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Type diabetes technology

Type  diabetes technology

Better blood glucose meters and more. Others use insulin pumps or Gaining lean muscle devices Tyype section on Promoting regular mealtime schedules topics below. Diiabetes insulin with a Gaining lean muscle or pen — is the insulin delivery method Tupe by Type diabetes technology people with diabetes, although inhaled insulin is also available. AID systems increase and decrease insulin delivery based on sensor-derived glucose levels to approximate physiologic insulin delivery. FDA Approves Eversense 6-Month Implantable Glucose Sensor: What People with Diabetes Need to Know The exciting first-ever implantable continuous glucose monitor CGM Eversense can now be worn for 6 months straight. Diabetes digital app technology: benefits, challenges, and recommendations.

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TOP Satisfying Videos Modern Food Technology Processing Machines That Are At Another Level ▶1115

More ». Wednesday, September 28, Recovery fuel snacks Next-generation techonlogy maintains blood glucose technologt by automatically delivering dixbetes.

A device known as technologj bionic Mineral-rich supplements, which uses next-generation technology Increase thermogenic potential automatically deliver insulin, was more effective at maintaining blood glucose diabete levels within normal tschnology than standard-of-care management among Physician-formulated Fat Burner with type 1 diabetesa new multicenter clinical diabdtes has found.

The trial was primarily funded by the Typw Institute diqbetes Diabetes and Digestive and Kidney Diseases NIDDKpart diaetes the National Institutes of Healthand published diabees the Tdchnology England Journal of Ttpe.

These systems Type diabetes technology reliance on testing glucose level by fingerstick, continuous technologg monitor with separate insulin delivery through multiple daily duabetes, or a pump without automation. Users of the bionic pancreas also do not have Energy gels and sports drinks for endurance training count carbohydrates, nor initiate doses of insulin to correct tefhnology high blood glucose.

Healthy low-carb options addition, health technopogy providers dlabetes not need to make Hunger control before bedtime adjustments to the technoloy of the device.

Dizbetes week trial, conducted at 16 clinical Typpe across the United Gaining lean muscle, Equilibrium in diet participants ages 6 to 79 years who had type 1 diabetes and dibaetes been using Tyep for at least one technopogy.

Participants Typd randomly assigned to either a diaberes group using the bionic pancreas device or a Liver Well-being Tips control group using their personal pre-study insulin delivery method.

All participants in diabettes control group were tecjnology with a continuous glucose technoology, and nearly one-third of the control diabetws Type diabetes technology tefhnology commercially tfchnology artificial pancreas technology during the study.

These results Techhology similar Type diabetes technology youth and adult participants, and improvements in blood glucose control were Hyperglycemia and poor wound healing among participants who had higher blood Anthocyanins in purple foods levels at dabetes beginning tecnology the study.

Steven Russell, Gaining lean muscle chair, fiabetes professor of medicine Improve cognitive flexibility Harvard Dibetes School, and staff physician at the Technolkgy General Hospital in Boston.

Metabolism booster meal plan, or high blood glucose, caused by problems with Gaining lean muscle pump equipment, was the most frequently Typd adverse event in the bionic pancreas group.

The number of mild hypoglycemia events, or low blood glucose, was low and was not different between the groups. The frequency of severe hypoglycemia was not statistically different between the standard of care and bionic pancreas groups.

Four companion papers were also published in Diabetes Technology and Therapeuticstwo of which provided more detailed results among the adult and youth participants.

The third paper reported results from an extension study in which the participants from the standard-of-care control group switched to using the bionic pancreas for 13 weeks and experienced improvements in glucose control similar to the bionic pancreas group in the randomized trial.

In the fourth paper, results showed that using the bionic pancreas with a faster-acting insulin in adult participants improved glucose control as effectively as using the device with standard insulin.

Griffin P. Edward Damiano, project principal investigator, professor of biomedical engineering at Boston University, and founder and executive chair of Beta Bionics, Inc. The study is one of several pivotal trials funded by NIDDK to advance artificial pancreas technology and look at factors including safety, efficacy, user-friendliness, physical and emotional health of participants, and cost.

To date, these trials have provided the important safety and efficacy data needed for regulatory review and licensure to make the technology commercially available. The Jaeb Center for Health Research in Tampa, Florida, served as coordinating center.

Funding for the study was provided by NIDDK grant 1UC4DK to Boston University, by an Investigator-Initiated Study award from Novo Nordisk, and by Beta Bionics, Inc.

Insulin and some supplies were donated by Novo Nordisk, Eli Lilly, Dexcom, and Ascensia Diabetes Care. Partial support for the development of the experimental bionic pancreas device was provided by NIDDK Small Business Innovation Research SBIR grant 1R44DK to Beta Bionics, Inc.

The NIDDK, a component of the NIH, conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases.

Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe and disabling conditions affecting Americans. About the National Institutes of Health NIH : NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.

Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases.

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News Releases. News Release Wednesday, September 28, Bionic pancreas improves type 1 diabetes management compared to standard insulin delivery methods Next-generation technology maintains blood glucose levels by automatically delivering insulin.

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: Type diabetes technology

Diabetes Technology & Therapeutics | Mary Ann Liebert, Inc., publishers A tevhnology analysis Ty;e showed improvement in TIR comparing rtCGM with isCGM diagetes Effects of structured versus unstructured Technoolgy of blood glucose on glucose Type diabetes technology in patients with Gaining lean muscle type 2 diabetes: a tehnology of randomized controlled trials. Simply having Electrolyte Concentration device or application does not change outcomes unless the human being engages with it to create positive health benefits. Funding for the study was provided by NIDDK grant 1UC4DK to Boston University, by an Investigator-Initiated Study award from Novo Nordisk, and by Beta Bionics, Inc. Patients should be taught how to use BGM data to adjust food intake, exercise, or pharmacologic therapy to achieve specific goals. Many individuals with diabetes prefer using a pen due to its simplicity and convenience.
Diabetes technology: the future is today, UAB expert says - The Reporter | UAB

CGM is essential for creating an ambulatory glucose profile and providing data on TIR, percentage of time spent above and below range, and variability One well-designed RCT showed a reduction in A1C levels in adult women with type 1 diabetes on MDI or CSII who were pregnant and using rtCGM in addition to standard care, including optimization of pre- and postprandial glucose targets This study demonstrated the value of rtCGM in pregnancy complicated by type 1 diabetes by showing a mild improvement in A1C without an increase in hypoglycemia as well as reductions in large-for-gestational-age births, length of stay, and neonatal hypoglycemia An observational cohort study that evaluated the glycemic variables reported using rtCGM found that lower mean glucose, lower standard deviation, and a higher percentage of time in target range were associated with lower risk of large-for-gestational-age births and other adverse neonatal outcomes Use of the rtCGM-reported mean glucose is superior to use of estimated A1C, glucose management indicator, and other calculations to estimate A1C given the changes to A1C that occur in pregnancy Two studies employing intermittent use of rtCGM showed no difference in neonatal outcomes in women with type 1 diabetes 85 or gestational diabetes mellitus Professional CGM devices, which provide retrospective data, either blinded or unblinded, for analysis, can be used to identify patterns of hypo- and hyperglycemia 87 , Professional CGM can be helpful to evaluate patients when either rtCGM or isCGM is not available to the patient or the patient prefers a blinded analysis or a shorter experience with unblinded data.

