Page 276 - Glucose Monitoring Devices

Commercial devices 283

Table 14.2 Commercial PLGS systems.
Minimed 640G/670G in open loop Tandem Basal-IQ
Calculation PLGS system PLGS system
- Suspends insulin when glucose - Suspends insulin when glucose
predicted to be 20 mg/dL above predicted to be < 80 mg/dL in
the modifiable threshold of 60 30 min
e90 mg/dL in 30 min - Resumes when glucose rising
- Resumes after 30e120 min
Adjustment Can modify: Cannot Can modify: Cannot
- All pump settings modify: - All insulin modify:
- Suspend threshold N/A pump settings - Suspend
50e90 mg/dL threshold
Revert n/a n/a
Education - Consider treating hypoglycemia - Consider treating hypoglycemia
with less CHO (e.g., 5e10) if the with less CHO if the system has
system has not delivered insulin not delivered insulin for a period
(been suspended) for period of time of time before low glucose
before low glucose - System may suspend/resume
insulin frequently, leave suspend
alerts off for less interruptions
Sensor Minimed Guardian 3 Dexcom G6 sensor
- Requires 2e4 calibrations for - Factory calibrated sensor
optimal use - 10 day sensor life
-6e7 day sensor life - Can use sensor value for
- - Perform fingerstick BG for diabetes management if sensor
diabetes management decisions value and arrow are present
- -Important to calibrate when - Can remotely follow glucose
glucose is stable to prevent levels with Follow app
calibration errors

modifiable lower threshold of 60e90 mg/dL in the next 30 min. The parameters for
the resumption of insulin delivery are as follows: if the sensor glucose value is at
least 20 mg/dL (1.1 mmol/L) above the preset low limit and predicted to be at least
40 mg/dL above the low limit in 30 min, and insulin has been suspended for at least
30 min. However, the patient can intervene during the suspend time and override the
PLGM feature. The pump suspension does not exceed 2 h, and the system allows the
user to receive an alert or not on the insulin resumption.
The t:slim X2 Insulin Pump with Basal-IQ Technology was approved by FDA in
June 2018. Based on sensor data, the Basal-IQ algorithm predicts if glucose values
fall below 80 mg/dL in the next 30 min or detect if the glucose level is currently
below 70 mg/dL. The controller suspends insulin if any of these scenarios occur.
The controller then resumes delivery the first time the system receives a CGM
glucose reading higher than the previous reading, if glucose is no longer predicted
to drop below 80 mg/dL, if no CGM data are available for 10 min, or if the insulin
suspension exceeds 120 min in any 150-min period. The algorithm operates silently
in the background when it suspends or resumes insulin delivery.