Florence Endocrine Philosophy:

Dr. Jackson and the providers at the Florence Endocrine Clinic strongly encourage the use of Continuous Glucose Monitors (CGMs) in all patients on insulin, especially those patients who have Type 1 diabetes. In addition, the Clinic encourages the use of insulin pumps in insulin dependent patients. At the Florence Endocrine Clinic, access to insulin pumps and CGMs is considered to be standard of care rather than a privilege for patients that have “proven” themselves worthy of the privilege.
Resources and Experience:

The Florence Endocrine Clinic is committed to supporting all of our patients with the latest technology: ​

  • The ONLY office in North Alabama with a certified pump trainer on staff for EVERY BRAND of pump sold in the USA, including Medtronic, Tandem T-Slim, and Insulet OmniPod.
  • The FIRST office in Alabama to certify with Sensionics Eversense implantable CGM.
  • The FIRST office in Alabama to certify with Dexcom for the Dexcom Professional G6 CGM.
  • Free training for our patients on Dexcom G6, Abbott Freestyle Libre, and Abbott Freestyle Libre 2.
Pump Overview:
An insulin pump provides a continuous source of insulin (basal), as well as allowing the user to administer extra insulin to correct high blood sugars or pre-treat carbohydrate meals (bolus). Pumps are wearable and provide fast-acting (humalog/novolog) insulin continuously through an easily replaceable “infusion site,” which connects the pump to the patient and delivers insulin into the blood stream.
One of the oldest and largest American pump manufacturers, the Medtronic 670g is the first pump on the market to integrate with a CGM and make some adjustment of basal insulin automatically.  It is due for replacement in late 2020. More info.
One of the newest American pump manufacturers, Tandem introduced the first pump with a touchscreen and free software updates much like a cell phone.  The latest software version, Control-IQ, allows the pump to integrate with the Dexcom G6 CGM to automatically adjust basal insulin as well as provide some automatic boluses. More info.
Insulet is the only “tubeless” pump available in the US, as well as also being an American company.  The OmniPod pump is completely tubeless and has adhesives that attach the pump directly to the patient.  The pump is disposable.  Future upgrades due in 2021 will add integration with the Dexcom G6 CGM. More info.
CGM Overview:
Continuous Glucose Monitors (CGMs) are disposable, wearable devices that the patient places on him/herself for 10-14 days at a time.  In addition to replacing the traditional “finger stick” blood glucose check throughout the day, CGMs provide nearly continuous measurements of the patient’s blood sugars 24 hours daily, including throughout the night while the patient sleeps. CGMs allow the Clinic to see and treat high or low blood sugars that are occurring sometimes when the patient is totally unaware. Some of the latest insulin pumps will “talk” to the CGMs and are able to make adjustments to the dosing based on the current measured blood sugar.
Dexcom is a well established American CGM company.  The G4 and G5 products made Dexcom a market leader and established them as an accurate CGM company.  The G6 is the first true CGM with no finger-stick calibration required and lasts for 10 days.   Because it transmits readings continuously, it is able to send alerts for high or low blood sugars.  It uses a bluetooth transmitter and works with the Dexcom Receiver, most iPhones, and some Android phones. More info.
Abbott is a longtime medical device company that in 2019 launched the Freestyle Libre.  While the Libre measures the glucose continuously, it does not continuously transmit readings to any meter or mobile device - instead it has to be “scanned” to download the current reading and past 8 hours. The Libre is a 14 day device with no calibrations required. It works with the Freestyle Libre meter, with most iPhones, and some Android phones. The Libre 2, released in 2020 adds alert notifications to the meter.  At this time an updated mobile app is expected to be approved by end of 2020, however only the Libre 2 meter is currently available to use with the device. More info.
The newest arrival to the CGM marketplace, in 2019 Sensionics launched the Eversense implantable CGM. Inserted during a very simple in-office procedure, the CGM lasts 90 days. A removable, rechargeable bluetooth transmitter links the CGM to a compatible iPhone or Android phone. This CGM does require a finger-stick calibration twice daily. A yearly or 6-month sensor is expected in 2021. More info.
Closed Loop - the “Artificial Pancreas”

The latest technological leap in diabetes is the “Closed Loop” system which marries a CGM to an Insulin Pump for automatic and continuous ADJUSTMENTS to the insulin dosing. These systems are often referred to as “artificial pancreas” in the media because they function much closer to a pancreas than previous systems have.

The Florence Endocrine Clinic has been at the forefront of getting these products in the hands of insulin dependent patients and we work the following systems:

Medtronic Automode
First introduced on the 670g pump with Guardian CGM, the 770g pump was recently released with new features and the 780g is expected in 2021.
Tandem Control-IQ
Marrying the Tandem tSlim X2 pump and the Dexcom G6 CGM the Tandem is the first software updatable pump and also the first pump to work with a CGM from another manufacturer.
Insulet OmniPod 5
Expected to release 2021 the OmniPod 5 marries the OmniPod “pods” with a Dexcom G6 CGM for tubeless and automatic insulin delivery.
The Diabetes Cloud

In addition to revolutionizing diabetes management for the patient, pumps & cgms also provide a previously unimaginable level of detail to the data used by health care providers to improve treatment. In the past a patient might bring a blood sugar log with 2-3 blood sugar measurements taken every day, and very rarely - a log of insulin doses administered each day. With CGM, blood sugars are read continuously, even throughout the night. With insulin pumps, every dose of insulin is recorded. The “diabetes cloud” is where all of this data goes. In some cases the patient’s personal smart phone can send this data directly to the “diabetes cloud” where our office can remotely access recorded data, and in some cases the patients CGM receiver/meter and/or insulin pump may need to be present in the office to “upload” the data. The “diabetes cloud” consists of many different systems that can be grouped as follows: independent clouds and manufacturer clouds.

The Florence Endocrine Clinic maintains clinic accounts with both Tidepool and Glooko/Diasend. These diabetes cloud systems are independent of any single manufacturer and can pull data from many different devices and systems.

The Florence Endocrine Clinic also maintains clinic accounts with Medtronic Carelink, Dexcom Clarity, Tandem tConnect, and Abbott LibreView for manufacturer specific diabetes cloud systems.