In this week’s issue of The Savvy Diabetic:
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- CMS Finalizes Competitive Bidding Changes to Diabetes Devices
- Twiist Partners with Arecor to Bring Concentrated Insulin to an Insulin Pump
- Diabetes Technology Updates – Winter 2025 by Diabetotech.com
- Implantable Pump Technology May Improve Diabetes Management
- How Do We Manage the Blood Sugar of a Patient with Type 1 Diabetes During Surgery? By CrushingT1
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CMS finalizes competitive bidding changes to diabetes devices by Elise Reuter for MedTechDive.com, 1 December 2025.
The final rule would go into effect starting Jan. 1. The CMS is expected to announce specific dates for registration and bidding in late spring or early summer. The agency plans to open the bid window in late summer or early fall next year and award contracts in 2027. The CMS said the final rule will eliminate the need to wait five years to replace equipment, allowing people to use the latest devices.
“We believe that the technology for CGMs and insulin infusion pumps, which are often used in conjunction with CGMs, will continue to change very rapidly in future years,” the CMS wrote in its final rule, noting that 17 new CGMs have been introduced to market in the last decade.
The final rule follows comments last month from the House and Senate Diabetes Caucuses calling for the CMS to address “serious flaws” with the proposed rule before restarting its competitive bidding problem. More recently, a watchdog report from the Department of Health and Human Services’ Office of Inspector General called on CMS to use its competitive bidding program to adjust payments for CGMs and supplies, after the report found that Medicare was paying above supplier costs and retail prices for the diabetes equipment.
Read more:
Twiist Partners with Arecor to Bring Concentrated Insulin to an Insulin Pump by Diabetech Justin & Itzel Estrada for Diabetech.info, 3 December 2025.
Arecor Therapeutics has partnered with Sequel Med Tech to pair its ultra-concentrated, rapid-acting insulin, AT278, with Sequel’s twiist automated insulin delivery (AID) system powered by Tidepool. The collaboration focuses on people who require higher insulin doses, including people with type 1 and type 2 diabetes, and prefer smaller, longer-wear insulin pumps. Both companies plan to contribute $1.3 million to move the project into Phase 2 clinical trials in 2026.
AT278 is a 500U/mL ultra-rapid and ultra-concentrated insulin in development. Once approved, it could become the first of its kind for next-generation pump systems. Arecor previously worked with Medtronic on a similar insulin initiative, continuing its effort to expand options for insulin delivery. Sequel’s twiist pump, launched in summer 2025, uses acoustic sensing to measure every microdose of insulin in real time. That precision makes it well suited for use with concentrated insulins like AT278. Sequel has also said it’s working on a proprietary infusion set.
If Sequel unlocks Arecor’s insulin, which is five times more concentrated than the insulin pumps use today, it could unlock the ability to install smaller insulin chambers and therefore smaller devices. Development and regulatory work for the AT278-twiist program will begin immediately, with an IND submission expected in 2026. If cleared, clinical studies could follow later in the year.
Diabetes Technology Updates – Winter 2025 by Dr. Inge von Boxelaer for Diabetotech.com, 28 November 2025.
Here is a great overview of all the newest diabetes technology for 2025.
Diabetes technology is evolving at high speed. Continuous Glucose Monitoring (CGM) and Automated Insulin Delivery (AID) are advancing in parallel, with new algorithms, sensors, hardware platforms, and clinical indications emerging every few months. Keeping track requires systematic, continuous updates.
Below is a concise, structured overview of the most important developments across all major AID companies — including pivotal trials, real-world performance, hardware roadmaps, sensor compatibility changes, algorithm upgrades, and upcoming regulatory indications.
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- Medtronic Diabetes Care (MiniMed): MiniMed 780G
- Tandem Diabetes Care: Control-IQ
- Insulet: Omnipod 5
- mylife Diabetes Care: mylife Loop
- Diabeloop: DBLG1
- Beta Bionics: iLet Bionic Pancreas
- Medtrum: TouchCare Nano System
- Sequel Med Tech: twiist AID system
- Open-source AID systems (AndroidAPS, DIY Loop, iAPS, Trio)
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Read more: Diabetes Technology Updates – Winter 2025
Implantable pump technology may improve diabetes management by Bailey Noah for Engineering.tamu.edu, 25 November 2025.
Technology, like insulin pumps and continuous glucose monitors, has improved quality of life for many living with Type 1 diabetes, but some patients still are unable to control their glucose with traditional pumps. For some, the only option to achieve control is an implantable pump that delivers insulin directly to the liver. While available technology is programmable, many pumps are operated mostly manually, introducing the risk of human error and additional management requirements.
To reduce this strain, one capstone team of five students from the Department of Biomedical Engineering at Texas A&M University was sponsored by Medtronic MiniMed to create a closed-loop algorithm for the implantable insulin pump system to serve the most vulnerable patients. “The pump calculates if your blood sugar is too high and if we need to lower it, then gives an insulin dose,” said team member Jacob Kimbrough, who lives with Type 1 diabetes. “If you’re low, the algorithm is going to back off on the basal rate to try and bring your blood sugar back up. With the closed-loop system, the pump and glucose monitor continuously communicate, so there’s no need for the patient to input numbers.”
Read more: Implantable pump technology may improve diabetes management
How do we manage the blood sugar of a patient with Type 1 diabetes during surgery? by Devon Holt as CrushingT1 on TikTok.com, 25 June 2025.
Devon Holt is a nurse anesthetist who is also the dad of the T1D daughter. He is passionate about caring for T1D patients during surgery … and he provides great suggestions and tips to be prepared for surgery. He posts on his Facebook page: https://www.facebook.com/groups/1390799941761436 and on TikTok: https://www.tiktok.com/@crushingt1
@crushingt1 Anesthesia and Type 1 Diabetes. #type1diabetes #diabetes #doctor #nurse
@crushingt1 How do we manage the blood sugar of a patient with Type 1 diabetes during surgery? #type1diabetes#diabetes#doctor#nurse
