The Medtronic™670G and the Tandem® t:slim X2™ insulin pumps have received approval from Health Canada. This is very big news for the Canadian insulin pump market!
Why is this such a big deal? The introduction of the Medtronic™670G has really opened the door to a whole new way of thinking by both the American Food and Drug Administration (FDA) and Health Canada. This is the first time a device has been approved that allows an individual to receive insulin without human input. The 670G is a very important step towards a fully automated insulin pump.
The Tandem® t:slim X2™ is also a first in the pumping world. It is currently the only pump approved by the FDA and Health Canada that can have it's software remotely updated. This allows the pump to be updated to Tandem's latest software version from a home computor. The fact that it is also bluetooth enabled allows it to communicate with other bluetooth devices such as the Dexcom G5® continous glucose monitor. This is an important step in bringing together several different devices on a common platform. Moving forward this could allow an individual to customize their pump system to their own unique needs.
Let's take a look at what we know about these two pumps:
The 670G is known as a hybrid closed loop insulin pump; Medtronic calls this it's SmartGuard™ technology. You may be wondering what this pump does and does not do.
What are the features of the 670G pump?
- The 670G attempts to maintain your blood glucose level within a target range using blood glucose readings from it's integrated continues glucose monitor
- In order to use the 670G's advanced features, the Medtronic Guardian 3 CGM must be worn; this may be costly for individuals without any form of insurance coverage
- It will automatically adjust your basal or background insulin if your blood glucose is elevated; it does this by bolusing small amounts of insulin every 5 minutes
- If the pump's algorithm predicts that your blood glucose is going to drop below a preset low limit, insulin will be temporarily stopped for up to 2 hours
- The pump will bolus small amounts of insulin up to approximately 5 times your normal basal rate to bring your blood glucose back to it's target zone
- Pump will function in Auto Mode; adjusting background insulin up or down to keep blood glucose within a target zone. Safe Mode means stopping basal or background insulin if blood glucose goes below a set target or as a conventional pump.
Others things to consider about the 670G
- The 670G won't bolus for carbohydrates eaten; you must enter this information before eating. Technically this is not a considered closed loop pump
- The continuous glucose monitor (CGM) that the 670G pairs with must be manually calibrated with finger sticks every 12 hours minimum and often requires additional finger checks when bolusing for carbohydrates
- Auto mode requires a high level of user input often with additional finger sticks
- The pumps menus can be complex and difficult to master
- It often requires many button presses and user input
- Frequent alarms may become overwhelming for some individuals
Tandem® t:slim X2™
The t:slim X2™ that has been approved by Health Canada is the only pump that will allow software to be remotely upgraded. It will also be integrated with the Dexcom G5® continuous glucose monitor. Tandem does have advanced features available in other countries that may be offered in the future.
What are the features of the t:slim X2™
- It is the only pump that can be updated remotely by plugging it into a computer and downloading the latest software from the Tandem website
- The X2™ is the smallest insulin pump on the market. It has a modern look and feel to it; much like a smart phone
- Two way bluetooth allows the X2™to communicate with external devices. This currently allows connectivity with the Dexcom G5® and future G6®. Note: the G6® with Basal-IQ was recently introduced in the USA, Canada should be next once the G6® has been approved for the Canadian market.
- The X2 has a rechargeable lithium battery; it is charged through a micro USB port plugged into a computer or wall adapter. Charging must be done 1-2 times weekly.
- User friendly home screen graphics displays insulin on board; and CGM blood glucose readings without multiple button pressing
- Tandem is currently working on a Bluetooth connected smartphone app that will give the X2 remote monitoring features; and possibly the ability to use other third party software to further advance pump functions........I will quietly say "closed loop pump" in the near future....
- Planned future updates including Basal-IQ and Control-IQ will bring this pump very close to a true closed loop system. Basal-IQ will automatically control background insulin and Control-IQ will begin looking after some of the routine bolusing functions.
Others things to consider about the t:slim X2™
- Advanced closed loop hybrid features pending in Canada
- Small touch screen buttons can be difficult to navigate for some individuals
- Requires extra confirmation steps with all programming compared to more traditional pumps
The take away
The good news is: Canadian and future pumpers now have more options. We are all different in what we are looking for in an insulin pump. We live with our pumps 24 hours a day so two new pumps are a welcome addition! This is a win for pumpers and it will hopefully open the door for future advancements in pump technology.
Click on the link below to view a comparison of all insulin pumps currently approved by Health Canada.