Dexcom G6

Diabetes Tech Updates: May 2020

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Another month, and another smaller flurry of diabetes tech news.

Among the most exciting news, I recently had a chat with my local AMSL rep. The recently approved Dexcom G6 Continuous Glucose Monitor is expected to launch into the Australian market in June, once stock hits our shores. Training is well underway for company reps. It’s expected that the launch will initially cater to the private market, as it will likely be a little while longer before G6 is available through the NDSS for users who are accessing the government subsidy.

Basal IQ, the predictive low glucose suspend update to the t:slim, has also been approved (this is per my rep, I can’t find a source myself). AMSL are planning to launch this later in the year, in a staggered fashion once G6 is a little more settled into the market.

In other news, Ypsomed have finally announced the long promised CGM partner for their insulin pump. An update to Ypsomed’s mylife app will integrate CGM readings from the Dexcom G6 (and future Dexcom iterations). The mylife app currently receives data from the YpsoPump via a Bluetooth connection, and is where users perform their bolus calculations.

Given that the Ypsomed app can also be used in MDI mode, I think CGM integration is a big win for those who aren’t using pumps, too. It’s also fantastic to see Dexcom forging partnerships with different players in the market to facilitate greater choice to people with diabetes. Because more choice for people with diabetes is always a good thing. This is expected to launch in Europe later this year/early 2021. No news as to when this will launch in Australia.

The press release goes on to suggest that Ypsomed are also working toward their roadmap which was outlined to us at YpsoPump launch event in May 2018. This involves eventually having the pump remotely controlled via the mylife smartphone app. Ypsomed also has the option of adding a hybrid closed loop feature, powered by the Dexcom TypeZero algorithm (I believe this is the same algorithm that is powering Tandem’s Basal IQ/Control IQ updates).

The official press release is here.

In some older news, there are temporary limits to the supply of insulin pump consumables via the NDSS for Aussies. In response to increased demand out of COVID-19, Diabetes Australia has advised limits of 2 boxes of insulin pump consumables and 2 boxes of cartridges per order. Test strips, needles and syringes are limited to 3 boxes per order. Please only order what you need.

In somewhat of a more unusual announcement, Roche Diabetes Care have added child resistant battery compartments to AccuChek Guide and Instant S blood glucose meters. I personally think the Guide is the best blood glucose meter I’ve ever used, and it’s great to see Roche’s commitment to standard blood glucose monitoring which is still important to so many people.

If you have any questions, feel free to pop them in the comments and I’ll do my best to answer.

Tandem t:slim X2 Insulin Pump Launches in Australia!

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Tandem’s t:slim X2 insulin pump officially hit Aussie shores last week at the Australasian Diabetes Congress. It will be distributed by AMSL Diabetes here in Australia as a successor to Animas, which is in the process of exiting the pump market. AMSL invited me to a launch dinner in Adelaide last week, where I had the opportunity to play with (but not keep) this new diabetes toy.

AMSL diabetes will be upgrading all of their customers with an existing, in warranty Animas Vibe insulin pump to the t:slim over the course of the next 12 months at no extra cost. Customers will need to return their old Animas pumps within one week as a condition of receiving the upgraded pump. This is a part of AMSL’s contract with Animas.

This upgrade is basically treated as a replacement for the pump I have already paid for two years ago. Then, in two years when my warranty period is up, I will be eligible for another through my private health insurance. It makes complete sense. Besides, AMSL will only have limited capacity to service Vibe pumps now that Animas have gone out of business.

AMSL have a dedicated transition team looking after upgrades, and they will be getting in touch with eligible customers over the next twelve months. You will need to go through a healthcare professional, which is regulatory, but frustrating considering I already know how to use an insulin pump! I hear that upgrades are expected to commence in October, however customers who wish to remain on an Animas Vibe will also be supported.

