DIY Loop
Insulin Pen
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.
Insulin pens make insulin delivery more convenient than traditional vial/syringe options. Pens are small, portable, and more discrete to use in public.
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.
Needles
Disposable needle attaches to insulin pen for daily injections.
Long-acting insulin
Basal (long-acting) insulin pen for steady release of insulin that helps control blood sugar between meals, and overnight.
Rapid-acting insulin
Bolus (fast-acting) insulin pen for meal time or high blood sugar correction.
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. Noticeable 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 for insulin-dependent type 1 and 2. Price range; 0-$1260/month depending on insurance coverage.
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.
28 Days
Can be kept at room temperature (not above 80º F) when in use for 28 days. Unopened insulin pens should be stored in the refrigerator (36ºF - 46ºF).
Vision / Auditory / Dexterity
NO text to speech
YES vibration alerts
A LOT of dexterity needed
NO text to speech
NO vibration alerts
A LOT of 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.
No attachments to the body. Insulin pens are easy to use and do not remain attached to the body, allowing for a flexible and active lifestyle.
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.
Limited customizability. Pens require manual dose adjustment and limit the ability to adjust basal insulin throughout the day.
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 pen and pen needles but nothing attached to the body.
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.
More precise than syringes. Ability to measure doses using a dial, increasing accuracy.
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 but many steps. Attach a new needle, dial the correct dose, inject, and dispose of needle.
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. Pens can be hidden when not in use but visible when in use. Frequent injections are unavoidable.