Diabetes Technology

Two types of continuous glucose monitoring (CGM) systems are currently available for daily diabetes self-management: real-time CGM and intermittently scanned CGM. Both approaches provide continuous measurement of glucose concentrations in the interstitial fluid; however, each has its own unique features that can impact their usefulness and acceptability within specific patient groups. This article explores the strengths and limitations of each approach and provides guidance to healthcare professionals in selecting the CGM type that is most appropriate to the individual needs of their patients...

Two types of continuous glucose monitoring (CGM) systems are now available: real-time CGM (rtCGM) and intermittently scanned (isCGM). Current rtCGM systems automatically transmit a continuous stream of glucose data to the user, provide alerts and active alarms, and transmit glucose data (trend and numerical) in real time to a receiver, smart watch, or smartphone. The current isCGM system provides the same type of glucose data but requires the user to purposely scan the sensor to obtain information, and it does not have alerts and alarms...

Importance: Given their high costs, payers have considered implementing quantity limits for reimbursement of blood glucose test strips. The effect of these limits on patient outcomes is unknown. Objective: To determine whether the introduction of quantity limits for blood glucose test strips in August 2013 was associated with changes in clinical outcomes. Design, Setting, and Participants: Cross-sectional time series analysis from April 2008 to March 2015 of residents of Ontario, Canada, aged 19 years and older with diabetes who were eligible for public drug coverage...

BACKGROUND: The safety and efficacy of continuous, multiday, automated glycaemic management has not been tested in outpatient studies of preadolescent children with type 1 diabetes. We aimed to compare the safety and efficacy of a bihormonal bionic pancreas versus conventional insulin pump therapy in this population of patients in an outpatient setting. METHODS: In this randomised, open-label, crossover study, we enrolled preadolescent children (aged 6-11 years) with type 1 diabetes (diagnosed for ≥1 year) who were on insulin pump therapy, from two diabetes camps in the USA...

BACKGROUND: The safety and effectiveness of automated glycemic management have not been tested in multiday studies under unrestricted outpatient conditions. METHODS: In two random-order, crossover studies with similar but distinct designs, we compared glycemic control with a wearable, bihormonal, automated, "bionic" pancreas (bionic-pancreas period) with glycemic control with an insulin pump (control period) for 5 days in 20 adults and 32 adolescents with type 1 diabetes mellitus...

Continuous subcutaneous insulin, or the insulin pump, has gained popularity and sophistication as a near-physiologic programmable method of insulin delivery that is flexible and lifestyle-friendly. The introduction of continuous monitoring with glucose sensors provides unprecedented access to, and prediction of, a patient's blood glucose levels. Efforts are underway to integrate the two technologies, from "sensor-augmented" and "sensor-driven" pumps to a fully-automated and independent sensing-and-delivery system...