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Biskupiak JE, Carlow DL, Munshi MN. Impact of a tubeless, disposable insulin pump on emergency department visits and inpatient admissions among a Medicare population. J Manag Care Spec Pharm 2024; 30:1128-1135. [PMID: 38884584 PMCID: PMC11424916 DOI: 10.18553/jmcp.2024.23292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
BACKGROUND A tubeless, disposable insulin pump (Omnipod DASH Insulin Management System, Insulet Corporation) has demonstrated improved glycemic outcomes for people with diabetes who require insulin. The impact of the system on downstream health care events has not been studied. OBJECTIVE To assess health care resource utilization for a Medicare population before and after starting tubeless, disposable insulin pump therapy. METHODS This retrospective, observational analysis used data from the Centers for Medicare & Medicaid Services 100% Research Identifiable Files. Study outcomes included change in event rates for diabetes-related emergency department (DRED) visits, all-cause emergency department (ACED) visits, diabetes-related inpatient (DRIP) admissions, and all-cause inpatient (ACIP) admissions among Medicare beneficiaries who started the tubeless, disposable insulin pump in 2020 (postpump observation period) as compared with the same duration and calendar period in 2019 (prepump observation period) with no pump use. Subgroup analyses were performed based on Medicare entitlement reason, diabetes type, and diagnosis status for depressive disorder. RESULTS A total of 811 users met the criteria for analysis: 46.2% had type 2 diabetes, a majority (59.2%) were aged 65 years or older, and 37.0% had a diagnosis for depressive disorder. Significant reductions were observed for DRED of -46.9% (95% CI = -63% to -23%); ACED of -29.0% (95% CI = -37% to -20%); ACIP of -19.9% (95% CI = -32% to -6%). DRIP rates declined notably (-36.6%; 95% CI = -61% to 4%). Event rates observed across subgroups demonstrated consistent downward trends; however, not all were statistically significant. CONCLUSIONS These findings demonstrate that use of the tubeless, disposable insulin pump was associated with reductions in DRED, ACED, and ACIP. Our results provide real-world evidence to support the use of the tubeless, disposable insulin pump among Medicare beneficiaries who require insulin, regardless of diabetes type or Medicare entitlement reason. Additional studies are recommended to further evaluate the effect of insulin pumps on health care utilization among the Medicare population and other insurance populations.
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Affiliation(s)
| | | | - Medha N Munshi
- Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA)
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2
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Krylova O, Marchenko S, Ermolaeva A, Shustikova N, Dyakonova K. Individualized selection of recent glucose monitoring devices for self-management based on competitive features. Pak J Med Sci 2024; 40:1853-1859. [PMID: 39281234 PMCID: PMC11395364 DOI: 10.12669/pjms.40.8.9855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/29/2024] [Accepted: 06/16/2024] [Indexed: 09/18/2024] Open
Abstract
Objective Goal of the study was to systematically review competitive advantages of medical devices for glucose monitoring in diabetic patients. Method The review is done systematically according to SALSA criteria and PRISMA guidelines. The search for eligible articles was held from February 16th 2023 to March 1st 2023 in Russian and English languages. The results were synthesized narratively, tabularly, and visually. The search was conducted in the following databases of scientific literature: PubMed, IEEE Xplore, Google Scholar, CyberLeninka, and eLibrary. Results Twenty-two out of fifty-two manuscripts met the inclusion criteria. The most promising and advantageous characteristics of the evaluated devices, as identified by researchers, include the following: the capability for noninvasive examination; features that facilitate use by patients with fine motor, hearing, and visual impairments; add-ons and software designed to improve patient compliance, including in pediatric populations; and device attributes that enhance the speed and accuracy of analysis while being free of iatrogenic effects. Conclusions With increasing prevalence of diabetes, glycemic control is crucial for preventing complications. The market offers numerous glucose monitoring devices (GMDs) with varying features, making selection challenging. Our study systematically categorized the strengths of each GMD model for diabetic patients, aiding informed device selection.