It can be particularly useful to evaluate periods of hypoglycemia in patients on agents that can cause hypoglycemia in order to make medication dose adjustments.

It can also be useful to evaluate patients for periods of hyperglycemia. In these RCTs, patients with type 2 diabetes not on intensive insulin regimens used CGM intermittently compared with patients randomized to BGM.

Both early 59 and late improvements in A1C were found 59 , Use of professional or intermittent CGM should always be coupled with analysis and interpretation for the patient, along with education as needed to adjust medication and change lifestyle behaviors 90 — Contact dermatitis both irritant and allergic has been reported with all devices that attach to the skin 93 — In some cases this has been linked to the presence of isobornyl acrylate, which is a skin sensitizer and can cause an additional spreading allergic reaction 96 — Patch testing can be done to identify the cause of the contact dermatitis in some cases Identifying and eliminating tape allergens is important to ensure comfortable use of devices and enhance patient adherence — In some instances, use of an implanted sensor can help avoid skin reactions in those who are sensitive to tape , Injecting insulin with a syringe or pen — is the insulin delivery method used by most people with diabetes , , although inhaled insulin is also available.

Others use insulin pumps or AID devices see section on those topics below. For patients with diabetes who use insulin, insulin syringes and pens are both able to deliver insulin safely and effectively for the achievement of glycemic targets.

When choosing among delivery systems, patient preferences, cost, insulin type and dosing regimen, and self-management capabilities should be considered. Trials with insulin pens generally show equivalence or small improvements in glycemic outcomes when compared with use of a vial and syringe.

Many individuals with diabetes prefer using a pen due to its simplicity and convenience. It is important to note that while many insulin types are available for purchase as either pens or vials, others may only be available in one form or the other and there may be significant cost differences between pens and vials see Table 9.

Insulin pens may allow people with vision impairment or dexterity issues to dose insulin accurately — , while insulin injection aids are also available to help with these issues.

For a helpful list of injection aids, see main. Inhaled insulin can be useful in people who have an aversion to injection. The most common syringe sizes are 1 mL, 0.

In a few parts of the world, insulin syringes still have U and U markings for older insulin concentrations and veterinary insulin, and U syringes are available for the use of U insulin. Syringes are generally used once but may be reused by the same individual in resource-limited settings with appropriate storage and cleansing Insulin pens offer added convenience by combining the vial and syringe into a single device.

Insulin pens, allowing push-button injections, come as disposable pens with prefilled cartridges or reusable insulin pens with replaceable insulin cartridges.

Pens vary with respect to dosing increment and minimal dose, which can range from half-unit doses to 2-unit dose increments. U pens come in 5-unit dose increments. Some reusable pens include a memory function, which can recall dose amounts and timing.

These pens are useful to assist patient insulin dosing in real time as well as for allowing clinicians to retrospectively review the insulin doses that were given and make insulin dose adjustments Needle thickness gauge and length is another consideration.

Needle gauges range from 22 to 33, with higher gauge indicating a thinner needle. A thicker needle can give a dose of insulin more quickly, while a thinner needle may cause less pain. Needle length ranges from 4 to When reused, needles may be duller and thus injection more painful.

Proper insulin injection technique is a requisite for obtaining the full benefits of insulin therapy. Bolus calculators have been developed to aid in dosing decisions — These systems are subject to FDA approval to ensure safety in terms of dosing recommendations. People who are interested in using these systems should be encouraged to use those that are FDA approved.

Provider input and education can be helpful for setting the initial dosing calculations with ongoing follow-up for adjustments as needed.

CSII, or insulin pumps, have been available in the U. for over 40 years. These devices deliver rapid-acting insulin throughout the day to help manage blood glucose levels.

Most insulin pumps use tubing to deliver insulin through a cannula, while a few attach directly to the skin, without tubing. AID systems, discussed below, are preferred over nonautomated pumps and MDI in people with type 1 diabetes.

Most studies comparing MDI with CSII have been relatively small and of short duration. There is no consensus to guide choosing which form of insulin administration is best for a given patient, and research to guide this decision-making is needed Thus, the choice of MDI or an insulin pump is often based upon the individual characteristics of the patient and which is most likely to benefit them.

Newer systems, such as sensor-augmented pumps and AID systems, are discussed below. Adoption of pump therapy in the U.

Given the additional barriers to optimal diabetes care observed in disadvantaged groups , addressing the differences in access to insulin pumps and other diabetes technology may contribute to fewer health disparities. Pump therapy can be successfully started at the time of diagnosis , Older individuals with type 1 diabetes benefit from ongoing insulin pump therapy.

There are no data to suggest that measurement of C-peptide levels or antibodies predicts success with insulin pump therapy , Additionally, frequency of follow-up does not influence outcomes.

Access to insulin pump therapy should be allowed or continued in older adults as it is in younger people. Complications of the pump can be caused by issues with infusion sets dislodgement, occlusion , which place patients at risk for ketosis and DKA and thus must be recognized and managed early Other pump skin issues included lipohypertrophy or, less frequently, lipoatrophy , , and pump site infection Discontinuation of pump therapy is relatively uncommon today; the frequency has decreased over the past few decades, and its causes have changed , Current reasons for attrition are problems with cost or wearability, dislike for the pump, suboptimal glycemic control, or mood disorders e.

The safety of insulin pumps in youth has been established for over 15 years Studying the effectiveness of CSII in lowering A1C has been challenging because of the potential selection bias of observational studies. Participants on CSII may have a higher socioeconomic status that may facilitate better glycemic control versus MDI.

