Technology for Augmenting Type 1 Diabetes Mellitus Management

Abstract

Type 1 diabetes mellitus has witnessed significant progress in its management over the past several decades. This review highlights technologic advancements in type 1 diabetes management. Continuous glucose monitoring systems are now available at various functionality and cost levels, addressing diverse patient needs, including a recently US Food and Drug Administration (FDA)–approved implantable continuous glucose monitoring system (CGMS). Another dimension to these state-of-the-art technologies is CGMS and insulin pump integration. These integrations have allowed for CGMS-based adjustments to basal insulin delivery rates and suspension of insulin delivery when a low blood glucose event is predicted. This review also includes a brief discussion of upcoming technologies such as patch-based CGMS and insulin-glucagon dual-hormonal delivery.

Continuous glucose monitoring systems in well-controlled children with type 1 diabetes mellitus

“…Numerous studies have demonstrated the clinical benefits of using CGM, especially as regards the efficacy in lowering HbA 1c across all age groups without increasing the incidence of hypoglycaemia or even reducing the duration of hypoglycaemia [2][3][4][5][6][7][8][9]. The reduction in HbA 1c ranged from 0.22% up to 2.05% [6,[8][9][10][11][12][13].…”

“…The potential ability to reduce the risk of hypoglycaemia is a huge advantage of CGM, especially in the paediatric population, because most children experienced asymptomatic postprandial and nocturnal hypoglycaemic events. The parents of children using CGM reported decreased stress and anxiety about their child’s health and improved quality of life [ 2 , 3 , 16 ]. These devices may also contribute to the reduction of diabetes care costs by alerting patients to potential glucose deviations and avoiding hospitalizations due to severe hypoglycaemia and diabetes ketoacidosis episodes [ 2 , 3 , 5 , 7 ].…”

“…The parents of children using CGM reported decreased stress and anxiety about their child’s health and improved quality of life [ 2 , 3 , 16 ]. These devices may also contribute to the reduction of diabetes care costs by alerting patients to potential glucose deviations and avoiding hospitalizations due to severe hypoglycaemia and diabetes ketoacidosis episodes [ 2 , 3 , 5 , 7 ].…”

The Effect of Frequency of Technology Uploads on Glycemic Control in Adult Insulin Pump Users

“…In an effort to deliver insulin in a more physiological manner, insulin pumps and continuous glucose monitors (CGMs) have been developed. 1 Insulin pumps are more widely used than CGMs, but in some cases, the two are integrated into a single system. This integrated system has shown efficacy in reducing hypoglycemia 2 and improving quality of life.…”