During the evening we heard from Aymeric Lecanu-Fayet, Senior Director at Tandem Diabetes Care in the States. The t:slim was designed based on over 6,000 interviews of people with diabetes, attempting to close the gaps that prevented people from using an insulin pump. Things like making it look modern like a smartphone, easy to use and easy to learn.

Kerri Bandelin, International Clinical Manager at Tandem then took us through a workshop with the pump.

The tslim has the option of integration with a Dexcom CGM, and the battery is rechargeable. The charge will last for 5 days if you’re using it with CGM integration, or 7 days if you’re using it standalone. The rechargeable battery is also covered under warranty in the off chance that it does get damaged. Those non diabetic lines sure are something to envy!

Users are normally encouraged to recharge their pumps while they’re in use. Suggestions were while on the couch, in front of a computer or while in the shower. We were also told that there is no such thing as over charging this pump, something I’m always mindful of when leaving my iPhone plugged in for too long. A full charge takes 1.5 hours on a dead battery, but I also got the impression that short charges of 15 minutes won’t do any damage to the pump’s battery.

We were told that the pump can be used with Animas infusion sets, but not insulin cartridges. Tandem consumables are on the ship as we speak, and I’m pleased to hear that there will be an option of angled sets. I was also pleased to hear that Australia will be receiving t:slim pumps with an updated algorithm that won’t trigger unnecessary occlusion alarms.

Insulin goes into a black hole, which is a bit concerning for detecting air bubbles. The minimum fill is 95 units, with the cartridge having a capacity of 300 units. We were told that there is also a thermometer inside the cartridge which can alert to risks of spoiled insulin. Carb ratios could be adjusted in increments of 0.1 when going past the 1:10g mark. There are also 6 different basal profiles with 16 different time segments.

The most promising feature for me is the ability to receive upgrades to this pump in the same fashion as upgrading your iPhone’s software. Basal IQ with Dexcom G6 is expected to launch this Australian summer, but is not yet approved. The system predicts glucose levels 30 minutes ahead and suspends insulin if levels are expected to drop below 4.4mmol.

We were told that this upgrade would be free, however I wasn’t impressed to hear that I would have to go through a healthcare professional every time there is an upgrade. I know there are regulations. But considering I already know how to use an insulin pump and spend relentless hours managing my diabetes on my own, it definitely feels like an insult to my lived experience.

Also in the pipeline is Control IQ. This upgrade would automatically adjust basal insulin levels in response to CGM readings, as well as deliver automated correction boluses. I would stress that this is only in its infancy, with a current 6 month study happening in Germany. Tandem would also not confirm whether this update would be free or not. I also got the impression (not an official comment) that the blood glucose target on this system would be better than the 6.6mmol target on the Medtronic 670G.

We were told that the pump would fit inside the coin pocket of a pair of jeans. What I didn’t like was the bulky case with a clip that added significant bulk to the pump. It was heavier than the YpsoPump at 113g, and here’s how it stacks up against the late Animas Vibe that I was wearing. We were told it is the size of a credit card.

It felt refreshing being able to type in numbers, rather than scrolling through until reaching your desired number. Nice and modern and sleek to use, just like the YpsoPump.

While I don’t think CGM will be in my budget anytime soon, I do feel hopeful that we are getting close to finally closing the loop.

Finally, we have a hashtag happening. A completely selfish one.

It’s #TslimForFrank.

Please jump onto social media and use it generously.

I have been dreaming of this little pump hitting our shores since forever, and I would love nothing more than to provide you with a user experience.

Disclosures: AMSL Diabetes hosted me at a dinner on Wednesday evening with a group of other Aussie diabetes bloggers. I was already in Adelaide for the Diabetes Congress as a guest of Diabetes Australia. I was fed and watered across the duration of the evening, and received a small bag containing a powerbank, information packets and an AMSL penguin. There was no expectation that I would blog about the t:slim. My opinions and my time, including the annual leave I had taken from work to be there, are my own.