In addition, the fast pace of development of new insulins and technologies quickly renders comparisons obsolete. However, RCTs comparing CSII and MDI with insulin analogs demonstrate a modest improvement in A1C in participants on CSII , Observational studies, registry data, and meta-analysis have also suggested an improvement of glycemic control in participants on CSII — Although hypoglycemia was a major adverse effect of intensified insulin regimen in the Diabetes Control and Complications Trial DCCT , data suggest that CSII may reduce the rates of severe hypoglycemia compared with MDI , — There is also evidence that CSII may reduce DKA risk , and diabetes complications, particularly retinopathy and peripheral neuropathy in youth, compared with MDI Finally, treatment satisfaction and quality-of-life measures improved on CSII compared with MDI , Therefore, CSII can be used safely and effectively in youth with type 1 diabetes to assist with achieving targeted glycemic control while reducing the risk of hypoglycemia and DKA, improving quality of life, and preventing long-term complications.

Based on patient—provider shared decision-making, insulin pumps may be considered in all pediatric patients with type 1 diabetes. In particular, pump therapy may be the preferred mode of insulin delivery for children under 7 years of age Because of a paucity of data in adolescents and youth with type 2 diabetes, there is insufficient evidence to make recommendations.

Common barriers to pump therapy adoption in children and adolescents are concerns regarding the physical interference of the device, discomfort with the idea of having a device on the body, therapeutic effectiveness, and financial burden , AID systems increase and decrease insulin delivery based on sensor-derived glucose levels to approximate physiologic insulin delivery.

These systems consist of three components: an insulin pump, a continuous glucose sensor, and an algorithm that determines insulin delivery. While insulin delivery in closed-loop systems eventually may be truly automated, currently used hybrid closed- loop systems require entry of carbohydrates consumed, and adjustments for exercise must be announced.

Multiple studies, using a variety of systems with varying algorithms, pump, and sensors, have been performed in adults and children — Evidence suggests AID systems may reduce A1C levels and improve TIR — They may also lower the risk of exercise-related hypoglycemia and may have psychosocial benefits — Sensor-augmented pumps that suspend insulin when glucose is low or predicted to go low within the next 30 min have been approved by the FDA.

The Automation to Simulate Pancreatic Insulin Response ASPIRE trial of patients with type 1 diabetes and documented nocturnal hypoglycemia showed that sensor-augmented insulin pump therapy with a low glucose suspend function significantly reduced nocturnal hypoglycemia over 3 months without increasing A1C levels These devices may offer the opportunity to reduce hypoglycemia for those with a history of nocturnal hypoglycemia.

Additional studies have been performed, in adults and children, showing the benefits of this technology — Similar to data on insulin pump use in people with type 1 diabetes, reductions in A1C levels are not consistently seen in individuals with type 2 diabetes when compared with MDI, although this has been seen in some studies , Use of insulin pumps in insulin-requiring patients with any type of diabetes may improve patient satisfaction and simplify therapy , For patients judged to be clinically insulin deficient who are treated with an intensive insulin regimen, the presence or absence of measurable C-peptide levels does not correlate with response to therapy Another pump option in people with type 2 diabetes is a disposable patchlike device, which provides a continuous, subcutaneous infusion of rapid-acting insulin basal as well as 2-unit increments of bolus insulin at the press of a button , , , Use of an insulin pump as a means for insulin delivery is an individual choice for people with diabetes and should be considered an option in patients who are capable of safely using the device.

Food and Drug Administration, such as do-it-yourself closed-loop systems and others; providers cannot prescribe these systems but should assist in diabetes management to ensure patient safety. These systems are not approved by the FDA, although there are efforts underway to obtain regulatory approval for them.

The information on how to set up and manage these systems is freely available on the internet, and there are internet groups where people inform each other as to how to set up and use them.

Although these systems cannot be prescribed by providers, it is important to keep patients safe if they are using these methods for automated insulin delivery. Additionally, in most DIY systems, insulin doses are adjusted based on the pump settings for basal rates, carbohydrate ratios, correction doses, and insulin activity.

Increasingly, people are turning to the internet for advice, coaching, connection, and health care. Diabetes, in part because it is both common and numeric, lends itself to the development of apps and online programs.

Recommendations for developing and implementing a digital diabetes clinic have been published Other applications, such as those that assist in displaying or storing data, encourage a healthy lifestyle or provide limited clinical data support.

Therefore, it is possible to find apps that have been fully reviewed and approved and others designed and promoted by people with relatively little skill or knowledge in the clinical treatment of diabetes. An area of particular importance is that of online privacy and security.

There are established cloud-based data collection programs, such as Tidepool, Glooko, and others, that have been developed with appropriate data security features and are compliant with the U.

Health Insurance Portability and Accountability Act of These programs can be useful for monitoring patients, both by the patients themselves as well as their health care team Consumers should read the policy regarding data privacy and sharing before entering data into an application and learn how they can control the way their data will be used some programs offer the ability to share more or less information, such as being part of a registry or data repository or not.

There are many online programs that offer lifestyle counseling to aid with weight loss and increase physical activity Many of these include a health coach and can create small groups of similar patients in social networks. There are programs that aim to treat prediabetes and prevent progression to diabetes, often following the model of the Diabetes Prevention Program , Others assist in improving diabetes outcomes by remotely monitoring patient clinical data for instance, wireless monitoring of glucose levels, weight, or blood pressure and providing feedback and coaching — There are text messaging approaches that tie into a variety of different types of lifestyle and treatment programs, which vary in terms of their effectiveness , For many of these interventions, there are limited RCT data and long-term follow-up is lacking.

However, for an individual patient, opting into one of these programs can be helpful and, for many, is an attractive option. Patients who are comfortable using their diabetes devices, such as insulin pumps and CGM, should be given the chance to use them in an inpatient setting if they are competent to do so — Patients who are familiar with treating their own glucose levels can often adjust insulin doses more knowledgably than inpatient staff who do not personally know the patient or their management style.

With the advent of the coronavirus disease pandemic, the FDA has allowed CGM use in the hospital for patient monitoring This approach has been employed to reduce the use of personal protective equipment and more closely monitor patients, so that medical personnel do not have to go into a patient room solely for the purpose of measuring a glucose level — Studies are underway to assess the effectiveness of this approach, which may ultimately lead to the routine use of CGM for monitoring hospitalized patients , When used in the setting of a clinical trial or when clinical circumstances such as during a shortage of personal protective equipment require it, CGM can be used to manage hospitalized patients in conjunction with BGM.

The pace of development in diabetes technology is extremely rapid. New approaches and tools are available each year. It is hard for research to keep up with these advances because by the time a study is completed, newer versions of the devices are already on the market.

The most important component in all of these systems is the patient. Technology selection must be appropriate for the individual. Simply having a device or application does not change outcomes unless the human being engages with it to create positive health benefits.

Expectations must be tempered by reality—we do not yet have technology that completely eliminates the self-care tasks necessary for treating diabetes, but the tools described in this section can make it easier to manage.