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Affiliation(s)
- Olga Krylova
- Olga Krylova Associate Professor, Department of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevara Marchenko
- Sevara Marchenko Associate Professor, Department of Organization and Management in the Field of Medicines Circulation, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexandra Ermolaeva
- Alexandra Ermolaeva Associate Professor, Department of Clinical, Pharmacology and Propaedeutics of Internal Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Natalia Shustikova
- Natalia Shustikova, PhD of Medical Sciences Associate Professor, Deputy Dean for Educational and Organizational Work, Moscow University for Industry and Finance Synergy, Moscow, Russia
| | - Kristina Dyakonova
- Kristina Dyakonova Researcher, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
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Garland NT, Kaveti R, Bandodkar AJ. Biofluid-Activated Biofuel Cells, Batteries, and Supercapacitors: A Comprehensive Review. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2303197. [PMID: 37358398 DOI: 10.1002/adma.202303197] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/06/2023] [Indexed: 06/27/2023]
Abstract
Recent developments in wearable and implanted devices have resulted in numerous, unprecedented capabilities that generate increasingly detailed information about a user's health or provide targeted therapy. However, options for powering such systems remain limited to conventional batteries which are large and have toxic components and as such are not suitable for close integration with the human body. This work provides an in-depth overview of biofluid-activated electrochemical energy devices, an emerging class of energy sources judiciously designed for biomedical applications. These unconventional energy devices are composed of biocompatible materials that harness the inherent chemistries of various biofluids to produce useable electrical energy. This work covers examples of such biofluid-activated energy devices in the form of biofuel cells, batteries, and supercapacitors. Advances in materials, design engineering, and biotechnology that form the basis for high-performance, biofluid-activated energy devices are discussed. Innovations in hybrid manufacturing and heterogeneous integration of device components to maximize power output are also included. Finally, key challenges and future scopes of this nascent field are provided.
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Affiliation(s)
- Nate T Garland
- Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST), North Carolina State University, Raleigh, NC, 27606, USA
| | - Rajaram Kaveti
- Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST), North Carolina State University, Raleigh, NC, 27606, USA
| | - Amay J Bandodkar
- Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST), North Carolina State University, Raleigh, NC, 27606, USA
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Choi E, Kim MS, Cho J, Kim S, Kwon EK, Kim Y, Kang D, Cho SY. Development and validation of a distress measurement for insulin injections among patients with diabetes. Sci Rep 2023; 13:11725. [PMID: 37474582 PMCID: PMC10359257 DOI: 10.1038/s41598-023-38982-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/18/2023] [Indexed: 07/22/2023] Open
Abstract
Insulin injections are stressful but necessary for people with diabetes. This study aimed to develop and validate the Distress of Self-Injection (DSI) scale for patients with diabetes aged ≥ 10 years. We created a questionnaire to evaluate DSI after examining each item following a literature review. The DSI scale with 20 questions in three domains (physical [4], psychosocial [7], and process [9]) was developed and tested at the Samsung Medical Center in Seoul, Korea, from April to September 2021. To verify structural validity, exploratory and confirmatory factor analyses (CFA) were conducted. Internal consistency was also calculated. To assess construct and criterion validity, the correlation between the DSI scale and Korean version of the Problem Areas in Diabetes (PAID-K) scale was obtained. Cronbach's alpha varied from 0.69 to 0.87, and the DSI score was 0.90, demonstrating acceptable internal consistency. CFA fit indices (CFI = 0.980; RMSEA = 0.033) were favorable. DSI and pertinent PAID-K domains correlated strongly. For measuring self-injection distress, the DSI score had good accuracy. For patients with diabetes aged ≥ 10 years who self-inject insulin, the DSI was a viable and accurate method for quantifying discomfort associated with insulin injection. Health practitioners should use the DSI to communicate with patients about their suffering.
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Affiliation(s)
- Eujin Choi
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea
| | - Min-Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea
| | - Sooyeon Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Kyung Kwon
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea
| | - Youngha Kim
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu 06351, Seoul, Republic of Korea.
