Appearance of Do‐It‐Yourself closed‐loop systems to manage type 1 diabetes

Abstract

Access to proprietary closed‐loop insulin pump systems is limited. The use of Do‐It‐Yourself closed‐loop systems in Australia is growing. A 2017 Facebook group survey indicated that 20 individuals were actively looping with another 38 yet to commence despite the lack of regulatory body approval. Improved glycaemic control with less hypoglycaemia and better sleep were the main benefits. Local health professionals need to be aware of this technology.

Use of a do-it-yourself artificial pancreas system is associated with better glucose management and higher quality of life among adults with type 1 diabetes

“…Here, we evaluated the association between AndroidAPS usage and QoL with minimum intervention of HCPs and revealed similar results as in commercial APS studies. Moreover, we applied validated QoL scales, rather than qualitative netnography 22 or unvalidated survey-specific questionnaires 23 as in other DIYAPS studies, to generate more objective, reliable, reproducible and generalizable evidence. In addition to the Hypoglycemia Fear Survey, which is commonly used in APS studies, the Diabetes Distress Scale and EQ-5D-5L questionnaire were applied to assess the changes in diabetes-related distress as well as generic health status.…”

Breathing life into Australian diabetes clinical guidelines

“…Two systematic reviews are currently under development to underpin these guidelines, focused on the comparative safety and effectiveness of therapeutics for blood glucose control in adults with type 2 diabetes and the use of technologies (such as insulin pumps and continuous glucose monitors) for the management of type 1 diabetes in adult and paediatric populations. The need for clear guidance relating to these topics is demonstrated by the ongoing uncertainty regarding the most appropriate choice of second line therapies and the inception of do‐it‐yourself closed loop systems …”

Use of continuous subcutaneous insulin infusion (CSII) therapy in pediatric diabetes patients in the perioperative period

“…In 2016, the FDA approved the first hybrid closed‐loop insulin system, capable of monitoring blood sugars and autonomously adjusting basal insulin doses in patients with type 1 diabetes. While the diabetes community awaits further closed‐loop insulin systems, there are patients who have created and utilize Do‐It‐Yourself closed loop systems to manage diabetes …”

“…While the diabetes community awaits further closed-loop insulin systems, there are patients who have created and utilize Do-It-Yourself closed loop systems to manage diabetes. 10,11 With the increasing use of insulin pumps in the pediatric diabetes population, it is inevitable that this scenario will arise in the surgical setting, such that anesthesiologists and surgeons should have some familiarity with insulin pump management in diabetes. Most of the existing literature and suggested guidelines for managing pumps in the perioperative time frame are adult focused, and thus there is a need for pediatric insulin pump guidelines in perioperative management.…”