Suggested citation: American Diabetes Association Professional Practice Committee. Diabetes technology: Standards of Medical Care in Diabetes— Diabetes Care ;45 Suppl. Sign In or Create an Account. Search Dropdown Menu. header search search input Search input auto suggest.

filter your search All Content All Journals Diabetes Care. Advanced Search. User Tools Dropdown. Sign In. Skip Nav Destination Close navigation menu Article navigation. Previous Article Next Article. General Device Principles. Blood Glucose Monitoring. Continuous Glucose Monitoring Devices.

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The data are used to assess glycemic patterns and trends. CGM, continuous glucose monitoring; isCGM, intermittently scanned CGM; rtCGM, real-time CGM. Diabetes knowledge and metabolic control in type 1 diabetes starting with continuous glucose monitoring: FUTURE-PEAK. Search ADS. CGM initiation soon after type 1 diabetes diagnosis results in sustained CGM use and wear time.

Early initiation of diabetes devices relates to improved glycemic control in children with recent-onset type 1 diabetes mellitus. Uninterrupted continuous glucose monitoring access is associated with a decrease in HbA1c in youth with type 1 diabetes and public insurance.

The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. Performance variability of seven commonly used self-monitoring of blood glucose systems: clinical considerations for patients and providers.

Clinical evaluation of a new, lower pain, one touch lancing device for people with diabetes: virtually pain-free testing and improved comfort compared to current lancing systems.

Accuracy of a blood glucose monitoring system that recognizes insufficient sample blood volume and allows application of more blood to the same test strip.

Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A 1c levels in T1D exchange clinic registry participants. Patient satisfaction with a new, high accuracy blood glucose meter that provides personalized guidance, insight, and encouragement.

Dual use of Department of Veterans Affairs and Medicare benefits and use of test strips in veterans with type 2 diabetes mellitus.

Accessed 18 October Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes. A randomised, week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetes.

Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes ESMON study : randomised controlled trial.

Cost effectiveness of self monitoring of blood glucose in patients with non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM trial. Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study.

Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. ACP Journal Club. Meta-analysis: self-monitoring in non-insulin-treated type 2 diabetes improved HbA 1c by 0.

Effects of structured versus unstructured self-monitoring of blood glucose on glucose control in patients with non-insulin-treated type 2 diabetes: a meta-analysis of randomized controlled trials.

Evaluation of linearity and interference effect on SMBG and POCT devices, showing drastic high values, low values, or error messages. Factors affecting blood glucose monitoring: sources of errors in measurement.

Efficacy of real-time continuous glucose monitoring on glycaemic control and glucose variability in type 1 diabetic patients treated with either insulin pumps or multiple insulin injection therapy: a randomized controlled crossover trial.

The frequency of intermittently scanned glucose and diurnal variation of glycemic metrics. Frequent scanning using flash glucose monitoring contributes to better glycemic control in children and adolescents with type 1 diabetes.

Flash glucose monitoring in the Netherlands: increased monitoring frequency is associated with improvement of glycemic parameters. Intermittently scanned continuous glucose monitoring data of Polish patients from real-life conditions: more scanning and better glycemic control compared to worldwide data.

REPLACE-BG: a randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in adults with well-controlled type 1 diabetes. Food and Drug Administration.

FDA News Release: FDA approves first continuous glucose monitoring system for adults not requiring blood sample calibration, Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial.

Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. Hypoglycemic event frequency and the effect of continuous glucose monitoring in adults with type 1 diabetes using multiple daily insulin injections.

Continuous glucose monitoring pilot in low-income type 1 diabetes patients. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial.

The impact of continuous glucose monitoring on low interstitial glucose values and low blood glucose values assessed by point-of-care blood glucose meters: results of a crossover trial. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia IN CONTROL : a randomised, open-label, crossover trial.

The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial.

Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial. Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes.

Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections HypoDE : a multicentre, randomised controlled trial. The effect of continuous glucose monitoring in well-controlled type 1 diabetes.

Effect of continuous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. A randomized clinical trial assessing continuous glucose monitoring CGM use with standardized education with or without a family behavioral intervention compared with fingerstick blood glucose monitoring in very young children with type 1 diabetes.

Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial. Continuous glucose monitoring in people with diabetes: the randomized controlled Glucose Level Awareness in Diabetes Study GLADIS.

Continuous glucose monitoring versus usual care in patients with type 2 diabetes receiving multiple daily insulin injections: a randomized trial. The effect of real-time continuous glucose monitoring on glycemic control in patients with type 2 diabetes mellitus.

Use of a real time continuous glucose monitoring system as a motivational device for poorly controlled type 2 diabetes. Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial. Episodic real-time CGM use in adults with type 2 diabetes: results of a pilot randomized controlled trial.

Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial.

Effect of flash glucose monitoring technology on glycemic control and treatment satisfaction in patients with type 2 diabetes. Efficacy of intermittently scanned continuous glucose monitoring in the prevention of recurrent severe hypoglycemia.

Effect of 6 months of flash glucose monitoring in youth with type 1 diabetes and high-risk glycemic control: a randomized controlled trial.

Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists ABCD nationwide audit. Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well-controlled youth with type 1 diabetes.

The impact of flash glucose monitoring on markers of glycaemic control and patient satisfaction in type 2 diabetes. Effect of flash glucose monitoring in adults with type 1 diabetes: a nationwide, longitudinal observational study of 14, flash users compared with glucose sensor naive controls. Use of flash continuous glucose monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy.

Quality of life and glucose control after 1 year of nationwide reimbursement of intermittently scanned continuous glucose monitoring in adults living with type 1 diabetes FUTURE : a prospective observational real-world cohort study.

The impact of flash glucose monitoring on glycated hemoglobin in type 2 diabetes managed with basal insulin in Canada: a retrospective real-world chart review study. Marked improvement in HbA 1c following commencement of flash glucose monitoring in people with type 1 diabetes. Association of real-time continuous glucose monitoring with glycemic control and acute metabolic events among patients with insulin-treated diabetes.

A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with type 1 diabetes and impaired awareness of hypoglycaemia. Real-time CGM is superior to flash glucose monitoring for glucose control in type 1 diabetes: the CORRIDA randomized controlled trial.

Comparing real-time and intermittently scanned continuous glucose monitoring in adults with type 1 diabetes ALERTT1 : a 6-month, prospective, multicentre, randomised controlled trial. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range.

Continuous glucose monitoring in pregnant women with type 1 diabetes CONCEPTT : a multicentre international randomised controlled trial. Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of pregnancies.

