivery device that sends insulin continuously under the skin at a fixed preset rate (basal) and is activated to deliver small amounts of insulin at mealtime. It is changed every day.

Continuous Glucose Monitoring (CGM)

With fingerstick blood sugar levels you see the result only at that given time. Continuous glucose monitoring (CGM) devices allow you to see not only the level at present but also look at past trends and see what will happen in the next 30 minutes so you can take action even before the sugar goes too low or too high. These devices don’t check blood glucose levels but the level in the fluid just under the skin which usually corresponds well to the blood glucose levels. There are several CGM systems on the U.S. market: Dexcom G6, Medtronic Guardian 3, Abbott Freestyle Libre 14-day and 2, and the only implantable (sensor placed under the skin for 90 days) one, Eversense®.