Diabetes Technology Information Session Transcript
Slide 1
Welcome to the Diabetes Technology Information Session! We are happy you are here! I hope you can learn some valuable information about the various diabetes technologies on the market.

Slide 2
We are going to review the following topics today.
1. What are continuous glucose monitors and what are the options?
2. What are insulin pumps and what are the options?
3. Finally, we will end with OSU’s pump protocol and the next steps for ordering your diabetes technology.

Slide 3
What are CGM or continuous glucose monitors?
• CGMs are small, wearable devices that check your blood sugar every 1-5 minutes (depending on the brand)
• These can be worn to shower, bathe, or swim while still receiving your glucose values
• You can receive blood glucose values either on a compatible phone or receiver– you should be carrying your phone or receiver with you at all times to get regular updates about your glucose
• Not only do you receive a number for your glucose, but you also know the direction it is heading which can help you make decisions for food intake, insulin dosing, and activity

Slide 4
• CGMs don’t measure glucose directly from your blood. Instead, they measure what’s called interstitial glucose, shown here with the purple arrow on the diagram. This is the glucose that’s found in the fluid between your cells — also known as interstitial fluid.
• This is different from blood glucose, which is the glucose that’s found directly in your bloodstream, shown here by the green arrow. It’s important to know that there’s a small delay between your blood glucose and your interstitial glucose levels. That’s because it takes a little bit of time for glucose to move from your blood vessels into the interstitial fluid.
• So, your CGM readings may be slightly behind your actual blood glucose, meaning the numbers may not match exactly and your CGM reading may be a little higher or lower than your current blood glucose. This can happen when your blood glucose is changing quickly— like after eating or exercising. But even with this small lag, CGMs still give you very valuable real-time trends and patterns that help you manage glucose levels more effectively."

Slide 5
• There are a variety of CGM options available. Most last for over a week, but all vary depending on the brand.
• All can be worn in water, so taking a shower or bath or going swimming are all safe.
• The Medtronic products shown here only work with Medtronic insulin pumps. Dexcom and Libre can work with a variety of insulin pumps, which we will discuss in the next section. The Eversense 365 does not currently work with the insulin pumps on the market.

Slide 6
Now let’s discuss what insulin pumps are and how they work.

Slide 7
• Insulin pumps are small, computerized devices that deliver a continuous flow of insulin into the bloodstream through a tiny tube called a cannula, which sits just under the skin.
• Essentially, insulin pumps replace insulin injections. They take over the job of both types of insulin that someone with diabetes would normally inject:
• Basal insulin — that’s the long-acting insulin that provides a steady background dose throughout the day and night.
• Bolus insulin — that’s the rapid-acting insulin taken at mealtimes to cover carbohydrates or to correct high blood sugars.
• One of the great features of insulin pumps is that they have built-in software to help calculate mealtime doses. This is called the bolus calculator.
The pump can suggest how much insulin to give based on your blood glucose level and how many carbs you’re about to eat.
• It’s really important to know how to count carbohydrates and identify which foods contain them. The pump helps with the math—but you still provide the information it needs to make those calculations.

Slide 8
• Insulin pumps can also connect with continuous glucose monitors, or CGMs.
• The CGM tracks glucose levels in real time and sends that data to the pump. The pump then adjusts how much insulin it delivers based on those glucose readings.
• This system is called automated insulin delivery, or AID.
• It helps keep blood sugar levels more stable by automatically increasing or decreasing insulin as your glucose changes—almost like the pump and sensor are ‘talking’ to each other.

Slide 9
In the next few slides, you will hear about the different insulin pump options and their features. After we review all the pump options, we will discuss which insulin pumps are compatible with each type of CGM.

