danatech · Technology Horizon
What we're watching in diabetes technology
A plain-language read on where the field is heading, why it matters for the people you support and the specific technology we're tracking. Each item is tagged with where it actually stands in development as of August 2026.
What the status tags mean
In practice·
FDA cleared, not yet widely available·
Regulatory review·
Pivotal / late-stage study·
Early development
01
Fewer device changes, less daily upkeep
Now
Infusion sets are changed every 2–3 days; most sensors run 10–15 days. Seven-day sets and a year-long implantable sensor already exist, proving longer wear is possible.
Next
The whole category shifting from frequent maintenance toward longer-wear, lower-upkeep systems: ideally resulting in fewer swaps, fewer supplies, fewer interruptions.
Why it matters for your practice
Device burden, meaning the changes and the supplies and the interruptions, is one of the most common reasons people hesitate to start technology or quietly abandon it. Fewer changes also mean fewer prescriptions, reorders and prior authorizations, which can lift a real load off both patients and your team and may support better adherence. What we teach shifts too: less "how to change it" and more "how to keep one site healthy for longer" and "when to change early anyway."
What we're watchingFDA cleared, not yet widely available
Tandem's SteadiSet is a 7-day infusion set that has FDA clearance but is not yet broadly available. It signals that extended wear is becoming the delivery-side norm, not just a one-product exception. Medtronic's 7-day Extended Wear set is already in use as baseline evidence that this shift is real.
Open Questions
- Does extended wear hold up in real-world site health and reliability, not just in trials?
- How does longer wear interact with insurance supply cycles and reordering?
- How do you coach site rotation and "change early if needed" when the label allows longer?
Evaluating & choosingSupporting ongoing use
02
Systems that work with more than one CGM
Now
Many AID systems already work with more than one sensor brand, because the "system" is the pump and CGM cleared together as a set. A person can often keep their pump and switch sensors within what's approved.
Next
That approved list keeps widening, and regulators now clear some components to interoperate. The direction is more sensor and controller choice over time, not any algorithm running on any pump.
Why it matters for your practice
Device selection becomes less all-or-nothing. A person can keep what works and swap one piece, so you're guiding a series of smaller choices rather than one locked commitment. What matters most is which combinations are cleared to run together, because a pairing that looks compatible may not be approved, and knowing that difference is the clinician's job. For more on compatibility view our Find & Compare Insulin Delivery Devices.
What we're watchingIn practice
Omnipod 5 already works with more than one CGM: Dexcom G6, Dexcom G7 and FreeStyle Libre 2 Plus and 3 Plus. Each pairing has its own setup and controller requirements, and only the specific combinations Insulet (the manufacturer) has cleared with the FDA will work together. The open question is how far this goes: whether future systems let people mix pumps, sensors and algorithms more freely, or whether choice stays inside each company's approved set.
Open Questions
- How far along the spectrum does this go, toward mixing any part freely, or wider but still bundled systems?
- Which pump-sensor-algorithm combinations are actually cleared together, versus theoretically compatible?
- How do you keep device-selection conversations clear as the number of moving parts grows?
Evaluating & choosingStarting & using
03
Sensing beyond glucose
Now
Continuous glucose monitoring systems track only glucose. Ketones are usually checked with separate blood or urine tests, if they're checked at all.
Next
Single wearables that continuously read more than glucose, starting with ketones, with other analytes being explored for related conditions.
Why it matters for your practice
Rising ketones can escalate to diabetic ketoacidosis (DKA) within hours, yet many people have no ketone testing supplies at home. A continuous ketone signal could provide visibility into rising ketones between episodic checks. That would reshape sick-day guidance and hand clinicians a new data stream to teach people how to read and act on.
What we're watchingRegulatory review · not FDA authorized
Abbott's Libre Duo is the first sensor to continuously measure glucose and ketones together. It received European authorization (CE Mark) in 2026 and has been submitted to the FDA, but is not yet authorized for use in the United States. It's designed to be compatible with automated insulin delivery systems.
