What’s New in Closed-Loop Land?
May 02, 2025
Although the pace of innovation in closed-loop systems has slowed somewhat in recent months, there is still plenty to report.
Below you will find a concise but in-depth update, based on our previous fall update from 2024.
👉 Did you miss the previous update or would you like the full overview including links to studies? Read the previous blog here.
What's in this update?
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- Key news about current closed-loop systems
- Preview of what's coming
- Downloadable overviews
- Invitation to our free Diabetes Tech Update Hour webinar on May 21st
Where are we now with closed-loop systems?
Medtronic - MiniMed 780G and more
- Number of users: Approximately 600,000
- Available in >100 countries in North America, Europe, Australia, and parts of Africa, Asia, and South America.
- News:
- Simplera Sync has been launched in 25 countries in Western Europe and has finally received an FDA label. The rollout is proceeding slightly slower than hoped.
- The Simplera CGM may have a negative bias compared to the Dexcom and Libre sensors, which may be important when interpreting Time In Range results.
- Medtronic has requested FDA approval for the MiniMed 780G as an interoperable insulin pump, so that it can also work with the new Abbott-based CGM.
- The development of the patch pump is progressing well. Users were recently asked which color they would prefer.
- New 8-series pump: no news yet.
- Medtronic's complete closed-loop algorithm (NMX-AID) is said to have very good results, but official information is lacking.
- The first real-world results with the new InPen System showed that people who responded to the advanced “missed bolus” and “correct high” alarms achieved better Time In Range. A study is also set to start soon in which the SmartGuard algorithm will be integrated into the Smart MDI System.
- Recent results of the MiniMed 780G in type 2 diabetes were very good, and official approval is being sought.
- Newer insulins: Both Fiasp® and Lyumjev® lead to better postprandial glycemic control in children and young people using the MiniMed 780G. However, the effect on Time In Range is limited. These insulins have already been approved for use with the MiniMed 780G in Europe. An FDA indication for this is still pending.
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Conclusion:
- Medtronic remains the global market leader in closed-loop systems. The MiniMed 780G is the most widely used and is widely regarded as the most efficient closed-loop system. We are curious to see whether the results will be as good with the new Abbott-based sensor.
- Looking ahead, we are particularly excited about the patch pump and the full closed-loop algorithm, as well as the closed-loop system with the InPen, and ultimately the all-in-one pump and sensor. However, there are no concrete timelines, so don't expect any major breakthroughs in this area in 2025.
Tandem Diabetes Care: Control-IQ and Control-IQ+
- Number of users: Approximately 480,000
- Available in 25 countries in North America, Australia, New Zealand, Israel, and parts of Europe.
- News:
- Control-IQ+ (formerly known as Control-IQ 1.5) has been launched in the US for people with type 1 diabetes aged 2 years and older and type 2 diabetes aged 18 years and older. It is not really more effective in terms of Time In Range, but it has broader limits in terms of weight (9-200 kg instead of 25-140 kg) and total daily insulin dose (5-200 U/d instead of 10-100 U/d). In addition, the meal bolus can now be extended up to 8 hours and a temporary basal rate can also be set in auto mode for up to 72 hours.
- Tandem experimented with a lower target value of 90-130 mg/dl (5-7.2 mmol/l) instead of the current 112.5-160 mg/dl (6.25-8.9 mmol/l), and a “late bolus function,” in which the meal bolus was reduced based on the time since the meal was eaten. These strategies were safe but did not lead to better Time In Range. It is unclear whether this will be integrated into the Control-IQ algorithm.
- In a feasibility study discussed at ATTD-Asia, the full closed-loop “Freedom” algorithm performed very well with meal announcements (Time in Range 82%), but less well without meal announcements (Time In Range 55%).
- The integration of the FreeStyle Libre 3 Plus and the 15-day Dexcom G7 with the t:slim insulin pump is planned for the second half of this year. Integration with the Mobi pump will follow.
- The t:connect app with phone bolus function is now called the Tandem t:slim Mobile app. Its launch in Europe has been postponed several times, but is still planned for 2025.
