A plain-English guide to what's genuinely new in 2026 — continuous glucose monitors, closed-loop insulin pumps, smart pens and apps — what each does, how well it works, and how to access it through the HSE in Ireland.
Diabetes technology has changed faster in the last five years than in the previous twenty. Continuous glucose monitors (CGM) have largely replaced finger-prick testing for people on insulin, and "closed-loop" insulin pumps that automatically adjust insulin delivery are now standard of care for Type 1 diabetes and increasingly used in Type 2 diabetes. This guide, reviewed by Dr Syed Kazmi, Consultant Endocrinologist at Naas Cardiology & Endocrinology Clinic, Co. Kildare (IMC 213626), explains what these devices actually do, how accurate they are, and how to access them in Ireland.
For GPs and endocrinology colleagues: read the clinical evidence review.
A CGM is a small sensor worn on the arm or abdomen that measures glucose in the fluid under the skin every few minutes, sending readings to a phone, receiver, or insulin pump — without finger-prick testing for most day-to-day decisions. The two most widely used systems in Ireland are Dexcom and FreeStyle Libre.
| Feature | Dexcom G7 | FreeStyle Libre 3 / 3 Plus |
|---|---|---|
| Published accuracy (MARD) | ~8.2% (arm, pivotal trial) | ~7.9% overall (Libre 3 pivotal trial) |
| Sensor warm-up time | 30 minutes | 60 minutes |
| Readings per day | 288 (every 5 min) | 1,440 (every 1 min) |
| Pump integration | Wide — Tandem Control-IQ+, Omnipod 5 | Growing — Omnipod 5 (2025–26); Tandem t:slim X2 from Jul 2026 (not yet confirmed for Ireland) |
Both devices are clinically excellent for everyday use; the small accuracy difference between them rarely matters for an individual patient. Libre 3 Plus uses the same sensing technology as Libre 3, extended to 15-day wear — a separate pivotal accuracy trial specific to the "Plus" variant was not identified, so the Libre 3 figure is used as the best available estimate. What usually matters more is which insulin pump (if any) you use, how the sensor sits on your body, and whether the associated app suits you. Manufacturer comparison — Dexcom.
A hybrid closed-loop (automated insulin delivery, or "AID") system pairs a CGM with an insulin pump and a control algorithm that automatically adjusts background insulin every few minutes based on real-time glucose trends. You still count carbohydrate and give meal doses — the "hybrid" part is that the system handles background correction automatically, not full autonomy.
Tubeless, waterproof patch pump. Compatible with Dexcom G6/G7 and FreeStyle Libre 2 Plus, with FreeStyle Libre 3 Plus support added during 2025–2026. Popular for children, active users, and anyone who dislikes tubing.
Touchscreen tubed pump with automatic correction boluses, sleep and exercise modes. From July 2026, also compatible with FreeStyle Libre 3 Plus — initially rolled out in the UK, Switzerland, Sweden, Finland and Italy, with Belgium, the Netherlands and Germany planned next. Ireland is not yet on the confirmed list; ask your team for the current status.
The 780G is a tubed pump using Medtronic's own Guardian sensors. Its newer sibling, MiniMed Flex — about half the size, with no screen, phone-controlled — received FDA clearance in March 2026 and is launching through 2026. Flex also pairs with Medtronic's Simplera Sync and, notably, Abbott's Instinct sensor.
A 2026 real-world study of 213 users found meaningful time-in-range improvements with all three systems (Medtronic 780G +21.1%, Omnipod 5 +15.2%, Tandem Control-IQ +10.1%), though the study notes these figures used different CGMs across systems and should not be read as proof one system is clinically superior to another. Khan et al., Diabetic Medicine, 2026 — PubMed.
Not everyone uses or wants a pump. Smart ("connected") insulin pens are a middle ground — they look and work like an ordinary insulin pen but automatically record the time and size of every dose, and can calculate suggested bolus doses from your carbohydrate intake and current glucose.
A real-world study by Novo Nordisk (Sweden, 2017–2018) found NovoPen 6 users gained up to two extra hours of good glycaemic control per day compared with standard pens. Diabetes Ireland — Novo Nordisk smart pen launch.
Automated insulin delivery has traditionally been used almost exclusively in Type 1 diabetes, but the evidence base for insulin-treated Type 2 diabetes is growing quickly:
If you have insulin-treated Type 2 diabetes and are interested in CGM or automated insulin delivery, ask your endocrinologist whether you currently meet criteria — this is an active and fast-moving area. Read the NEJM trial.
Consumer smartwatches and smart rings that claim to measure blood glucose without any sensor on the body are heavily marketed but not currently approved for clinical use. The U.S. FDA issued a specific safety communication on 21 February 2024 stating it has not authorised, cleared, or approved any smartwatch or smart ring for glucose measurement, warning that inaccurate readings can lead to dangerous dosing errors — particularly during rapid glucose swings, which is exactly when accurate readings matter most.
This is different from wearing a CGM sensor (like Dexcom or Libre) and viewing its data on your smartwatch — that is safe and simply a display of an approved sensor's readings. Genuinely non-invasive sensing technology is progressing (for example, the FDA granted De Novo classification on 23 September 2025 to Biolinq Shine, a forearm patch using a shallow microsensor array rather than a traditional needle/filament sensor, for people with Type 2 diabetes who are not on insulin), but as of 2026 no fully non-invasive consumer device has matched the accuracy of established CGMs for people who use insulin.
Ireland has expanded public funding for diabetes technology significantly since 2023:
Your consultant or diabetes nurse specialist can confirm your current eligibility and submit the LTI/HSE application on your behalf. HSE GP Circular on CGM funding.
Book a consultation with Dr Kazmi, Consultant Endocrinologist, to discuss CGM, insulin pump, or smart pen options suited to your diabetes and lifestyle. Self-referral welcome. GP referral preferred.