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Aleppo G, DeSalvo DJ, Lauand F, Huyett LM, Chang A, Vienneau T, Ly TT. Improvements in Glycemic Outcomes in 4738 Children, Adolescents, and Adults with Type 1 Diabetes Initiating a Tubeless Insulin Management System. Diabetes Ther 2023; 14:593-610. [PMID: 36763329 PMCID: PMC9913031 DOI: 10.1007/s13300-023-01366-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Despite recent advances in diabetes technology, most people living with type 1 diabetes mellitus (T1D) are unable to meet glycemic targets. Real-world evidence can provide insight into outcomes achieved with specific treatment devices when used in clinical practice. The aim of this study was to analyze real-world outcomes collected from a large cohort of people living with T1D and initiating treatment with the Omnipod DASH System. METHODS In this retrospective observational study, real-world outcomes were analyzed from a database of information collected from people with T1D initiating the Omnipod DASH System. Information in the database was either taken directly from the patient's medical record or self-reported if medical records were unavailable. The primary outcome was change in glycated hemoglobin (HbA1c) from baseline (before initiation) to 3 months after initiation. Secondary outcomes were changes in total daily dose of insulin (TDD) and self-reported frequency of hypoglycemic events (< 70 mg/dL). Results are separated for the adult (≥ 18 years, N = 3341) and pediatric (< 18 years, N = 1397) cohorts. RESULTS The change in HbA1c from baseline was - 0.9 ± 1.6% ( - 10 ± 18 mmol/mol; p < 0.0001) in adults and - 0.9 ± 2.0% ( - 10 ± 22 mmol/mol; p < 0.0001) in the pediatric cohort. For those previously using multiple daily injections, HbA1c decreased by - 1.0 ± 1.7% ( - 11 ± 19 mmol/mol) in adults and - 1.0 ± 2.1% ( - 11 ± 23 mmol/mol) in the pediatric cohort (both p < 0.0001). Hypoglycemic events decreased in adults from 2.9 to 1.3 episodes per week ( - 1.6 ± 3.2 events/week; p < 0.0001), and in the pediatric cohort from 2.8 to 1.5 episodes per week ( - 1.3 ± 2.7 events/week; p < 0.0001). In adults, TDD decreased by 19.9% (p < 0.0001), and it remained stable in the pediatric cohort (p > 0.05). CONCLUSIONS Real-world outcomes from this large cohort of people initiating therapy with the Omnipod DASH System showed significant improvement in HbA1c and a substantial reduction in hypoglycemic events after 3 months of use.
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Affiliation(s)
- Grazia Aleppo
- Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, 645 North Michigan Ave, Suite 530, Chicago, IL, 60611, USA
| | - Daniel J DeSalvo
- Baylor College of Medicine, 1 Moursund St., Houston, TX, 77030, USA
| | - Felipe Lauand
- Insulet Corporation, 100 Nagog Park, Acton, MA, 01720, USA
| | | | - Albert Chang
- Insulet Corporation, 100 Nagog Park, Acton, MA, 01720, USA
| | - Todd Vienneau
- Insulet Corporation, 100 Nagog Park, Acton, MA, 01720, USA
| | - Trang T Ly
- Insulet Corporation, 100 Nagog Park, Acton, MA, 01720, USA
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Díaz-Balzac CA, Pillinger D, Wittlin SD. Continuous subcutaneous insulin infusions: Closing the loop. J Clin Endocrinol Metab 2022; 108:1019-1033. [PMID: 36573281 DOI: 10.1210/clinem/dgac746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Indexed: 12/29/2022]
Abstract
CONTEXT Continuous subcutaneous insulin infusions (CSIIs) and continuous glucose monitors (CGMs) have revolutionized the management of diabetes mellitus (DM). Over the last two decades the development of advanced, small, and user-friendly technology has progressed substantially, essentially closing the loop in the fasting and post-absorptive state, nearing the promise of an artificial pancreas. The momentum was mostly driven by the diabetes community itself, to improve its health and quality of life. EVIDENCE ACQUISITION Literature regarding CSII and CGM was reviewed. EVIDENCE SYNTHESIS Management of DM aims to regulate blood glucose to prevent long term micro and macrovascular complications. CSIIs combined with CGMs provide an integrated system to maintain tight glycemic control in a safe and uninterrupted fashion, while minimizing hypoglycemic events. Recent advances have allowed to 'close the loop' by better mimicking endogenous insulin secretion and glucose level regulation. Evidence supports sustained improvement in glycemic control with reduced episodes of hypoglycemia using these systems, while improving quality of life. Ongoing work in delivery algorithms with or without counterregulatory hormones will allow for further layers of regulation of the artificial pancreas. CONCLUSION Ongoing efforts to develop an artificial pancreas have created effective tools to improve the management of DM. CSIIs and CGMs are useful in diverse populations ranging from children to the elderly, as well as in various clinical contexts. Individually and more so together, these have had a tremendous impact in the management of DM, while avoiding treatment fatigue. However, cost and accessibility are still a hindrance to its wider application.