- The Tandem Mobi launch in Europe has also been postponed to “late 2025,” but this could also be 2026. Please note: the Tandem Mobi is only available for iPhone users; there is no Android app yet.
- Patch pump (Mobi:tubeless), Sigi pump, 7-day infusion set: no concrete updates.
- Conclusion:
- Tandem remains popular in the US. Outside the US, the launch of their software and hardware updates has been delayed somewhat. Regardless, the Tandem pump remains a good option for people who want more control over their insulin delivery. It is the only commercial closed-loop system that allows you to adjust not only the target value and carbohydrate ratio, but also the basal insulin delivery and insulin sensitivity to your personal insulin requirements.
- Looking ahead, we are particularly excited about the Mobi:tubeless and the Freedom algorithm.
Insulet: Omnipod 5
- Number of users: Approximately 365,000.
- Availability in 15 countries (USA, Germany, UK, Netherlands, France, Belgium, Italy, Denmark, Finland, Norway, Sweden, Canada, Australia, Israel, and Switzerland), with planned rollout in other European countries in 2025.
- News:
- In most regions, the Omnipod 5 is now compatible with both the Dexcom G6 and the Dexcom G7 and FreeStyle Libre 2 Plus. There is no news about a possible integration with the FreeStyle Libre 3 Plus.
- Note: For the time being, there is no follow app available for people using the FreeStyle Libre 2 Plus, but this is reportedly being worked on.
- Small update for the Omnipod 5 Controller: you can now set "Favorite Meals", allowing people to use meal announcements instead of counting carbohydrates.
- The Omnipod 5 app on mobile phones will remain available only in the US for the time being. The Android app is compatible with Dexcom G6 and G7, while the iOS app is only compatible with Dexcom G6.
- The SmartAdjust 2.0 algorithm with a lower target value and the fully closed-loop algorithm (EVOLUTION) are under development. The initial results with the EVOLUTION algorithm (without boluses) were mixed: Time In Range for people with type 1 diabetes was 57%, and for type 2 diabetes 65%.
- Conclusion:
- Omnipod 5 is currently the most popular closed-loop system worldwide, thanks to its simplicity and patch design. Further growth and wider availability are expected in 2025.
- Looking ahead, we hope that the Omnipod 5 mobile app will soon be available outside the US, in combination with the newer algorithms.
YpsoMed: mylife Loop
- Number of users: Approximately 68,000.
- Available in: Most countries in Europe, Canada, Australia, and New Zealand
- News:
- Ypsomed Diabetes Care AG was acquired by TecMed Medical Technology. Since TecMed is owned by the same family, we expect little impact for end users.
- TecMed has announced that it is also working on a patch pump in combination with mylife Loop.
- The iOS version of the mylife CamAPS FX app has been launched (first in Sweden, then in other countries).
- Research into the full closed-loop algorithm (CamAPS HX) in people with type 1 diabetes is still ongoing. For people with type 2 diabetes, this algorithm has already been approved in Europe but has not yet been commercialized.
- Conclusion:
- The mylife Loop system is very popular in the countries where it is available. According to the ADA guidelines, it is the preferred closed-loop system for women with type 1 diabetes who are pregnant or want to become pregnant, which is a very important group of people.
- Looking to the future, we are looking forward to a possible patch pump and also to the results and commercialization of the full closed-loop system.
Diabeloop: DBLG1
- Number of users: Approximately 12,000
- Available in the Netherlands (with Kaleido), Germany (with Kaleido and Dana-i) and France (with Kaleideo). Rollout to the UK and Italy is planned but delayed.
- News:
- A new Kaleido 2 is expected at the end of 2026. This pump will be slightly smaller and will work with the Diabeloop app and the DBLG2 algorithm.
- The DBLG1 software on the handset has been slightly updated, allowing, among other things, insulin delivery during exercise to be better adjusted to the type of exercise you are doing.
- No news about integration with Dexcom G7, MEDISAFE WITH, or results from the full closed-loop algorithm (DBLG2).