Open Questions
- US regulatory timing: dual-analyte sensing remains investigational in the United States.
- How should a continuous ketone reading reshape sick-day and DKA-prevention teaching?
- Do additional analytes generate actionable data, or just more numbers to interpret?
Interpreting & acting on dataTroubleshooting & safety
04
Automated delivery built for type 2 diabetes
Now
Automated insulin delivery continues to expand into type 2 diabetes and the ADA's 2026 Standards of Care removed several prerequisites for starting technology. The "can people with T2D use pumps?" question is settled.
Next
Systems designed to make setup and ongoing management less of a burden for both clinicians and patients: built for T2D and nonspecialist settings from the start.
Why it matters for your practice
The question is shifting from "does this person qualify?" to "what happens when automated delivery becomes simple enough to start and support outside specialty diabetes clinics?" More starts may happen in primary care, changing who needs to understand initiation, education and follow-up.
What we're watchingPivotal study enrolling
Insulet's fully closed-loop system for type 2 diabetes is designed to run without user settings, meal announcements or manual boluses. After feasibility studies (its EVOLUTION program), the EVOLVE pivotal trial began enrolling in 2026 under an FDA investigational device exemption, with the company targeting a regulatory filing in 2027 and launch in 2028.
Open Questions
- How much training is still necessary when a system needs no settings, and who delivers it?
- Who initiates it, and how does primary care support it?
- What happens, and who responds, when a "hands-off" system fails?
- How does guideline expansion translate into actual insurance coverage and access?
Evaluating & choosingStarting & usingInterpreting & acting on data
05
Systems asking less of the user
Now
Today's automated systems still mostly expect meal announcements, carb counting and manual boluses throughout the day.
Next
Less manual entry at each step, moving toward systems that may need little or no meal announcement at all.
Why it matters for your practice
Less daily input means lower burden, but it changes what people need to understand, not how much. When a system asks for less, the real question is whether users still hold the mental model they'll need on the day something goes wrong and they have to troubleshoot. Less interaction may mean different education, but not less of it.
What we're watchingPivotal data reported
Insulet's next-generation Omnipod 6 reported pivotal-trial results (its STRIVE study) in 2026 showing strong glucose outcomes with less user input. MiniMed's Vivera algorithm, now in a US pivotal trial, goes further still: it makes meal announcements fully optional, with early feasibility data around 74% time-in-range even without them. Both are concrete steps from today's hybrid systems toward more hands-off delivery.
Open Questions
- What do people still need to be taught, and what can they safely stop tracking?
- Does reduced input erode the understanding people rely on when problems arise?
- How do you keep troubleshooting skills intact when the system usually handles it?
Starting & usingTroubleshooting & safety
06
Beyond insulin-only automation
Now
Every automated system on the market delivers insulin only. Treating lows still depends on the user acting: eating carbs or using rescue glucagon.
Next
Systems that automate two hormones, insulin to lower glucose and glucagon to raise it, more closely mimicking how the body regulates itself.
Why it matters for your practice
A bihormonal system would change what "automated insulin delivery" even means, rippling into hypoglycemia prevention, rescue-glucagon concepts, device burden, training and prescribing. It's the most conceptually different direction on this page, which is exactly why it's worth understanding early, even though it's the furthest from routine use.
What we're watchingEarly development
Beta Bionics is developing a bihormonal iLet that would deliver both insulin and glucagon. It remains in early feasibility: a 2026 Phase 2a study led the company to refine the glucagon formulation and dosing algorithm before further trials. This is a direction, not a near-term product, and it faces a long road.
Open Questions
- How would a second hormone change hypoglycemia teaching and rescue-glucagon conversations?
- What added complexity in filling, cost and training comes with a two-hormone system?
- How does prescribing and coverage work for a device that delivers glucagon continuously?
Evaluating & choosingTroubleshooting & safety
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