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Affiliation(s)
- Carlos A Díaz-Balzac
- Division of Endocrinology, Diabetes and Metabolism, University of Rochester Medical Center, 601 Elmwood Avenue, Box 693, Rochester, NY 14642, USA
| | - David Pillinger
- Division of Endocrinology, Diabetes and Metabolism, University of Rochester Medical Center, 601 Elmwood Avenue, Box 693, Rochester, NY 14642, USA
| | - Steven D Wittlin
- Division of Endocrinology, Diabetes and Metabolism, University of Rochester Medical Center, 601 Elmwood Avenue, Box 693, Rochester, NY 14642, USA
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Mende J, Eichenlaub M, Waldenmaier D, Haug C, Freckmann G, Ziegler R. Evaluation of the Accuracy and Reliability of a Tubeless Insulin Infusion System Under Laboratory Conditions. J Diabetes Sci Technol 2022; 16:788-789. [PMID: 35043694 PMCID: PMC9294567 DOI: 10.1177/19322968211070815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Jochen Mende
- Institut für Diabetes-Technologie Forschungs-
und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Manuel Eichenlaub
- Institut für Diabetes-Technologie Forschungs-
und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
- Manuel Eichenlaub, PhD, Institut für
Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm,
Lise-Meitner-Straße 8/2, 89081 Ulm, Germany.
| | - Delia Waldenmaier
- Institut für Diabetes-Technologie Forschungs-
und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Cornelia Haug
- Institut für Diabetes-Technologie Forschungs-
und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie Forschungs-
und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents,
Muenster, Germany
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8
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Eichenlaub M, Ziegler R, Heinemann L, Waldenmaier D, Kamecke U, Haug C, Freckmann G. Patch Pumps: Periodic Insulin Delivery Patterns. J Diabetes Sci Technol 2022:19322968221091843. [PMID: 35466704 DOI: 10.1177/19322968221091843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent in vitro experiments with patch pumps (PP) Omnipod (OP), Omnipod DASH (OP-D), A6 TouchCare (A6), and Accu-Chek Solo (ACS) have observed periodic fluctuations in the delivered amount of insulin during basal rate and consecutive bolus delivery in some PP, calling for a more systematic characterization of these periodic delivery patterns. Here, it was found that during basal rate delivery of 1 U/h, some devices of OP, OP-D, and A6 showed deviations of up to ±30% from target delivery that consistently repeated every 5 hours, whereas ACS showed no clear periodicity with considerably lower deviations. Similar results were found during consecutive bolus delivery of 1 U, where deviations repeated consistently every five boluses in some devices of OP, OP-D, and A6. However, there was a large variability in the periodic delivery patterns between individual devices of the same PP model. Examining their pumping techniques indicated a connection between the insulin delivery mechanism and observed delivery patterns of the PP. However, the clinical impact of such patterns is unclear.
