Posted on August 30, 2022 at 08PM
Dexcom & Omni Pods: The Future Of Managing Diabetes Management
More Cash For Test Strips
Diabetes technology has grown in leaps and bounds in recent decades. It’s now possible to glance at your smartwatch and know your blood sugar levels thanks to Continuous glucose monitoring (CGM) systems like the Dexcom systems. Additionally, it’s possible for patients to continuously adjust their insulin dosage based on current CGM values thanks to Continuous Subcutaneous Insulin Infusion systems such as the Omnipod.
With the improvement of these devices and their proliferation, we may have a future where test strips are obsolete.
Dexcom G6 And Omni Pods: An In-depth Look
Continuous glucose monitoring technology was introduced to the market in 1999 to improve the quality of monitoring, thereby reducing episodes of hyperglycemia and hypoglycemia. Over the years, studies have shown that CGMs significantly improve diabetes management among children, adolescents, and adults (https://link.springer.com/article/10.1007/s00592-020-01607-4).
On the other hand, Continuous Subcutaneous Insulin Infusion systems are an advanced type of insulin pump used by Type 1 Diabetes Mellitus (T1DM) that delivers exogenous insulin mainly to manage hyperglycemia. However, the introduction of closed-loop systems has also availed the technology to the Type 2 Diabetes Mellitus (T1DM) population.
What Are The Capabilities Of Dexcom G6 Continuous Glucose Monitoring (CGM) Systems
Dexcom G6 is Continuous Glucose Monitoring (CGM) System. It’s designed to be interoperable between various compatible devices, including insulin pumps, automated insulin dosing systems, and electrical medical devices. Released in 2018, the G6 is renowned for being the first CGM that does not require FSBS calibration.
The G6 is designed with ease of use in mind. For instance, it has an auto-applicator which is activated by a simple touch of a button. The applicator will insert the sensor transmitter into the skin, taking up to 30 minutes to pair with the receiver. Once paired, users must wait for another 10 hours before the G6 starts to log data. After that, the device will work continuously for the next 10 days.
While G6 can integrate with the Omnipod 5 System, the two systems are sold separately. The Omnipod 5 uses the measurement values derived from the G6 CGM to implement the Automated Mode when users opt to automate insulin delivery. Additionally, the Omnipod 5 uses Dexcom G6 values to perform bolus calculations in both Manual and Automated Modes.
Other CGM systems on the market include:
#2. Dexcom G5
#4. FreeStyle Libre 14-Day System
#5. Guardian Sensor 3
#6. FreeStyle Libre 2
What Are The Capabilities of Omnipods
While you might consider the Omnipods as just another insulin pump, Insulet (the device manufacturer) asserts that their Pods are markedly different from traditional insulin pumps. For starters, the tubeless device uses their proprietary Pod Therapy tech (the SmartAdjust™) to deliver personalized insulin doses based on the user’s personal programmed glucose targets for up to three days. Alternatively, Omnipod users can integrate their Pods with a CGM for continuous automated insulin delivery.
The Omnipod 5 System Features
– Wearable Pod – The Omnipod 5 has a pod that users can wear for up to 3 days. The Pod can be filled with a minimum of 85 units of U-100 rapid-acting insulin or a maximum of 200 units, which it uses to provide continuous subcutaneous insulin delivery.
– Tubeless Construction – The Pod is designed and made to function without any dangling tubes. Consequently, you can place the tub anywhere you would typically inject insulin.
– The Omnipod 5 App – The Omnipod 5 App gives users complete control over the Pod. For instance, you can choose a basal profile, bolus settings, and target bolus and glucose settings. The app is also the primary method to turn the Pod on and off and select the delivery method.
The app provides an easy and intuitive interface for Omnipod users who want to integrate their Pod with the Dexcom G6 Continuous Glucose Monitoring System. The Controller comes preinstalled with the Omnipod 5 App. However, you can download the app on your phone to access the same level of control.
– Waterproof – The Pod has an IP28 waterproof rating. As such, it stays waterproof to a depth of 25 feet (or 7.6 m) for up to one hour.