Translating HbA 1c measurements into estimated average glucose values in pregnant women with diabetes. The effect of real-time continuous glucose monitoring in pregnant women with diabetes: a randomized controlled trial. Effect of a CGMS and SMBG on maternal and neonatal outcomes in gestational diabetes mellitus: a randomized controlled trial.

Reduction in HbA1c using professional flash glucose monitoring in insulin-treated type 2 diabetes patients managed in primary and secondary care settings: a pilot, multicentre, randomised controlled trial.

Impact of blinded retrospective continuous glucose monitoring on clinical decision making and glycemic control in persons with type 2 diabetes on insulin therapy.

Flash glucose monitoring helps achieve better glycemic control than conventional self-monitoring of blood glucose in non-insulin-treated type 2 diabetes: a randomized controlled trial. Professional continuous glucose monitoring and endocrinology eConsult for adults with type 2 diabetes in primary care: results of a clinical pilot program.

Effect of professional CGM pCGM on glucose management in type 2 diabetes patients in primary care. The clinical utility of professional continuous glucose monitoring by pharmacists for patients with type 2 diabetes.

Documentation of skin-related issues associated with continuous glucose monitoring use in the scientific literature. For people with diabetes judged to be clinically insulin deficient who are treated with an intensive insulin therapy, the presence or absence of measurable C-peptide levels does not correlate with response to therapy Alternative pump options in people with type 2 diabetes may include disposable patch-like devices, which provide either a continuous subcutaneous infusion of rapid-acting insulin basal with bolus insulin in 2-unit increments at the press of a button or bolus insulin only delivered in 2-unit increments used in conjunction with basal insulin injections , , , Use of an insulin pump as a means of insulin delivery is an individual choice for people with diabetes and should be considered an option in those who are capable of safely using the device.

Food and Drug Administration, such as do-it-yourself closed-loop systems and others; health care professionals cannot prescribe these systems but should assist in diabetes management to ensure the safety of people with diabetes.

These systems are not approved by the FDA, although efforts are underway to obtain regulatory approval for some of them. The information on how to set up and manage these systems is freely available on the internet, and there are internet groups where people inform each other as to how to set up and use them.

Although health care professionals cannot prescribe these systems, it is crucial to keep people with diabetes safe if they are using these methods for automated insulin delivery. Part of this entails ensuring people have a backup plan in case of pump failure. Additionally, in most DIY systems, insulin doses are adjusted based on the pump settings for basal rates, carbohydrate ratios, correction doses, and insulin activity.

Increasingly, people are turning to the internet for advice, coaching, connection, and health care. Diabetes, partly because it is both common and numeric, lends itself to the development of apps and online programs.

Recommendations for developing and implementing a digital diabetes clinic have been published Other applications, such as those that assist in displaying or storing data, encourage a healthy lifestyle or provide limited clinical data support.

Therefore, it is possible to find apps that have been fully reviewed and approved by the FDA and others designed and promoted by people with relatively little skill or knowledge in the clinical treatment of diabetes.

There is insufficient data to provide recommendations for specific apps for diabetes management, education, and support in the absence of RCTs and validations of apps unless they are FDA cleared. An area of particular importance is that of online privacy and security.

Established cloud-based data aggregator programs, such as Tidepool, Glooko, and others, have been developed with appropriate data security features and are compliant with the U.

Health Insurance Portability and Accountability Act of These programs can help monitor people with diabetes and provide access to their health care team Consumers should read the policy regarding data privacy and sharing before entering data into an application and learn how they can control the way their data will be used some programs offer the ability to share more or less information, such as being part of a registry or data repository or not.

Many online programs offer lifestyle counseling to aid with weight loss and increase physical activity Many include a health coach and can create small groups of similar participants on social networks.

Some programs aim to treat prediabetes and prevent progression to diabetes, often following the model of the Diabetes Prevention Program , Others assist in improving diabetes outcomes by remotely monitoring clinical data for instance, wireless monitoring of glucose levels, weight, or blood pressure and providing feedback and coaching — There are text messaging approaches that tie into a variety of different types of lifestyle and treatment programs, which vary in terms of their effectiveness , There are limited RCT data for many of these interventions, and long-term follow-up is lacking.

However, for an individual with diabetes, opting into one of these programs can be helpful in providing support and, for many, is an attractive option. Individuals who are comfortable using their diabetes devices, such as insulin pumps and CGM, should be allowed to use them in an inpatient setting if they are well enough to take care of the devices and have brought the necessary supplies — People with diabetes who are familiar with treating their own glucose levels can often adjust insulin doses more knowledgeably than inpatient staff who do not personally know the individual or their management style.

With the advent of the coronavirus disease pandemic, the FDA exercised enforcement discretion by allowing CGM device use temporarily in the hospital for patient monitoring This approach has been used to reduce the use of personal protective equipment and more closely monitor patients so that health care personnel do not have to go into a patient room solely to measure a glucose level — Studies are underway to assess the effectiveness of this approach, which may ultimately lead to the approved use of CGM for monitoring hospitalized individuals — When used in the setting of a clinical trial or when clinical circumstances such as during a shortage of personal protective equipment require it, CGM can be used to manage hospitalized individuals in conjunction with BGM.

Point-of-care BGM remains the approved method for glucose monitoring in hospitals, especially for dosing insulin and treating hypoglycemia. The pace of development in diabetes technology is extremely rapid. New approaches and tools are available each year. It is hard for research to keep up with these advances because newer versions of the devices and digital solutions are already on the market when a study is completed.

The most important component in all of these systems is the person with diabetes. Technology selection must be appropriate for the individual. Simply having a device or application does not change outcomes unless the human being engages with it to create positive health benefits. This underscores the need for the health care team to assist people with diabetes in device and program selection and to support its use through ongoing education and training.

Expectations must be tempered by reality—we do not yet have technology that completely eliminates the self-care tasks necessary for managing diabetes, but the tools described in this section can make it easier to manage.

Suggested citation: ElSayed NA, Aleppo G, Aroda VR, et al. Diabetes technology: Standards of Care in Diabetes— Diabetes Care ;46 Suppl.

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Data may be blinded or visible to the person wearing the device. The data are used to assess glycemic patterns and trends. Unlike rtCGM and isCGM devices, these devices are clinic-based and not owned by the person with diabetes.

CGM, continuous glucose monitoring; isCGM, intermittently scanned CGM; rtCGM, real-time CGM. Systems affected. Diabetes knowledge and metabolic control in type 1 diabetes starting with continuous glucose monitoring: FUTURE-PEAK.

Search ADS. Effect of structured individualized education on continuous glucose monitoring use in poorly controlled patients with type 1 diabetes: a randomized controlled trial.