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Affiliation(s)
- Manuel Eichenlaub
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents, Muenster, Germany
| | | | - Delia Waldenmaier
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | | | - Cornelia Haug
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
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Lau HH, Gan SU, Lickert H, Shapiro AMJ, Lee KO, Teo AKK. Charting the next century of insulin replacement with cell and gene therapies. MED 2021; 2:1138-1162. [DOI: 10.1016/j.medj.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
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Forlenza GP, Buckingham BA, Brown SA, Bode BW, Levy CJ, Criego AB, Wadwa RP, Cobry EC, Slover RJ, Messer LH, Berget C, McCoy S, Ekhlaspour L, Kingman RS, Voelmle MK, Boyd J, O'Malley G, Grieme A, Kivilaid K, Kleve K, Dumais B, Vienneau T, Huyett LM, Lee JB, O'Connor J, Benjamin E, Ly TT. First Outpatient Evaluation of a Tubeless Automated Insulin Delivery System with Customizable Glucose Targets in Children and Adults with Type 1 Diabetes. Diabetes Technol Ther 2021; 23:410-424. [PMID: 33325779 PMCID: PMC8215410 DOI: 10.1089/dia.2020.0546] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: The objective of this study was to assess the safety and effectiveness of the first commercial configuration of a tubeless automated insulin delivery system, Omnipod® 5, in children (6-13.9 years) and adults (14-70 years) with type 1 diabetes (T1D) in an outpatient setting. Materials and Methods: This was a single-arm, multicenter, prospective clinical study. Data were collected over a 14-day standard therapy (ST) phase followed by a 14-day hybrid closed-loop (HCL) phase, where participants (n = 36) spent 72 h at each of three prespecified glucose targets (130, 140, and 150 mg/dL, 9 days total) then 5 days with free choice of glucose targets (110-150 mg/dL) using the Omnipod 5. Remote safety monitoring alerts were enabled during the HCL phase. Primary endpoints were difference in time in range (TIR) (70-180 mg/dL) between ST and HCL phases and proportion of participants reporting serious device-related adverse events. Results: Mean TIR was significantly higher among children in the free-choice period overall (64.9% ± 12.2%, P < 0.01) and when using a 110 mg/dL target (71.2% ± 10.2%, P < 0.01), a 130 mg/dL target (61.5% ± 7.7%, P < 0.01), and a 140 mg/dL target (64.8% ± 11.6%, P < 0.01), and among adults using a 130 mg/dL target (75.1% ± 11.6%, P < 0.05), compared to the ST phase (children: 51.0% ± 13.3% and adults: 65.6% ± 15.7%). There were no serious device-related adverse events reported during the HCL phase, nor were there episodes of severe hypoglycemia or diabetic ketoacidosis. Conclusion: The Omnipod 5 System was safe and effective when used at glucose targets from 110 to 150 mg/dL for 14 days at home in children and adults with T1D.
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Affiliation(s)
- Gregory P. Forlenza
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Bruce A. Buckingham
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA
| | - Sue A. Brown
- Division of Endocrinology and Medicine, University of Virginia, Charlottesville, Virginia, USA
| | | | - Carol J. Levy
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy B. Criego
- Department of Pediatric Endocrinology, Park Nicollet Clinic, International Diabetes Center at Park Nicollet, Minneapolis, Minnesota, USA
| | - R. Paul Wadwa
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Erin C. Cobry
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Robert J. Slover
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Laurel H. Messer
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Susan McCoy
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Laya Ekhlaspour
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA
| | - Ryan S. Kingman
- Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, California, USA
| | - Mary K. Voelmle
- Division of Endocrinology and Medicine, University of Virginia, Charlottesville, Virginia, USA
| | | | - Grenye O'Malley
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Aimee Grieme
- Department of Pediatric Endocrinology, Park Nicollet Clinic, International Diabetes Center at Park Nicollet, Minneapolis, Minnesota, USA
| | | | | | | | | | | | | | | | | | - Trang T. Ly
- Insulet Corporation, Acton, Massachusetts, USA
- Address correspondence to: Trang T. Ly, MBBS, FRACP, PhD, Insulet Corporation, 100 Nagog Park, Acton, MA 01720, USA
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Mulka A, Lewis BE, Mao L, Sharafieh R, Kesserwan S, Wu R, Kreutzer DL, Klueh U. Phenolic Preservative Removal from Commercial Insulin Formulations Reduces Tissue Inflammation while Maintaining Euglycemia. ACS Pharmacol Transl Sci 2021; 4:1161-1174. [PMID: 34151206 DOI: 10.1021/acsptsci.1c00047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Indexed: 11/28/2022]
Abstract
Background: Exogenous insulin therapy requires stabilization of the insulin molecule, which is achieved through the use of excipients (e.g., phenolic preservatives (PP)) that provide protein stability, sterility and prolong insulin shelf life. However, our laboratory recently reported that PP, (e.g., m-creosol and phenol) are also cytotoxic, inducing inflammation and fibrosis. Optimizing PP levels through filtration would balance the need for insulin preservation with PP-induced inflammation. Method: Zeolite Y (Z-Y), a size-exclusion-based resin, was employed to remove PP from commercial insulin formulations (Humalog) before infusion. Results: PP removal significantly decreased cell toxicity in vitro and inflammation in vivo. Infusion site histological analysis after a 3 day study demonstrated that leukocyte accumulation increased with nonfiltered preparations but decreased after filtration. Additional studies demonstrated that a Z-Y fabricated filter effectively removed excess PP such that the filtered insulin solution achieved equivalent glycemic control in diabetic mice when compared to nonfiltered insulin. Conclusion: This approach represents the proof of concept that using Z-Y for in-line PP removal assists in lowering inflammation at the site of insulin infusion and thus could lead to extending the functional lifespan of insulin infusion sets in vivo.