– Pod Placement Site Tracker- You can track the placement of the pods. When you activate a new Pod, you’re given an option to note the site where you’ve applied the Pod. You can use this information to determine where to place Pods in the future.
– Logging CGM Values And Insulin – The Omnipod 5 System can log up to 90 days of CGM values and insulin delivery data. Some of the data the system logs includes basal delivery, carbohydrates, bolus doses, glucose-related data, and alarms. When the user activates the Automated Mode, the Pod logs the automated insulin delivery and CGM data every 5 minutes.
– The Omnipod App home screen gives users a detailed CGM graph that allows users to learn more about CGM values in relation to insulin delivery.
How To Use The Dexcom G6 And Omnipod 5
To integrate and use the Dexcom G6, you must activate the CGM in the Dexcom app. This will allow Omnipod 5 system to access and use CGM trends and values. After applying the Pod, The Dexcom G6 CGM, the Omnipod 5, and The SmartAdjust™ Tech will constantly communicate to help keep your glucose in range.
Other Continuous Subcutaneous Insulin Infusion (CSII) Systems on the market include:
#1. Tandem T: Slim X3
#2. Medtronic MiniMed 670G
#3. Tandem T: Slim X2
#4. Tandem T: Flex Pump
#5. MiniMed 670G
#6. MiniMed 630G
#7. MiniMed 530G
#8. MiniMed Paradigm Revel
Integration Of CGM Systems And Insulin Pump Systems
Integrating a continuous glucose monitoring system with insulin pumps has allowed diabetic patients to make more accurate insulin delivery. For instance, the integrated tech allows CGM-based adjustment to basal insulin delivery rates rather than multiple daily insulin injections. In the same light, the integration of CGM systems and advanced insulin pumps allows patients to suspend the delivery of insulin when low blood glucose is predicted.
The enhanced and accurate glycemic control mechanism makes the system more responsive to your needs. Importantly, it reduces the episode of hypo- and hyperglycemic.
Self-Monitoring Blood Glucose With Traditional Test Strips/ The Capillary Blood Glucose Test
Diabetes test strips have proven to be effective in testing glucose levels. They help patients living and managing diabetes to attain an on-the-spot reading of their glucose levels. Knowing your blood sugar levels is crucial in helping patients manage the disease. For decades, individuals living with diabetes have used strip tests for long-term tracking of glucose levels. The accumulated test results help the patients learn how different foods, activities, and medications affect their blood sugar.
The typical self-monitoring blood glucose (SMBG) meter, test strips, and a lancet to prick your finger. Some modernized blood glucose monitors make it easy for users to use the device.
For instance, some monitors have wired and/or wireless connections that allow users to log their blood sugars on their computers or phones. Other monitors come with an insulin-to-carbohydrates ratio calculator that syncs with a smartphone or computer app. Other meters use a preinstalled cassette rather than using strips. Finally, some meters are capable of testing for and measuring your ketone levels.
With the above in mind, we must appreciate that test strips have helped many diabetic patients live healthier lives.
How To Use A Glucose Test Strip
Using the test strip is easy and intuitive:
– Install the test strip into the meter.
– Clean the lancet with water and soap and let it dry completely.
– Dry your finger completely.
– Prick your finger and squeeze a drop of blood.
– Hold the edge of the test strip against the blood.
The meter will give you a reading of your blood glucose level in a few seconds. Your doctor will direct you on how many times you should test yourself as part of your self-monitoring regimen. For some people, daily checks are not necessary. Others have to test the blood sugar levels multiple times every day (for instance, after every 2 hours).
Typically, diabetic individuals will test their blood glucose level at bedtime and before meals. Some patients must check their blood sugar levels in the middle of the night. Other times a person with diabetes will test the glucose include:
– When they feel sick,
– Before exercising,
– If you have symptoms of hypoglycemia (low blood sugar),
– When you’re stressed, and
– If you skip snacks or meals.
How The Test Strip Works
The blood glucose test strip is anything but mundane. A typical diabetes test strip is made of a complex system of technology. For electrochemical strips, the plastic strips are coated with a thin layer of gold deposited in a pattern that forms a circuit. The other end of the strip, where you deposit the blood droplet, is coated with special chemicals. These chemicals convert glucose to electricity, which travels up the gold circuit and into the meter. The higher the glucose levels, the faster the electrical signal (and the higher the reading on the meter). However, other test strips and meters measure glucose concentration using photometry and colorimetry.
