Barriers to Uptake of Insulin Technologies and Novel Solutions

PAULEY, MEGHAN E.; Berget, Cari; Messer, Laurel H.; Forlenza, Gregory P.

doi:10.2147/mder.s312858

Cited by 20 publications

(18 citation statements)

References 124 publications

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“…These reasons include issues with wearability, such as allergic reactions to the adhesives used to secure the devices and other comfort issues. 8,9 Inflammation, skin irritation, or local infections can occur at the insertion site if IISs are worn longer than recommended. Additionally, smaller children with diabetes have fewer skin sites available to rotate their IISs, increasing risk of skin irritation.…”

Section: Overcoming Barriers To Insulin Pump Therapymentioning

confidence: 99%

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Nguyen

Buckingham

et al. 2022

J Diabetes Sci Technol

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Continuous subcutaneous insulin infusion (CSII) therapy is becoming increasingly popular. CSII provides convenient insulin delivery, precise dosing, easy adjustments for physical activity, stress, or illness, and integration with continuous glucose monitors in hybrid or other closed-loop systems. However, even as insulin pump hardware and software have advanced, technology for insulin infusion sets (IISs) has stayed relatively stagnant over time and is often referred to as the “Achilles heel” of CSII. To discuss barriers to insulin pump therapy and present information about advancements in, and results from clinical trials of extended wear IISs, Diabetes Technology Society virtually hosted the “Improving the Patient Experience with Longer Wear Infusion Sets Symposium” on December 1, 2021. The symposium featured experts in the field of IISs, including representatives from Steno Diabetes Center Copenhagen, University of California San Francisco, Stanford University, Medtronic Diabetes, and Science Consulting in Diabetes. The webinar’s seven speakers covered (1) advancements in insulin pump therapy, (2) efficacy of longer wear infusion sets, and (3) innovations to reduce plastics and insulin waste.

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Section: Overcoming Barriers To Insulin Pump Therapymentioning

confidence: 99%

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Nguyen

Buckingham

et al. 2022

J Diabetes Sci Technol

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“…A recent study in the USA (Pauley et al, 2021) represent that despite the benefits associated with the use of diabetes insulin pump, ongoing barriers to technology adoption are well recognized and include common themes: Physical burden concerns include a continual attachment to a device and hindrance in physical activity, cosmetic impact, and skin injury.…”

Section: Barriers or Causes Of Not Using Insulin Pumpmentioning

confidence: 99%

“…The research results if the health service structure was insufficient, the quality of care was not standardized, and capacity was poor. Moreover, that insulin pump therapy relied more on the patient's desire and knowledge (Pauley et al, 2021).…”

Section: Medical Science L Analysis Articlementioning

confidence: 99%

Effectiveness of the insulin pump on type 1 diabetes in controlling HbA1C in Riyadh, Saudi Arabia

Brazanji¹,

Al-Nafisi²

2022

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Background: Type 1 diabetes is one of the most common spreading diseases in Saudi Arabia. In addition, HbA1C is the gold standard measure for diabetes glycemic control, so the aim is to reduce the HbA1C to minimize the microvascular and macrovascular complications of diabetes. Aim: To measure the use of therapeutic insulin pumps for type 1 diabetic patients and asses the HbA1C level before and after the insulin pump insertion. Methods: A crosssectional study was done to type 1 diabetic (T1D) on a Medtronic insulin pump with a sensor (basal vs. IQ) in KSH and a virtual clinic. Conclusion:Insulin pump therapy considers an ideal solution for the reduction in HbA1C, increased patients' treatment satisfaction, and maintaining glycemic control compared to injectable insulin.

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“…Recent years have witnessed rapid advancements in technological devices assisting in insulin delivery and glucose monitoring in type 1 diabetes (T1D) care, with the goal of improving glucose levels to more closely resemble those in people without diabetes. Integration of insulin pump and sensor technologies has progressed from low-glucose and predictive low-glucose suspension (insulin cessation when sensor glucose crosses or is predicted to cross the low threshold level) to automated insulin delivery (AID) systems ( 1 – 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Initial hybrid systems combining automated basal insulin delivery with manual meal and residual correction boluses have swiftly been advanced with autocorrection boluses, meal detection, as well as more personalized treatment options (e.g. multiple target set points) and new algorithm enhancements are underway ( 1 – 3 ).…”

Section: Introductionmentioning

confidence: 99%

The Psychological Implications of Automated Insulin Delivery Systems in Type 1 Diabetes Care

Nefs

2022

Front. Clin. Diabetes Healthc.

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Automated insulin delivery (AID) systems have brought important glycemic benefits to type 1 diabetes management. The present paper provides an overview of their psychological implications. Trials and real-world observational studies report improvements in diabetes-specific quality of life, with qualitative work describing reduced management burden, increased flexibility and improved relationships. Not all experiences are positive, however, evidenced by dropping algorithm use soon after device initiation. Apart from finance and logistics, reasons for discontinuation include technology frustrations, wear-related issues and unmet glycemic and work load expectations. New challenges include distrust in proper AID functioning, overreliance and deskilling, compensatory behaviors to override or trick the system and optimize time in range, and concerns related to wearing multiple devices on the body. Research efforts may focus on incorporating a diversity perspective, updating existing person-reported outcome measures according to new technology developments, addressing implicit or explicit health professional bias in technology access, examining the merits of incorporating stress reactivity in the AID algorithm, and developing concrete approaches for psychological counseling and support related to technology use. An open dialogue with health professionals and peers about expectations, preferences and needs may foster the collaboration between the person with diabetes and the AID system.

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Barriers to Uptake of Insulin Technologies and Novel Solutions

Cited by 20 publications

References 124 publications

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Improving the Patient Experience With Longer Wear Infusion Sets Symposium Report

Effectiveness of the insulin pump on type 1 diabetes in controlling HbA1C in Riyadh, Saudi Arabia

The Psychological Implications of Automated Insulin Delivery Systems in Type 1 Diabetes Care

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