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Affiliation(s)
- Adam Mulka
- Department of Biomedical Engineering, Integrative Biosciences Center, Wayne State University, Detroit, Michigan 48202,United States
| | - Brianne E Lewis
- Department of Biomedical Engineering, Integrative Biosciences Center, Wayne State University, Detroit, Michigan 48202,United States
| | - Li Mao
- Department of Biomedical Engineering, Integrative Biosciences Center, Wayne State University, Detroit, Michigan 48202,United States
| | - Roshanak Sharafieh
- Department of Surgery, School of Medicine, University of Connecticut, Farmington, Connecticut 06030-2100, United States
| | - Shereen Kesserwan
- Department of Biomedical Engineering, Integrative Biosciences Center, Wayne State University, Detroit, Michigan 48202,United States
| | - Rong Wu
- Connecticut Convergence Institute, School of Medicine, University of Connecticut, Farmington, Connecticut 06030-6022, United States
| | - Donald L Kreutzer
- Department of Surgery, School of Medicine, University of Connecticut, Farmington, Connecticut 06030-2100, United States
| | - Ulrike Klueh
- Department of Biomedical Engineering, Integrative Biosciences Center, Wayne State University, Detroit, Michigan 48202,United States
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Carlson AL, Huyett LM, Jantz J, Chang A, Vienneau T, Ly TT. Improved glycemic control in 3,592 adults with type 2 diabetes mellitus initiating a tubeless insulin management system. Diabetes Res Clin Pract 2021; 174:108735. [PMID: 33711396 DOI: 10.1016/j.diabres.2021.108735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/22/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
AIMS To compare glycemic outcomes in adults with type 2 diabetes mellitus (T2DM) before and 90 days after initiating Omnipod® or Omnipod DASH® Insulin Management Systems. METHODS In this retrospective observational study (N = 3,592) change in HbA1c level, total daily dose (TDD) of insulin (n = 3,053), and frequency of self-reported hypoglycemic events (HE, <70 mg/dL, n = 2,922) were assessed overall and by prior treatment modality (multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII)), age group, and baseline HbA1c category. RESULTS Change (mean ± SD) in HbA1c was -1.3 ± 1.7% [-14 ± 19 mmol/mol] overall, -1.4 ± 1.7% [-15 ± 19 mmol/mol] for prior MDI users, and -0.9 ± 1.5% [-10 ± 16 mmol/mol] for prior CSII users (p<0.0001). The percentage of patients with HbA1c ≥9% [≥75 mmol/mol] decreased (49% to 19%), and with HbA1c <7% [<53 mmol/mol] increased (10% to 22%) (p<0.0001). Prior therapy, age, and baseline HbA1c category were factors affecting change in HbA1c (p<0.05). Reductions in TDD (overall, -33 ± 52U, p<0.0001) and HE per week (overall, -0.5 ± 2.0, p<0.0001), were seen regardless of prior treatment, age, or baseline HbA1c. CONCLUSIONS Omnipod System use was associated with statistically and clinically meaningful reductions in HbA1c, TDD, and HE compared to prior treatments in T2DM.