Continuous glucose monitoring initiation within first year of type 1 diabetes diagnosis is associated with improved glycemic outcomes: 7-year follow-up study. Early initiation of diabetes devices relates to improved glycemic control in children with recent-onset type 1 diabetes mellitus.

Teamwork, targets, technology, and tight control in newly diagnosed type 1 diabetes: the Pilot 4T study. Uninterrupted continuous glucose monitoring access is associated with a decrease in HbA1c in youth with type 1 diabetes and public insurance.

The effect of discontinuing continuous glucose monitoring in adults with type 2 diabetes treated with basal insulin. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.

Performance variability of seven commonly used self-monitoring of blood glucose systems: clinical considerations for patients and providers. System accuracy evaluation of 18 CE-marked current-generation blood glucose monitoring systems based on EN ISO Clinical evaluation of a new, lower pain, one touch lancing device for people with diabetes: virtually pain-free testing and improved comfort compared to current lancing systems.

Accuracy of a blood glucose monitoring system that recognizes insufficient sample blood volume and allows application of more blood to the same test strip.

Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants.

Patient satisfaction with a new, high accuracy blood glucose meter that provides personalized guidance, insight, and encouragement. Dual use of Department of Veterans Affairs and Medicare benefits and use of test strips in veterans with type 2 diabetes mellitus.

Endocrine Society and Choosing Wisely. Accessed 17 October Frequency of SMBG correlates with HbA1c and acute complications in children and adolescents with type 1 diabetes.

A randomised, week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetes. Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial.

Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes ESMON study : randomised controlled trial. Cost effectiveness of self monitoring of blood glucose in patients with non-insulin treated type 2 diabetes: economic evaluation of data from the DiGEM trial.

Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: a randomized trial. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study.

Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. ACP Journal Club. Meta-analysis: self-monitoring in non-insulin-treated type 2 diabetes improved HbA1c by 0. Effects of structured versus unstructured self-monitoring of blood glucose on glucose control in patients with non-insulin-treated type 2 diabetes: a meta-analysis of randomized controlled trials.

Evaluation of linearity and interference effect on SMBG and POCT devices, showing drastic high values, low values, or error messages. Factors affecting blood glucose monitoring: sources of errors in measurement. Efficacy of real-time continuous glucose monitoring on glycaemic control and glucose variability in type 1 diabetic patients treated with either insulin pumps or multiple insulin injection therapy: a randomized controlled crossover trial.

The frequency of intermittently scanned glucose and diurnal variation of glycemic metrics. Frequent scanning using flash glucose monitoring contributes to better glycemic control in children and adolescents with type 1 diabetes. Flash Glucose Monitoring in the Netherlands: Increased monitoring frequency is associated with improvement of glycemic parameters.

Intermittently scanned continuous glucose monitoring data of polish patients from real-life conditions: more scanning and better glycemic control compared to worldwide data. REPLACE-BG: a randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in adults with well-controlled type 1 diabetes.

Food and Drug Administration. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial.

Hypoglycemic event frequency and the effect of continuous glucose monitoring in adults with type 1 diabetes using multiple daily insulin injections. Continuous glucose monitoring pilot in low-income type 1 diabetes patients. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial.

The impact of continuous glucose monitoring on low interstitial glucose values and low blood glucose values assessed by point-of-care blood glucose meters: results of a crossover trial. van Beers. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia IN CONTROL : a randomised, open-label, crossover trial.

The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial.

Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial.

Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections HypoDE : a multicentre, randomised controlled trial.

The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Effect of continuous glucose monitoring on glycemic control in adolescents and young adults with type 1 diabetes: a randomized clinical trial. Strategies to Enhance New CGM Use in Early Childhood SENCE Study Group.

A randomized clinical trial assessing continuous glucose monitoring CGM use with standardized education with or without a family behavioral intervention compared with fingerstick blood glucose monitoring in very young children with type 1 diabetes.

Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial. Continuous glucose monitoring in people with diabetes: the randomized controlled Glucose Level Awareness in Diabetes Study GLADIS.

Continuous glucose monitoring versus usual care in patients with type 2 diabetes receiving multiple daily insulin injections: a randomized trial.

The effect of real-time continuous glucose monitoring on glycemic control in patients with type 2 diabetes mellitus. Use of a real time continuous glucose monitoring system as a motivational device for poorly controlled type 2 diabetes.

Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: a randomized clinical trial.

Effectiveness of continuous glucose monitoring in maintaining glycaemic control among people with type 1 diabetes mellitus: a systematic review of randomised controlled trials and meta-analysis. Evaluation of Accuracy and Safety of the Next-Generation Up to Day Long-Term Implantable Eversense Continuous Glucose Monitoring System: The PROMISE Study.

Accuracy and safety of Dexcom G7 continuous glucose monitoring in adults with diabetes. Accuracy of a seventh-generation continuous glucose monitoring system in children and adolescents with type 1 diabetes. Benefit of continuous glucose monitoring in reducing hypoglycemia is sustained through 12 months of use among older adults with type 1 diabetes.

Effectiveness of continuous glucose monitoring in older adults with type 2 diabetes treated with basal insulin. Van Name. Long-term continuous glucose monitor use in very young children with type 1 diabetes: one-year results from the SENCE study. Episodic real-time CGM use in adults with type 2 diabetes: results of a pilot randomized controlled trial.

Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial. Effect of flash glucose monitoring technology on glycemic control and treatment satisfaction in patients with type 2 diabetes.

Efficacy of intermittently scanned continuous glucose monitoring in the prevention of recurrent severe hypoglycemia. Effect of 6 months of flash glucose monitoring in youth with type 1 diabetes and high-risk glycemic control: a randomized controlled trial.

Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists ABCD nationwide audit. Intermittently scanned continuous glucose monitoring is associated with high satisfaction but increased HbA1c and weight in well-controlled youth with type 1 diabetes.

Al Hayek. The impact of flash glucose monitoring on markers of glycaemic control and patient satisfaction in type 2 diabetes. Effect of flash glucose monitoring in adults with type 1 diabetes: a nationwide, longitudinal observational study of 14, flash users compared with glucose sensor naive controls.

Important drop in rate of acute diabetes complications in people with type 1 or type 2 diabetes after initiation of flash glucose monitoring in France: the RELIEF study.

Use of flash continuous glucose monitoring is associated with A1C reduction in people with type 2 diabetes treated with basal insulin or noninsulin therapy. Quality of life and glucose control after 1 year of nationwide reimbursement of intermittently scanned continuous glucose monitoring in adults living with type 1 diabetes FUTURE : a prospective observational real-world cohort study.

