What is new in diabetes technology 2025

Technological advances

Diabetes technology is becoming an increasingly important part of managing the condition. Many people living with diabetes would benefit from using continuous glucose monitoring (CGM), including those not using insulin, and those diagnosed with pre-diabetes. This is because CGM can provide valuable insights into how and why glucose levels change throughout the day.

While CGM has been around for a while, it’s currently only subsidised through the NDSS for people with type 1 diabetes.

Standards of Care in Diabetes guidelines

The American Diabetes Association (ADA) recently released a new document, the Standards of Care in Diabetes – 2025. Based on the latest scientific research and clinical trials, the document includes strategies for diagnosing and treating diabetes in both youth and adults. It also includes methods to prevent or delay type 2 diabetes. In this document the ADA suggests that people with type 2 diabetes, on glucose lowering agents other than insulin, should consider using CGM for the management of their diabetes.

Continuous glucose monitoring

In the US, the Federal Drug Authority of America (FDA), has approved various CGM systems recommended for people with type 2 diabetes, and even some that can be used by people who do not have diabetes.

CGM systems for people without diabetes include:

• Dexcom Stelo
• Abbott Lingo
• LinX

So far none of these systems have received approval from the Therapeutic Goods Administration of Australia (TGA) and therefore will not be available commercially here for some time.

Non-invasive glucose monitoring

The invention of a method to check glucose levels, without having to prick the skin or draw blood, has been a dream of people with diabetes for many years.

The first diabetes wristwatch concept was introduced in 2001. Although this device gained approval from the FDA, it was discontinued in 2007 as it unfortunately failed to deliver. There have been many (ongoing) attempts since, but none have managed to get TGA approval.

Although it is possible to view glucose data on a smart watch, it is not the watch that measures the glucose levels, but the separate CGM system that measures the glucose and sends that data to a watch, via a smartphone app.

Some companies are attempting to develop other systems, such as wrist bands or finger scanning devices. One company is working on a glucose sensor that is placed under the lower eyelid, not too dissimilar to Google’s contact lens research that was scrapped a few years ago. So far, none have managed to develop an accurate system.

BEWARE!

We have seen a rise in fraudulent advertisements and scams for bogus products, including those that falsely claim endorsement by Diabetes Australia.

Scammers are using deceptive tactics, including fake endorsements from supposed doctors and misleading claims about product origins, to market questionable non-invasive blood glucose monitoring devices and other products.

These ads often appear on social media platforms, such as Facebook, and are designed to exploit trust. They publish fabricated claims and unauthorised use of reputable names to boost credibility.

We strongly advise the community to remain vigilant and verify product claims through trusted sources before making any purchases. If a product seems too good to be true, it probably is.

However, there are some promising developments regarding CGM systems currently available in Australia (and some new ones) that we like to bring to your attention.

Dexcom

It is anticipated that the Dexcom G7 15-day sensor will get FDA approval in 2025. Dexcom G7 has been available in Australia privately since August 2024, but it is not known when the Dexcom G7 will be subsidised through the NDSS.

Dexcom has also announced the launch of Dexcom ONE+, a CGM made for people with type 2 diabetes. It has adjustable high and low alerts, so you can set them to match your needs and avoid getting too many notifications. You can also time the alerts around meals and insulin doses. Dexcom ONE+ works with a smartphone app or a pocket-sized receiver, which is helpful if you don’t have a compatible phone.

Dexcom ONE+, like the Dexcom G7, is 60% smaller than the Dexcom G6, has the fastest warm-up time of any CGM on the market (currently just 30 minutes), and generates less waste due to smaller packaging. The main difference between Dexcom One+ and Dexcom G7, is that the latter has insulin pump connectivity and predictive alerts.

Dexcom has also announced that it is making a US $75 million investment into ŌURA Ring.

ŌURA Ring>

The ŌURA Ring was founded in Finland in 2013. It tracks biometric data using three sensors – a heart monitor, a movement monitor and a temperature gauge to measure sleep, stress, and movement.

Dexcom say that their partnership with ŌURA Ring will help people improve their metabolic health by integrating Dexcom glucose data (which appears to come from the Stelo CGM device) with data from the ŌURA Ring. Combining glucose data with biometrics could give you more insights in what causes fluctuations in glucose levels and deliver a more complete picture of overall health.

The ŌURA Ring is a fully titanium design, crafted in three colours. It has up to eight days of battery life, is water resistant, but not cheap. It will set you back approximately US$400, plus a subscription to get the readings at an additional cost of around US$70 per year.

FreeStyle Libre

Abbott Diabetes Care has announced that their FreeStyle Libre 2 sensors will be discontinued in the UK at the end of August 2025. It will be replacing the FreeStyle Libre 2 with the FreeStyle Libre 2 Plus, which has been available there since April 2024. FreeStyle Libre 2 Plus will be launched in Australia early in 2025.

