Devices and technology: Glycemic control

People with type 1 diabetes treated with multiple daily insulin injections struggle to achieve guideline-recommended targets for time in hypoglycemia while simultaneously reaching their glycated hemoglobin goals, researchers report.

Simon Heller explains why time-in-range targets are so helpful for people with diabetes… yet handing out continuous glucose monitoring devices willy-nilly could do more harm than good.

The d-Nav system, which calculates insulin dose adjustments according to glucose levels, can help people with type 2 diabetes achieve larger reductions in glycated hemoglobin levels than with healthcare professional support alone, shows a randomized trial in The Lancet.

DIY closed-loop insulin delivery has provoked controversy within the diabetes community, raising questions around patient empowerment, safety and liability, and whether the regulatory process remains fit for purpose in a technological age. medwireNews takes a look at the issues.

Editorial Board member Lori Berard discusses how the ambulatory glucose profile is quietly revolutionizing the analysis of blood glucose and glycemic control for patients and practitioners.

Lucidi P et al. Curr Diab Rep 2018; 18: 83. doi: 10.1007/s11892-018-1065-6

Advisory Board member Katharine Barnard scrutinizes the opinion that clinicians should be relying on glycemic outcomes when weighing the decision to prescribe a diabetes device.

Nishimura A et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0457-6

McDonnell ME. Curr Diab Rep 2018; 18: 42. doi: 10.1007/s11892-018-1015-3

Editorial Board member Sanjay Kalra presents his view on the march toward greater integration of digital health technologies and how traditional approaches to diabetes management are already changing.

Zivkovic M, Petrovski G, Bitoska I. Acta Diabetol 2018; Advance online publication. doi: 10.1007/s00592-018-1147-6

As the utility and availability of devices surges, so too do patient expectations. Advisory Board member Katharine Barnard provides key consultation questions to help determine your patients’ greatest needs and obstacles.

Kishimoto M, Tamada S, Oshiba Y. J Diabetes Metab Disord 2017; 16: 44. doi: 10.1186/s40200-017-0327-1

Editorial Board member Sanjay Kalra shares his pragmatic and practical suggestions on initiating, monitoring, and titrating suitable patients on U500 regular insulin.