All diabetes test strips are single-use only, owing to the nature of the fingertip test methods
Drawbacks Of Blood Sugar Test Strips
One of the main drawbacks of using strip tests is the single-use nature of the strips. You must use new test strips every time you need to test your blood glucose level. There is also the issue of the uncomfortable prick of the finger to draw blood every time you want to test your blood sugar levels.
SMBG is also affected by numerous user errors that might affect the accuracy of the results. For instance, improper patient training, contaminated blood sample, and inadequate blood samples is a major cause of inaccuracies.
Additionally, the test strips are still fallible. For instance, using damaged, expired, or the wrong strips for your meter might yield the wrong results. The strips are also susceptible to heat, humidity, and moisture damage. Finally, you might need to calibrate your meter every time you use different brands of strips.
Other issues that might result in inaccurate test results include:
– Dirty fingers,
– Wet fingers,
– Applying inadequate blood on the test strip,
– Temperature changes, and
– Dirty meter.
Why CGM Systems And CSII Systems Are Making Test Strips Obsolete
CGM Makes Monitoring A Lot Easier
As you can appreciate monitoring your blood sugar levels using traditional test strips is an involving task. Testing glucose levels involves preparing your finger, pricking it, squeezing blood, and then applying the blood droplet to the test strip. You have to do this every time you want to spot-check your blood glucose levels.
However, wearing CGMs that sync with your phone or smartwatch (such as Garmin, Apple, and Android watches) and allow you to read your real-time blood glucose levels has become a standard way of managing diabetes. CGMs allow users to understand better and track their diabetes, enhancing their capacity and capability to manage the disease. As such, it’s easier and more convenient than traditional diabetes test strips.
The Lowering Of CGM and CSII Prices Will Accelerate Uptake
It’s not all rosy when using Dexcon and Omnipods. The devices are costly, and managing diabetes can be daunting if you pay out-of-pocket. Traditional test strips are still cheaper than the CGMs on the market.
That being said, the technological advancement on the horizon will likely shift the cost implications of using CGMs. For starters, the competition among CGM producers is only increasing every year. Market leaders such as Dexcom, Abbott, Eversense, and Medtronic are investing in research and development to improve the performance of their products and lower the costs of manufacturing their CGM systems. Furthermore, new entrants in the market, including SugarBeat, will help push competition and possibly lower costs.
The accuracy of sensors used in CGMs has improved steadily in the last decades. The best sensors of leading CGMs have an accuracy of about ±10% MARD (Mean Absolute Relative Difference), which is sufficient to allow users to adjust their insulin dosages as needed using CSII like the Omnipod. This improvement in accuracy has made it possible to reduce the number of the confirmatory capillary blood glucose test. Consequently, many physicians are more comfortable recommending CMGs, while many patients are now willing to use CGMs like the Dexcom G6.
Reduced Need For Calibration
Patients are now using CGMs as plug-and-play medical devices. The sensors and the corresponding improvements in software powering the CGMs have allowed diabetic patients to apply and use the devices without having to conduct frequent calibrations. The reduced need for calibration is crucial in convincing patients to ditch the fingerstick testing and take up CGMs.
Effectiveness Of CGMs When Used With CSIIs
Recent studies have shown that CSIIs are just as effective in glycemic control as multiple daily injections (MDI). However, CSII systems that integrate with CGMs have an added advantage of providing patients with glycemic control without ensuring multiple injects in any given day. T1DM can effectively control the disease using the traditional MDI and CSII such as Omnipod.
With anticipated improvements in CGM and CSII systems, diabetic patients can expect to wear these systems for longer. Additionally, it’s anticipated that the sensors and the software controlling these system will only improve moving forward. These considerations and factors will enhance the user experience, effectiveness and accuracy of the test and significantly lower the cost of the devices.
We can expect the improvements will spur more demand CGMs and a corresponding decline in demand for traditional test strips and meters. Consequently, fewer people may rely on test strips, leading to dropping supply and demand.