The FreeStyle Libre 2 Plus is wearable for up to 15 days and is available for children and adults from two years of age. In comparison, the FreeStyle Libre 2 sensor that we currently have in Australia can only be worn for up to 14 days and is indicated for children over four years of age.

The FreeStyle Libre 2 Plus is compatible with the current FreeStyle LibreLink app and the Libre 2 reader. It is said to be more accurate and is compatible with the Omnipod 5 Automated Insulin Delivery System.

Abbott has also developed the FreeStyle Libre 3 and FreeStyle Libre 3 Plus systems. The FreeStyle Libre 3 systems are design for use by people with type 1 diabetes; it is said to be the smallest sensor on the market to date. FreeStyle Libre 3 has 14-day wear, whereas the FreeStyle Libre 3 Plus has a 15-day wear. Both systems automatically send data, every minute, to the FreeStyle Libre 3 app or to MyLife Loop. It can also keep 14 days of data stored in the sensor (compared to just eight hours of data storage in the FreeStyle Libre 2). They have a larger Bluetooth range, 10 meters rather than six meters. FreeStyle Libre 3 is suitable for children over 4 years of age, FreeStyle Libre 3 Plus expands the age indication to two years and older.

Medtronic

Medtronic and Abbott have announced a partnership to develop a new CGM that will work with Medtronic’s insulin delivery systems. It is expected to be based on the FreeStyle Libre 3 Plus, weigh no more than 1g, have a 14- or 15-day wear time, and no more than a one-hour warm up time (rather than the current two-hour Guardian sensor warm up).

Medtronic has also applied for FDA approval for their first disposable, all-in-one CGM.

Simplera

The Simplera system received FDA approval in August 2024, it has also received Europe’s CE Mark and TGA approval in January 2025, so we can expect to see it on the market in Australia in the not-too-distant future. The Simplera is for use with the Medtronic pumps and the In-Pen that we wrote about last year.

Simplera consists of a sensor and mobile app. It is indicated for the management of diabetes in adults aged 18 years and older. The sensor can be used for up to six days, plus an additional grace period of 24 hours. It is compact in size, easy to use, and although this system still has a two-hour warm up time, it is possible to have overlapping sensors.

Eversense

You may recall that we wrote about the Eversense three-month CGM in a previous issue of Circle magazine. Now, there is the Eversense 365, an implantable CGM that lasts a whole year!

Eversense 365 has a removable transmitter that attaches to the outside of your body, while the actual sensor gets inserted under the skin of your upper arm by a health professional. It is less than 2cm long and only 0.4cm wide. The width is equivalent to a 27-gauge needle; in comparison most fingerprick lancets are around 28 gauge (0.36 mm diameter), and COVID vaccinations generally use a 22- or 23-gauge needle (0.71 to 0.64mm). There is no risk of the sensor falling out or being knocked off. The downside? After 13 days it requires one fingerprick calibration per week.

The manufacturers state that this system has “exceptional accuracy with almost no false low alerts from sleeping on your CGM”. The transmitter provides glucose readings every five minutes, whether you have your mobile device or not. It is submergible up to one meter for up to 30 minutes and provides on-body vibration alerts when your level is high or low.

The manufacturers say this system is very accurate and rarely gives false low alerts from sleeping on your CGM. It sends glucose readings every five minutes, even if you don’t have your mobile device with you. It’s waterproof up to one meter for 30 minutes and vibrates on your body if your glucose is too high or low. You can share real-time data from the Eversense app with your doctor, family, and friends.

Insulin pump technology

Just as CGM technology continues to advance, many companies are also focused on improving insulin pumps. Some are working on combining these two technologies into a single device, which seems like a logical next step. Let’s explore some of the latest developments in Automated Insulin Delivery (AID) systems.

Insulet Omnipod 5

The Omnipod 5 is Australia’s first tubeless, and waterproof AID system, if used with a compatible CGM (Dexcom G6). The Insulet Omnipod 5 has been approved by the TGA and is expected to be available in Australia in early 2025. Insulet will provide a transition pathway to Omnipod 5 for any new or existing Omnipod users.

The exclusive SmartAdjust technology automatically adjusts your basal (background) insulin every five minutes based on your CGM readings. This helps to protect you against highs and lows by improving time in range, throughout the day and night.

When in automatic mode with a compatible CGM, the Omnipod 5 System adjusts insulin delivery every five minutes based on your current CGM value, predicted levels for the next hour, glucose trends, and past insulin delivery. This is designed to keep your glucose levels in target range.

A new iPhone app will replace the Personal Diabetes Manager (PDM), so you no longer need to carry two devices. It is hoped that Dexcom G7 support will also become available in the not-too-distant future.

