DIY Loop
Afrezza
Summary
Loop is a DIY (do-it-yourself) system. It takes some work to set up but allows people to think about diabetes less by automating basal insulin delivery based on predicted glucose levels. This system can be used with the Dexcom G6 and the Omnipod or Medtronic pumps. Information about DIY Loop can be found on the Loop or Riley Link websites.
Inhalable regular human insulin. Cartridges come in three doses: 4, 8, and 12-unit doses.
Components
Controller
Smartphone or smartwatch receives CGM readings and automatically adjusts insulin delivery via an Omnipod or Medtronic pump.
Transmitter
RileyLink allows the pump and sensor to communicate. It is only required if a Medtronic pump is used.
Sensor
Automatic applicator inserts sensor just under the surface of the skin and can be applied to many places on the body.
Pump
The system is compatible with Omnipod (left) or Medtronic (right) pumps. Both options can be applied anywhere on the body that is comfortable.
Inhaler
Small refillable inhaler contains a compartment for powdered insulin containing cartridges.
Cartridge
Cartridges come in three doses: 4, 8, and 12-unit doses. All color coded.
Device Details
Overview
This is a DIY (do-it-yourself) system that needs significant setup. It has the most flexibility in settings and device options. It also depends on a third device called a "Riley Link" to communicate between sensor, phone, and pump.
Nothing on the body when not in use. Visible when dosing.
Affordability and Access
$$$$
Supplies can be covered for Omnipod or Medtronic pumps and Dexcom. Price range; $0-$8,574 to start and 0-$300/month. iPhone, app, and Riley link are not covered and must be set up independently. Riley link price range; $135-$165.
$$$$
Widely covered. Price range; 0-$99/month, depending on insurance coverage. $35/month for medicare and commercial insurance plans.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
No Options
Data View Options
Yes
Data can be viewed on an iPhone.
No Options
Duration and Storage
3-day pump 10-day sensor
Sensors last 10 days and transmitters last 90, and work at 50ºF – 108ºF. Pods or pump reservoirs last for up to 72 hrs and work from 40ºF – 104ºF.
10 Days
Open cartridges last up to 10 days. Sealed cartridges may be stored in a refrigerator at 36°F - 46°F until the expiration date.
Vision / Auditory / Dexterity
NO text to speech
YES vibration alerts
A LOT of dexterity needed
NO text to speech
NO vibration alerts
LITTLE dexterity needed
Patient Considerations
Active Lifestyle
Automatic responses. Can set custom blood sugar targets and insulin and carb sensitivities based on type of activity. App automatically responds to blood sugar changes during activity. *Medtronic option is not waterproof. Omnipod option is fully waterproof.
Body free of devices. Does not remain attached to the body.
Avoiding Highs and Lows
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
Very short-acting. Absorbs quickly through the lungs to correct high blood sugar but requires attention to prevent lows.
Comfort
Low-profile but extra device. Low profile/low maintenance sensor. The RileyLink is an extra device that must be carried.
Many components. Have to carry multiple cartridges that can be bulky.
Easy Insulin Dosing
All settings are completely customizable. Can bolus from phone or smartwatch. Can operate “open-loop” where the user must enact insulin delivery based on recommendations or “closed-loop” where modifications to insulin delivery are automatically delivered.
Less precise but easy dosing. Dosing may be less precise due to the inhaled method of dosing, but color-coded cartridges make dosing easier. Dosing can also be done based on small, medium, or large meals and can be administered 1-2 hours post meals.
Easy to Use
Difficult set-up but easy to use. Software makes most dosing decisions. Requires many parts. Can be difficult to set up.
Simple design. Whistle-like device for inhaling insulin.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
Frequent finger-sticks are required.
Privacy
Discreet. Ability to give insulin via watch or phone. Ability to check sugar on phone or watch. Alerts available. *Medtronic pump has tubing. Omnipod is most hideable pump option (no tubes or separate controller needed).
Hideable. Small, discreet, and portable device that's not as noticeable as injections.