- Conclusion:
- The update to the Kaleido pump was well received and it is the only pump that offers so many color options.
- However, the planned updates to Diabeloop are experiencing significant delays, and there has been little proactive communication from the company.
Beta Bionics
- Number of users: Approximately 15,000
- Only available in the US (no plans for commercialization outside the US at this time)
- News:
- The new iLet pump with color screen is 20% smaller than the previous version (partly because the second reservoir that was initially intended for glucagon has been omitted).
- Beta Bionics is also working on a modular patch pump and plans to enable pump control via the iLet Mobile app (which is currently only a view app).
- The latest investor presentation shows that the iLet also works reasonably well as a fully closed-loop system (GMI 7.4% without meal announcements).
- The bihormonal closed-loop system (iLet Duo with insulin and glucagon) has been delayed, possibly due to problems with glucagon stability.
- Conclusion:
- The iLet Bionic Pancreas is unique because you only need to enter your weight and there is no need to count carbohydrates. This is very interesting for people who are looking for simplicity, but it is currently only available in the US.
- Looking to the distant future, we are looking forward to the patch pump, approval for people with type 2 diabetes, and their bihormonal system.
Medtrum: TouchCare Nano System
- Number of users: Approximately 400.
- Available in United Kingdom, Czech Republic, Croatia, Estonia, Greece, Slovenia, Sweden, Denmark, Italy, Hungary, Netherlands, Argentina, Turkey
- News:
- New studies from Turkey and Argentina show promising Time In Range results, although there is little data on CGM accuracy.
- The TouchCare Nano Pro CGM is expected to be launched soon. It is a modular CGM similar to the FreeStyle Libre 3.
- The TouchCare Nano Pump 400 U is also expected to be launched (200 U and 300 U are already available).
- Conclusion:
- The TouchCare Nano System is an interesting alternative to Omnipod 5, as it is smaller, offers full mobile phone control, and has a follow app. However, there is a lack of transparency regarding the AI algorithm and CGM accuracy, so the potential benefits and risks should be carefully considered.
Open-source closed-loop systems: AndroidAPS, DIY Loop, iAPS and Trio
- Number of users: Approximately 25,000
- The algorithm is available worldwide free of charge, but its use is limited by the inaccessibility of “loopable” insulin pumps.
- News:
- Every open-source closed-loop system has been updated in recent months: AndroidAPS v3.3 in December 2024, DIY Loop v3.6 in April 2025, iAPS v6.4 in March 2025, and Trio v0.2.5 in April 2025.
- The CLOSE IT study showed that AndroidAPS without meal boluses is not inferior to entering meals with carb counting. This makes it the first full closed-loop system available.
- Conclusion:
- The open-source community innovates quickly. This is ideal for advanced users who want to take everything into their own hands.
Future closed-loop systems
(A downloadable version of the overview can be found here)
In addition to existing systems, a number of promising innovations are in the pipeline.
Some are already in the testing phase, others are still under development – but they give a good idea of where the technology is heading:
- Twiist - expected to launch in 2025, initially only in the US.
- MicroTech Medical - combines a redesigned 300 U Equil patch pump with the LinX CGM.
- INREDA - is working on a bihormonal system, which is expected to be available in the Netherlands in 2026.
- Luna Diabetes - is developing a patch pump that only needs to be worn at night.
- Modular Medical - in development, collaboration with Nudge BG.
- Eoflow - continues to develop its closed-loop system, but is in a patent dispute with Insulet.
- PharmaSens - is building an all-in-one pump and CGM device.
- SFC Fluidics - is working on a bihormonal system (Gemini-DHAP).
Also in the pipeline: AI-driven algorithms, such as:
- Dexcom's Liberty project - discussed at ATTD-Asia2024
- Neural-net artificial pancreas - discussed at ATTD2025
Downloadable overviews
>> Click here to download the English comparison of the 10 available closed-loop systems in 2025.
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- The latest updates on CGM and closed-loop systems
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Kind regards,