Medtronic 8-series

There is not a lot of information available on the latest developments with Medtronic pumps. However, it looks like they’re working on an advanced hybrid closed-loop system that combines next-generation CGM. The design is expected to be sleek, resembling a vape pen or an Apple TV remote rather than a traditional insulin pump. It likely won’t have a screen and will be fully controlled by a smartphone. No doubt it will be compatible with the new Simplera CGM, mentioned above.

Medtronic also seems to be developing an all-in-one infusion set that not only delivers insulin but also has a built-in CGM. Wouldn’t that be amazing? Imagine just applying an infusion set, connecting it to your pump, and having everything you need. It will need to have a smaller sensor technology, but I guess that’s where the aforementioned partnership with Abbott comes in.

Pharmasens NIIA

Pharmasens have developed three insulin patch pumps, based on the same technology. The NIIA pumps are semi-reusable patch pumps, slightly smaller than Omnipod.

The first, NIIA Essential was submitted to FDA in January 2024. It is not a smart device as it is not automated. You simply put it on, it gives you a basal, and you can bolus on the device that holds up to 3ml of rapid-acting insulin.

The second Pharmasens pump is the NIIA Advanced, it can be controlled via a smartphone and has more user options. The NIIA Advanced can be connected to an external CGM.

The NIIA Signature is the first device that combines both CGM and a pump in the one device. It is a tubeless pump that consists of two parts. The reusable part includes the pump and CGM electronics and lasts for two years. The disposable part holds a 3ml insulin reservoir.

The best thing about the NIIA Signature is that you will not have to worry about Bluetooth not working, for example when you are in the water, as the CGM is inside the pump and can communicate directly to the pump. There are two prototypes. The first has two separate strands, a steel cannula needle and a sensor that are in the device side-by-side. The second is a single steel cannula needle that is encapsulated by the sensor.

The downside? At present it seems that any bolus of 10 units or more affects the accuracy of the sensor for about 10-15 minutes. The company is doing studies to investigate how accurate the CGM in this system is. They think that an algorithm that can take dilution into account can help improve accuracy, if the issue is consistent, but this requires an app to be developed, so it will take some time before this system will be available commercially.

Tandem Mobi

Last time we mentioned the Tandem Mobi it was still in its development stage, but Tandem Mobi is now available in the US, and since May 2024 can be used with the Dexcom G7 CGM system. It uses Control IQ software, similar to the t:slim X2 pump that is available in Australia. Tandem is also looking at having the Mobi operate with Abbott’s Freestyle Libre CGMs.

Mobi, compared to the t:slim X2, is about half the size. It does not include a screen, but instead can be managed through an iPhone app. You can also deliver a quick bolus with the on-pump button. It holds up to 2ml (200 units) of insulin and can be secured to a belt or clothing using the clip provided. Alternatively it can fit in the coin pocket of your jeans, or be worn with an armband or adhesive sleeve. It is water resistant, supports wireless charging and can receive remote software updates.

In the coming months and years, we expect further exciting developments from Tandem, including:

• The Steadiset infusion set made from soft cannula materials but kink resistant, with a seven-day wear time and hidden needle.
• An update to the t:slim X3, featuring improved Bluetooth connectivity and extended battery life.
• A tubeless version of the Mobi pump (previously called Mobi:tubeless), offering the convenience of sticking the pump directly to your body, on a pump base with an integrated infusion set.
• The Sigi pump, which is said to use pre-filled insulin cartridges and is set to launch with a seven-day infusion set in 2027.
• Updates to Control IQ to expand the system to a broader cross-section of people with diabetes including younger children and people with a larger body mass (by accommodating higher total daily insulin doses). They are also working on a next-generation AID system that will make meal announcements and bolusing optional this will provide even more flexibility to users.

TWIIST

Another new player in the world of AID is the TWIIST from Sequal MedTech. This system, called TWIIST because it twists open, uses an algorithm from the DIY Looping space, called Tidepool. The algorithm allows you to control the pump from your iPhone, your connected Apple watch (android is being worked on) or with the bolus button on the pump itself. This Loop algorithm was cleared in March 2024 by the FDA, for ages six and up.

The TWISST is a 3ml tubed pump that can be worn in a few different ways; it can be secured to a belt or clothing using the clip provided, it can fit in the coin pocket of your jeans and the company is working on adhesive patches that will allow it to be worn on your body, like a patch pump. You can also even disconnect and reposition it, so you are no longer stuck with wearing it in the same position for three days.

With the TWIIST you can bolus and log carbs directly from your Apple Watch. You can set a pre-meal target and pre-workout presets. TWISST has the lowest target range of any pump so far (87 mg/dL or 4.8mmol/L). Most impressively, it can detect blockages nine times faster by measuring insulin delivered through sound waves. Currently, this system only supports Apple devices, but Android is expected eventually as well.

In closing

There are many other companies that are working on the development of diabetes technology, too many to cover in this article. We encourage you to stay informed.

By Credentialled Diabetes Educator and Registered Nurse, Carolien Koreneff