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Affiliation(s)
- Anders L Carlson
- International Diabetes Center at Park Nicollet, 3800 Park Nicollet Blvd, Minneapolis, MN 55416, United States
| | - Lauren M Huyett
- Insulet Corporation, 100 Nagog Park, Acton, MA 01720, United States
| | - Jay Jantz
- Insulet Corporation, 100 Nagog Park, Acton, MA 01720, United States
| | - Albert Chang
- Insulet Corporation, 100 Nagog Park, Acton, MA 01720, United States
| | - Todd Vienneau
- Insulet Corporation, 100 Nagog Park, Acton, MA 01720, United States
| | - Trang T Ly
- Insulet Corporation, 100 Nagog Park, Acton, MA 01720, United States.
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13
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Eberle C, Stichling S, Löhnert M. Diabetology 4.0: Scoping Review of Novel Insights and Possibilities Offered by Digitalization. J Med Internet Res 2021; 23:e23475. [PMID: 33759789 PMCID: PMC8074865 DOI: 10.2196/23475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/13/2020] [Accepted: 01/18/2021] [Indexed: 02/06/2023] Open
Abstract
Background The increasing prevalence of diabetes mellitus and associated morbidity worldwide justifies the need to create new approaches and strategies for diabetes therapy. Therefore, the ongoing digitalization offers novel opportunities in this field. Objective The aim of this study is to provide an updated overview of available technologies, possibilities, and novel insights into diabetes therapy 4.0. Methods A scoping review was carried out, and a literature search was performed using electronic databases (MEDLINE [PubMed], Cochrane Library, Embase, CINAHL, and Web of Science). The results were categorized according to the type of technology presented. Results Different types of technology (eg, glucose monitoring systems, insulin pens, insulin pumps, closed-loop systems, mobile health apps, telemedicine, and electronic medical records) may help to improve diabetes treatment. These improvements primarily affect glycemic control. However, they may also help in increasing the autonomy and quality of life of people who are diagnosed with diabetes mellitus. Conclusions Diabetes technologies have developed rapidly over the last few years and offer novel insights into diabetes therapy and a chance to improve and individualize diabetes treatment. Challenges that need to be addressed in the following years relate to data security, interoperability, and the development of standards.
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Affiliation(s)
- Claudia Eberle
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
| | - Stefanie Stichling
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
| | - Maxine Löhnert
- Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
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14
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Intelligent automated drug administration and therapy: future of healthcare. Drug Deliv Transl Res 2021; 11:1878-1902. [PMID: 33447941 DOI: 10.1007/s13346-020-00876-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
In the twenty-first century, the collaboration of control engineering and the healthcare sector has matured to some extent; however, the future will have promising opportunities, vast applications, and some challenges. Due to advancements in processing speed, the closed-loop administration of drugs has gained popularity for critically ill patients in intensive care units and routine life such as personalized drug delivery or implantable therapeutic devices. For developing a closed-loop drug delivery system, the control system works with a group of technologies like sensors, micromachining, wireless technologies, and pharmaceuticals. Recently, the integration of artificial intelligence techniques such as fuzzy logic, neural network, and reinforcement learning with the closed-loop drug delivery systems has brought their applications closer to fully intelligent automatic healthcare systems. This review's main objectives are to discuss the current developments, possibilities, and future visions in closed-loop drug delivery systems, for providing treatment to patients suffering from chronic diseases. It summarizes the present insight of closed-loop drug delivery/therapy for diabetes, gastrointestinal tract disease, cancer, anesthesia administration, cardiac ailments, and neurological disorders, from a perspective to show the research in the area of control theory.