Slide 10
Say hello to Omnipod 5, the only tube-free automated insulin delivery system that integrates with leading sensor brands. Working together to help protect against highs and lows day and night with no multiple daily injections. The Omnipod 5 tube-free pod connects with your compatible sensor and the Omnipod 5 app with SmartBolus calculator. Every 5 minutes, your sensor reports glucose levels to the pod. SmartAdjust technology within the pod automatically adjusts your insulin. The pod stays at work while you live your life. Even better, everything can be controlled from a compatible iPhone or Android smartphone. The Omnipod 5 app features helpful tools like the SmartBolus calculator for meals and the activity feature for exercise. Take control without compromise with the only tube-free waterproof automated insulin delivery system that integrates with leading sensor brands. Simplify diabetes. Simplify life. Omnipod 5.

Slide 11
Trying to keep your blood sugar in range can be stressful. Control-IQ plus technology makes it easier by using CGM values to predict glucose levels 30 minutes ahead and automatically adjusting insulin delivery. So how does Control-IQ plus work? Let’s break it down. If Control-IQ+ predicts your glucose to be at-or-below 112.5mg/dl 30 minutes in the future, it will begin to decrease insulin delivery from your active personal profile rate to help keep your glucose within the target range. If Control-IQ+ predicts your glucose to below 70mg/dl, it will stop basal insulin delivery. Basal insulin delivery will resume once your glucose is predicted to be above 70mg/dl. This can help improve time-in-range 24/7. When Control-IQ+ predicts your glucose to be above 160mg/dl, it will increase basal delivery. When Control-IQ+ predicts your glucose to be at-or-above 180mg/dl and when it is either increasing delivery or delivering a max basal rate, it tells the pump to automatically deliver an auto-bolus to help return you to the target range. AutoBolus is designed to prevent highs and cover missed meal boluses, helping users achieve better A1c results, even for those who occasionally miss meal boluses. Control-IQ+ is tested, trusted, better. Ready to experience our best algorithm yet? Visit tandemdiabetes.com to learn more.

Slide 12
No audio.

Slide 13
The iLet insulin pump uses 3 algorithms to adjust insulin doses and keep your blood sugar stable.
• Basal Insulin Algorithm, shown in green, calculates how much “baseline” insulin you should have and increases or decreases that dose based on current CGM trends
• Bolus corrective insulin algorithm, shown in red, makes adjustments or “corrections” to bring you blood sugar to target, no input necessary
• Meal announcement insulin algorithm, shown in purple, is how you tell the iLet that you are having a meal, and the algorithm will figure out how much insulin you need. This algorithm will learn and adapt as you announce meals over time. 
The iLet never stops learning and is always adapting to your insulin needs. It will continue to adapt as your insulin needs change over time. The iLet will start out conservatively, based on your weight entered, and then adapt over time. 

