Devices and technology

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.

Continuous glucose monitoring is well accepted and reduces time in hypoglycemia among older individuals with type 1 diabetes, report researchers in JAMA.

Continuous subcutaneous insulin infusion users have more stable glycated hemoglobin levels over the long term than multiple daily injection users with type 1 diabetes, a real-world study suggests.

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.

medwireNews talks to one of the pioneers of closed-loop insulin delivery, Roman Hovorka, about his algorithm, his research so far, and his plans for commercialization.

Glycated hemoglobin levels correlate strongly with continuous glucose monitoring-measured average blood glucose and hyperglycemia, but poorly with hypoglycemia, say researchers.

Insulin pumps and multiple daily injections deliver similar glycemic control and safety profiles when allocated alongside education and support at the point of type 1 diabetes diagnosis, say researchers.

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.

The effect of sleep duration on glucose regulation and cardiometabolic risk is becoming an increasingly high-profile issue. medwireNews takes a look at the latest evidence, which shows the gravity of the problem but also offers some solutions.

Blaurock MG et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0495-0

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.

Fully closed-loop insulin delivery results in a markedly improved time in range among inpatients with type 2 diabetes receiving noncritical care, researchers have reported.

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

Oriot P et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1170-7

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

A diabetes self-management support system delivered by text message may help patients to improve their glycemic control, shows a study in The BMJ.

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.