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danatech · Insulin/Medicine Delivery 101

Manual Patch Pumps (Non-Automated): An Orientation

A clinician's guide to the wearable insulin devices that sit between injections and automated delivery: what the category is, how the options differ, and what to confirm before starting one.

Developed By

ADCES Clinical Staff

Current as of September 2026

These wearable devices reduce the burden of injecting for the right person. None of them is automated. The person still decides and delivers every dose.

For people who want wearable insulin delivery without automated insulin adjustment, several devices can reduce the burden of repeated injections. They differ substantially in how much insulin delivery they take over. Many clinicians encounter these devices infrequently, so this page explains what the category is, how the devices differ, and what to confirm before starting one.

Consider this category when repeated injections are a meaningful barrier to a person's insulin regimen. This may include the burden of repeated injections, difficulty dosing discreetly, or avoiding or delaying mealtime insulin because injecting is inconvenient. These devices reduce repeated injections but are not needle-free; each still involves cannula insertion and, depending on the product, steps to fill the device with insulin. They primarily address insulin-delivery burden rather than responding to glucose patterns. If the person would benefit from insulin delivery that automatically responds to CGM data, or needs dosing flexibility beyond what a particular device provides, consider another insulin-delivery option.

These devices are not interchangeable with automated insulin delivery (AID) systems. None uses CGM data to automatically calculate or adjust insulin delivery. A device can be worn on the body and still be non-automated. Delivery method and automation level are separate things.

A person holding a CeQur Simplicity wearable insulin delivery device
CeQur Simplicity is shown as one example of a non-automated wearable insulin delivery device. Size, design, and insulin delivery vary by product.

The three devices covered here are indicated for adults.

How the three devices compare

Key question CeQur Simplicity CeQur Mealtime dosing only V-Go MannKind Fixed basal + mealtime dosing Pivot Modular Medical Programmable basal + mealtime dosing FDA cleared; U.S. launch planned Q4 2026
What problem does it solve? Replaces the repeated pen or syringe injections a person takes at meals and for correction doses for high glucose. Replaces both basal and mealtime injections for a person whose basal need is steady and predictable. Adds programmable basal flexibility in a tubeless patch pump, with fewer features than a conventional pump or automated system.
What does it deliver? Rapid-acting insulin at meals and for correction doses only. No basal insulin. The person continues separate long-acting insulin. A preset, unchanging basal rate of 20, 30, or 40 units over 24 hours, plus mealtime doses. Fully mechanical, with no programming or electronics. A programmed basal schedule with up to two basal rates in 24 hours, plus mealtime doses from a button on the device. It is a tubeless patch pump that is not automated.
How are doses given? Press the buttons on the patch. FDA-cleared in 1-unit and 2-unit dosing configurations; check current availability. Worn up to 7 days. Press the button for each mealtime dose, in 2-unit steps. A new device is applied daily. Deliver mealtime doses from the device's button. Basal runs on the schedule set up in advance.
Who is it a fit for? A person on injections, stable on basal insulin, whose main barrier is mealtime injecting. The 1-unit configuration may accommodate smaller or more precise doses, where available. A person, often with type 2 diabetes, whose basal insulin need is stable enough for one fixed daily rate and who wants no screens or programming. A person who needs more basal insulin flexibility than a fixed-rate wearable device but may prefer fewer features than a conventional pump or automated system.
What does the person still do? Continue separate long-acting insulin. Decide each mealtime and correction dose and deliver it with the patch. Work with the care team to confirm the fixed basal dose remains appropriate. Decide and deliver each mealtime dose. Apply a new device daily. Set up the basal schedule with the care team. Decide and deliver each mealtime dose.
Adjusts insulin automatically? No No No

Devices are ordered by how much of the insulin work each one handles, from mealtime dosing only, to a fixed basal rate, to an adjustable one. More capability does not mean a better fit; the right device depends on the person. Availability and coverage vary by device and are still expanding for the newer options; confirm both locally before raising a device as an option.

Before starting any device in this category

A few points hold true across all three. Confirm each with the person before starting.

Basal insulin is accounted for

CeQur does not provide basal insulin; V-Go and Pivot do. Review the person's complete insulin regimen so that basal insulin is not unintentionally duplicated or omitted when moving to a wearable device.

A plan is in place for interrupted insulin delivery

CeQur users continue their separate basal insulin. V-Go and Pivot provide basal insulin through continuous rapid-acting insulin delivery, so interrupting delivery also interrupts basal insulin. This can put the person at risk for hyperglycemia, ketosis, or DKA. Make sure the person knows what to do if the device comes off, runs empty, malfunctions, or unexplained hyperglycemia suggests insulin is not being delivered, and has access to insulin by pen or syringe.

The insulin is compatible with the device

Insulin compatibility differs by device. Confirm the insulin type and concentration in current labeling before prescribing or starting. See Medication & Device Compatibility below.

Skin, site, and device use are addressed

Wear depends on adhesive tolerance and site rotation. Make sure the person knows how to fill, apply, activate, remove, and dose with the specific device, including how to confirm a dose and recognize required indicators or alarms. Identify any support or accommodations needed for vision, hearing, dexterity, cognition, language, or caregiver assistance.

Training and follow-up are planned

Provide training for the specific device, confirm that the person can complete the key steps safely, and plan an early review of glucose patterns, insulin delivery, wear-site concerns, and questions after starting.

A plan exists for reviewing glucose and insulin use

None of these devices adjusts insulin using CGM data. CeQur and V-Go do not electronically capture doses. Pivot automatically records insulin-delivery information in its app, where it can be reviewed with glucose information. Consider how glucose and insulin-use information will be reviewed after starting.

Think a patient fits? Confirm current availability and coverage in your area, then review the device's instructions for use and prescribing details before starting.

Go deeper

Specifications, compatibility, and per-device detail live in these danatech resources.

Find & Compare Insulin Delivery Devices Current specifications for each device, side by side. Medication & Device Compatibility Which insulins are labeled for each device. The Bolus-Only Insulin Patch: An Overview A closer look at wearable mealtime dosing.

Scope: This orientation covers non-automated wearable insulin delivery devices labeled for use in the United States. Device availability and labeling change; confirm current status and instructions for use before prescribing. Specifications shown are summarized for orientation and are not a substitute for each manufacturer's current labeling.

Omnipod 5 integrated with Dexcom G7 CGM

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DISCLAIMERS: 

This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit the ADCES finder tool.

ADCES and danatech curate product specifics and periodically review them for accuracy and relevance. As a result, the information may or may not be the most recent. We recommend visiting the manufacturer's website for the latest details if you have any questions.

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