Slide 14
This is the MiniMed 780G system designed for you and the way you live your life. Let's face it we all might miscount carbs or miss a meal dose, that's why we're excited to bring you the only system with meal detection technology. It automatically adjusts and corrects sugar levels every 5 minutes with no fingersticks when using Smartguard technology and it's compatible with the only infusion set you can wear for up to 7 days. Let the advanced technology of the MiniMed 780G system take on more of the work for you so you can focus less on managing diabetes and more on enjoying life. Smartguard technology is the automated insulin feature available with the system. Here's how it works: the Guardian 4 sensor measures your sugar levels and sends that information to the pump. The pump uses that information to anticipate your glucose trend and automatically adjusts insulin delivery and corrects highs up to every 5 minutes. Smartguard technology treats to a target that you and your healthcare provider select. The Mini Med 780g system is the only insulin pump that offers three flexible glucose targets 120 mg/dl, 110mg/dl and including the lowest available target of 100 mg/dl. If you're trending above that target, it will give you more insulin if you're trending below, it decreases or stops insulin delivery. The MiniMed 780G system is also the only system with meal detection technology; it can tell when you're eating by how quickly your sensor glucose is rising and in response automatically deliver corrections. So, if you undercount carbs before a meal, it automatically delivers a correction dose to help prevent highs and if you miss a meal dose the system delivers an autocorrection up to every 5 minutes to help stabilize your sugar levels. Next an infusion set is connected to the pump to deliver insulin continuously and discreetly throughout the day. The pump is compatible with the Medtronic extended infusion set, the only infusion set with up to 7-days of wear time. Compared to multiple daily injections, using the MiniMed 780g system with extended infusion set means 96% fewer injections. With the MiniMed mobile app you can see your levels and get notified of highs and lows directly on your phone or Apple watch and with the CareLink Connect App, care partners can be notified of real-time sugar levels whenever you are. The MiniMed 780g system is designed for the realities of life with diabetes. It's just another part of our commitment at Medtronic to empower and support you with life-transforming technologies so you can manage your diabetes your way.
Slide 15
Life with diabetes can be unpredictable, but now it doesn't have to be. Introducing a breakthrough in diabetes management. The Twist automated insulin delivery system. It's the only one powered by TidePool. friendly app allows you to check your active glucose, insulin, and carbohydrate levels anytime, anywhere with presets for exercise and an extensive food emoji library that factors in food absorption rates to help make it easier to estimate the insulin you really need. And if you change your mind about what you eat during or even after your meal, you can adjust your carb values and Twist will adjust your insulin. And with the widest glucose target range, you can wear the twist aid system the way you want with flexible options to wear on body or discreetly tucked away. How does the twist system do it? With eyes technology, the first and only technology to use sound waves to precisely measure each insulin dose for accurate delivery, giving you confidence that you're getting the insulin you need. This means that for each dose, the twist system directly measures the amount of insulin and includes four checkpoints along the way to help ensure accurate delivery. Equally impressive, blockages are identified up to nine times faster with the twist system than they are with any other automated insulin delivery system available, so you can make corrections and avoid unexpected highs. And with a six-hour glucose forecast, the Twist system tunes in to where your body is and where your glucose needs to go. So, you get the insulin you need when you need it, giving you real control for real life with more time in range and the power to live your life, your way. Are you ready for it? Because a brand-new twist on personalized diabetes control is coming soon to a pharmacy near you. Learn more at twist.com.
Slide 16
AID (or automated insulin delivery) requires connection with a CGM in order to function. Please take a moment to review the options shown for compatibility with the pump you are interested in. It is typically possible to change your current CGM to match with your desired pump, though this requires insurance and doctor approval.

Slide 17
Now we will discuss the process to order and start a new insulin pump. To get approved for an insulin pump through OSU’s Division of Endocrinology, we require all patients to follow our Pump Protocol which helps set you up for success in using an insulin pump and reduces safety risks. Let’s review the steps together.
Slide 18
Step 1: Complete Tech Survey
1. After you are done with this online session, please take our tech survey
2. You will be able to indicate which pump and CGM you are interested in
3. Completing the survey starts the pump ordering process

Slide 19
Step 2: Attend Pre-Pump Education
At OSU, we require that you attend an education session before we can order an insulin pump for you. After completing the survey, you will be referred to attend one of our pre-pump education classes to meet this requirement.
What we will cover:
* All CGM and insulin pump options available on the market
* Review of carb counting
* And many other topics to help you be successful whether you are new to pumps or have been on one for a long time
* It is always important to have a refresher

Slide 20 
Step 3: Select Pump and Compatible CGM
• After you complete the required education, we can begin the process of ordering your insulin pump. You will work with your diabetes educator to select the pump option that works best for you. 
• Your diabetes educator will pass along your pump and CGM selection to our patient navigator team who will send the order to your endocrinologist to sign off and send to your insurance company.
• Depending on the insulin pump ordered and paperwork needed by your insurance, this process can take between 2-8 weeks, sometimes longer if more information is needed.
Slide 21
Step 4: Schedule Pump Training
• After you receive your insulin pump, you will contact our Diabetes Education administrator who will help schedule you for your pump training. 
• This visit is necessary to start your insulin pump with the correct settings as ordered by your doctor. 
• This session will also teach you about how to use your pump for the best results. We will check in regularly throughout this process to help you be successful wearing your insulin pump.

Slide 22
Thanks for attending this session! I hope it was helpful and interesting. I know that this can be overwhelming, but we are here to help you. Remember that your class will go over all this information and more– and we can answer any questions you have. In order to get started with the pump ordering process and get your education scheduled, please select “Please take Survey” in the red box once you exit the video. We look forward to working with you soon!