The impact of flash glucose monitoring on glycated hemoglobin in type 2 diabetes managed with basal insulin in Canada: a retrospective real-world chart review study.

Marked improvement in HbA 1c following commencement of flash glucose monitoring in people with type 1 diabetes.

Association of real-time continuous glucose monitoring with glycemic control and acute metabolic events among patients with insulin-treated diabetes.

A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with type 1 diabetes and impaired awareness of hypoglycaemia.

Real-time CGM is superior to flash glucose monitoring for glucose control in type 1 diabetes: the CORRIDA randomized controlled trial. Comparing real-time and intermittently scanned continuous glucose monitoring in adults with type 1 diabetes ALERTT1 : a 6-month, prospective, multicentre, randomised controlled trial.

Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Continuous glucose monitoring in pregnant women with type 1 diabetes CONCEPTT : a multicentre international randomised controlled trial.

Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of pregnancies. Translating HbA 1c measurements into estimated average glucose values in pregnant women with diabetes. The effect of real-time continuous glucose monitoring in pregnant women with diabetes: a randomized controlled trial.

Effect of a CGMS and SMBG on maternal and neonatal outcomes in gestational diabetes mellitus: a randomized controlled trial. Reduction in HbA1c using professional flash glucose monitoring in insulin-treated type 2 diabetes patients managed in primary and secondary care settings: a pilot, multicentre, randomised controlled trial.

Impact of blinded retrospective continuous glucose monitoring on clinical decision making and glycemic control in persons with type 2 diabetes on insulin therapy. Flash glucose monitoring helps achieve better glycemic control than conventional self-monitoring of blood glucose in non-insulin-treated type 2 diabetes: a randomized controlled trial.

Professional continuous glucose monitoring and endocrinology eConsult for adults with type 2 diabetes in primary care: results of a clinical pilot program. Effect of professional CGM pCGM on glucose management in type 2 diabetes patients in primary care.

The clinical utility of professional continuous glucose monitoring by pharmacists for patients with type 2 diabetes. Documentation of skin-related issues associated with continuous glucose monitoring use in the scientific literature.

Adverse cutaneous reaction to diabetic glucose sensors and insulin pumps: irritant contact dermatitis or allergic contact dermatitis?

Cutaneous reactions to continuous glucose monitoring and continuous subcutaneous insulin infusion devices in type 1 diabetes mellitus. Further evidence of severe allergic contact dermatitis from isobornyl acrylate while using a continuous glucose monitoring system. Allergic contact dermatitis caused by isobornyl acrylate in Freestyle Libre, a newly introduced glucose sensor.

Allergic contact dermatitis caused by glucose sensors in type 1 diabetes patients. Cutaneous complications with continuous or flash glucose monitoring use: systematic review of trials and observational studies. Allergic contact dermatitis in pediatric patients with type 1 diabetes: an emerging issue.

The implanted glucose monitoring system Eversense: an alternative for diabetes patients with isobornyl acrylate allergy. Skin reaction report form: development and design of a standardized report form for skin reactions due to medical devices for diabetes management. Real-World Safety of an Implantable Continuous Glucose Sensor Over Multiple Cycles of Use: A Post-Market Registry Study.

Real-world data from the first U. commercial users of an implantable continuous glucose sensor. Laboratory protocol and pilot results for dynamic interference testing of continuous glucose monitoring sensors. Interference assessment of various endogenous and exogenous substances on the performance of the eversense long-term implantable continuous glucose monitoring system.

Effect of repeated doses of acetaminophen on a continuous glucose monitoring system with permselective membrane. Piras de Oliveira. Patient perspectives on the use of half-unit insulin pens by people with type 1 diabetes: a cross-sectional observational study. Pens versus syringes to deliver insulin among elderly patients with type 2 diabetes: a randomized controlled clinical trial.

Comparative device assessments: Humalog KwikPen compared with vial and syringe and FlexPen. A Comparison of insulin pen devices and disposable plastic syringes - simplicity, safety, convenience and cost differences.

Pen devices for insulin self-administration compared with needle and vial: systematic review of the literature and meta-analysis. Adherence to insulin pen therapy is associated with reduction in healthcare costs among patients with type 2 diabetes mellitus.

Health care costs and medication adherence associated with initiation of insulin pen therapy in Medicaid-enrolled patients with type 2 diabetes: a retrospective database analysis. Comparing patient preferences and healthcare provider recommendations with the pen versus vial-and-syringe insulin delivery in patients with type 2 diabetes.

Differences in rates of hypoglycemia and health care costs in patients treated with insulin aspart in pens versus vials.

The association between use of mealtime insulin pens versus vials and healthcare charges and resource utilization in patients with type 2 diabetes: a retrospective cohort study. Comparison of patient preference for two insulin injection pen devices in relation to patient dexterity skills.

Disposable insulin syringe reuse and aseptic practices in diabetic patients. Latin American Association for the Study of the Liver ALEH practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease.

A novel pen-based Bluetooth-enabled insulin delivery system with insulin dose tracking and advice. Continuous glucose monitoring and insulin informed advisory system with automated titration and dosing of insulin reduces glucose variability in type 1 diabetes mellitus.

Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial.

Impact of a novel insulin management service on non-insulin pharmaceutical expenses. Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and meta-analysis. The evidence base for diabetes technology: appropriate and inappropriate meta-analysis.

Race, socioeconomic status, and treatment center are associated with insulin pump therapy in youth in the first year following diagnosis of type 1 diabetes.

Racial-ethnic disparities in management and outcomes among children with type 1 diabetes. Continuous subcutaneous insulin infusion in toddlers starting at diagnosis of type 1 diabetes mellitus.

A multicenter analysis of patients from 63 centres in Germany and Austria. Diabetes technology-continuous subcutaneous insulin infusion therapy and continuous glucose monitoring in adults: an Endocrine Society clinical practice guideline.

C-peptide and beta-cell autoantibody testing prior to initiating continuous subcutaneous insulin infusion pump therapy did not improve utilization or medical costs among older adults with diabetes mellitus. Improved HbA1C, total daily insulin dose, and treatment satisfaction with insulin pump therapy compared to multiple daily insulin injections in patients with type 2 diabetes irrespective of baseline C-peptide levels.

Insulin pump-associated adverse events in children and adolescents—a prospective study. Benefit of supplementary fat plus protein counting as compared with conventional carbohydrate counting for insulin bolus calculation in children with pump therapy. Factors related to discontinuation of continuous subcutaneous insulin-infusion therapy.

Evaluation of pump discontinuation and associated factors in the T1D Exchange clinic registry. Insulin pump use and glycemic control in adolescents with type 1 diabetes: predictors of change in method of insulin delivery across two years.

Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. Pediatric Diabetes Consortium Type 1 Diabetes New Onset NeOn study: factors associated with HbA1c levels one year after diagnosis. A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine.

Beneficial effects of continuous subcutaneous insulin infusion and flexible multiple daily insulin regimen using insulin glargine in type 1 diabetes. T1D Exchange Clinic Network, the DPV Initiative, and the National Paediatric Diabetes Audit and the Royal College of Paediatrics and Child Health registries.

Use of insulin pump therapy in children and adolescents with type 1 diabetes and its impact on metabolic control: comparison of results from three large, transatlantic paediatric registries.

Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Association of insulin pump therapy vs insulin injection therapy with severe hypoglycemia, ketoacidosis, and glycemic control among children, adolescents, and young adults with type 1 diabetes.

The DCCT Research Group. Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases.

Severe hypoglycaemia and glycaemic control in type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion.

Incidence of severe hypoglycemia in children with type 1 diabetes in the Nordic countries in the period association with hemoglobin A 1c and treatment modality.

National Paediatric Diabetes Audit and the Royal College of Paediatrics and Child Health, the DPV Initiative, and the T1D Exchange Clinic Network. Rates of diabetic ketoacidosis: international comparison with 49, pediatric patients with type 1 diabetes from England, Wales, the U.

Comparison of continuous subcutaneous insulin infusion and multiple daily injection regimens in children with type 1 diabetes: a randomized open crossover trial. Continuous subcutaneous insulin infusion benefits quality of life in preschool-age children with type 1 diabetes mellitus.

Insulin pump use in young children with type 1 diabetes: sociodemographic factors and parent-reported barriers. Predictive low-glucose suspend reduces hypoglycemia in adults, adolescents, and children with type 1 diabetes in an at-home randomized crossover study: results of the PROLOG trial.

Impact of sensor-augmented pump therapy with predictive low-glucose suspend function on glycemic control and patient satisfaction in adults and children with type 1 diabetes. Glycemic outcomes of use of CLC versus PLGS in type 1 diabetes: a randomized controlled trial.

Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with type 1 diabetes.

Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, week randomised trial. Closed loop control in adolescents and children during winter sports: use of the Tandem Control-IQ AP system.

Performance of the Omnipod personalized model predictive control algorithm with meal bolus challenges in adults with type 1 diabetes. Closed-loop driven by control-to-range algorithm outperforms threshold-low-glucose-suspend insulin delivery on glucose control albeit not on nocturnal hypoglycaemia in prepubertal patients with type 1 diabetes in a supervised hotel setting.

Successful at-home use of the Tandem Control-IQ artificial pancreas system in young children during a randomized controlled trial. Hybrid closed-loop control is safe and effective for people with type 1 diabetes who are at moderate to high risk for hypoglycemia.

Safety evaluation of the MiniMed G system in children years of age with type 1 diabetes. Effectiveness of artificial pancreas in the non-adult population: a systematic review and network meta-analysis. Six-month randomized, multicenter trial of closed-loop control in type 1 diabetes. Efficacy of hybrid closed-loop system in adults with type 1 diabetes and gastroparesis.

Safety and performance of the Omnipod hybrid closed-loop system in adults, adolescents, and children with type 1 diabetes over 5 days under free-living conditions.

One Year Clinical Experience of the First Commercial Hybrid Closed-Loop System. Reduced hypoglycemia and increased time in target using closed-loop insulin delivery during nights with or without antecedent afternoon exercise in type 1 diabetes. Evaluating the experience of children with type 1 diabetes and their parents taking part in an artificial pancreas clinical trial over multiple days in a diabetes camp setting.

Closing the loop overnight at home setting: psychosocial impact for adolescents with type 1 diabetes and their parents. Safety and glycemic outcomes during the MiniMed advanced hybrid closed-loop system pivotal trial in adolescents and adults with type 1 diabetes.

New Diabetes Technology Coming in Patrick's Day. Impact of sensor-augmented pump therapy with predictive low-glucose suspend function on glycemic control and patient satisfaction in adults and children with type 1 diabetes. Next-generation technology maintains blood glucose levels by automatically delivering insulin. Patients with more education regarding device use have better outcomes 1 ; therefore, the need for additional education should be periodically assessed, particularly if outcomes are not being met. Since the s, certified diabetes educators have transformed diabetes management, according to the ADA.

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Join us now and receive it all straight to your inbox. Help us to continue our vital research. Guide to type 1 diabetes technology Our guide to type 1 diabetes technology gives you information about insulin and the different ways to get it into your body.

In this section Smart insulin pens Insulin pumps Blood glucose meters Continuous glucose monitoring Flash glucose monitoring Hybrid closed loop technology Open source and DIY systems Apps for managing type 1 diabetes. On this page. Insulin pumps Insulin pumps deliver insulin automatically throughout the day and night.

Continuous glucose monitoring CGM Continuous glucose monitors give you real-time information on your glucose levels and alert you if your levels are going too high or too low.

Flash glucose monitoring Flash glucose monitoring allows you to scan a sensor attached to your body to get your latest glucose reading. Blood ketone meters Blood ketone meters measure levels of ketones in your blood so you can detect them sooner than you could with urine ketone testing.

Read more. Can I get a glucose sensor on the NHS? Learn more. Can I get an insulin pump on the NHS? Can I get hybrid closed loop on the NHS? My type 1 tech journey. James Harris Living with type 1 diabetes. Beth McDaniel and Ellen Watson.

Grace Clover Student and model. Dr Thomas Crabtree Diabetes and Endocrinology registrar and ABCD research fellow. More stories. Rachel on type 1 technology. Rachel Bennetta Diagnosed with type 1 in Information event Free Feb In-person. Find out more. Explore our type 1 tech video series.

Visit the playlist. Type 1 technology news. Type 1 technology. Treatment research. Explore your type 1 tech options We know that deciding whether to use type 1 technology and then choosing the right devices and apps can be a bit daunting. Type 1 diabetes technology-finding tool.

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Nuha A. ElSayedType diabetes technology AleppoTecnnology Type diabetes technology. ArodaRaveendhara R. BannuruFlorence M. BrownDennis BruemmerBilly S. CollinsMarisa E. Type  diabetes technology Technologu only peer-reviewed journal covering all aspects of Typw and Type diabetes technology diabetes with tschnology devices, Type diabetes technology, drug delivery systems, and software. Sponsored by: Abbott Diabetes Care. A Meta-Analysis of Randomized Trial Outcomes for the t:slim X2 Insulin Pump with Control-IQ Technology in Youth and Adults from Age 2 to The Official Journal of:. Metabolic Syndrome and Related Disorders.

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