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15
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Manoni A, Loreti F, Radicioni V, Pellegrino D, Della Torre L, Gumiero A, Halicki D, Palange P, Irrera F. A New Wearable System for Home Sleep Apnea Testing, Screening, and Classification. SENSORS (BASEL, SWITZERLAND) 2020; 20:E7014. [PMID: 33302407 PMCID: PMC7762585 DOI: 10.3390/s20247014] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/11/2022]
Abstract
We propose an unobtrusive, wearable, and wireless system for the pre-screening and follow-up in the domestic environment of specific sleep-related breathing disorders. This group of diseases manifests with episodes of apnea and hypopnea of central or obstructive origin, and it can be disabling, with several drawbacks that interfere in the daily patient life. The gold standard for their diagnosis and grading is polysomnography, which is a time-consuming, scarcely available test with many wired electrodes disseminated on the body, requiring hospitalization and long waiting times. It is limited by the night-by-night variability of sleep disorders, while inevitably causing sleep alteration and fragmentation itself. For these reasons, only a small percentage of patients achieve a definitive diagnosis and are followed-up. Our device integrates photoplethysmography, an accelerometer, a microcontroller, and a bluetooth transmission unit. It acquires data during the whole night and transmits to a PC for off-line processing. It is positioned on the nasal septum and detects apnea episodes using the modulation of the photoplethysmography signal during the breath. In those time intervals where the photoplethysmography is detecting an apnea, the accelerometer discriminates obstructive from central type thanks to its excellent sensitivity to thoraco-abdominal movements. Tests were performed on a hospitalized patient wearing our integrated system and the type III home sleep apnea testing recommended by The American Academy of Sleep Medicine. Results are encouraging: sensitivity and precision around 90% were achieved in detecting more than 500 apnea episodes. Least thoraco-abdominal movements and body position were successfully classified in lying down control subjects, paving the way toward apnea type classification.
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Affiliation(s)
- Alessandro Manoni
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (F.L.); (F.I.)
| | - Federico Loreti
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (F.L.); (F.I.)
| | - Valeria Radicioni
- STMicroelectronics, Agrate Brianza, 20864 MB, Italy; (V.R.); (L.D.T.); (A.G.); (D.H.)
| | - Daniela Pellegrino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.P.); (P.P.)
| | - Luigi Della Torre
- STMicroelectronics, Agrate Brianza, 20864 MB, Italy; (V.R.); (L.D.T.); (A.G.); (D.H.)
| | - Alessandro Gumiero
- STMicroelectronics, Agrate Brianza, 20864 MB, Italy; (V.R.); (L.D.T.); (A.G.); (D.H.)
| | - Damian Halicki
- STMicroelectronics, Agrate Brianza, 20864 MB, Italy; (V.R.); (L.D.T.); (A.G.); (D.H.)
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.P.); (P.P.)
| | - Fernanda Irrera
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (F.L.); (F.I.)
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16
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Berget C, Lange S, Messer L, Forlenza GP. A clinical review of the t:slim X2 insulin pump. Expert Opin Drug Deliv 2020; 17:1675-1687. [PMID: 32842794 DOI: 10.1080/17425247.2020.1814734] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Insulin pumps are commonly used for intensive insulin therapy to treat type 1 diabetes in adults and youth. Insulin pump technologies have advanced dramatically in the last several years to integrate with continuous glucose monitors (CGM) and incorporate control algorithms. These control algorithms automate some insulin delivery in response to the glucose information received from the CGM to reduce the occurrence of hypoglycemia and hyperglycemia and improve overall glycemic control. The t:slim X2 insulin pump system became commercially available in 2016. It is an innovative insulin pump technology that can be updated remotely by the user to install new software onto the pump device as new technologies become available. Currently, the t:slim X2 pairs with the Dexcom G6 CGM and there are two advanced software options available: Basal-IQ, which is a predictive low glucose suspend (PLGS) technology, and Control-IQ, which is a Hybrid Closed Loop (HCL) technology. This paper will describe the different types of advanced insulin pump technologies, review how the t:slim X2 insulin pump works, and summarize the clinical studies leading to FDA approval and commercialization of the Basal-IQ and Control-IQ technologies.
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Affiliation(s)
- Cari Berget
- School of Medicine, Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Campus , Aurora, CO, USA
| | - Samantha Lange
- School of Medicine, Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Campus , Aurora, CO, USA
| | - Laurel Messer
- School of Medicine, Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Campus , Aurora, CO, USA
| | - Gregory P Forlenza
- School of Medicine, Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Campus , Aurora, CO, USA
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17
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Cobry EC, Berget C, Messer LH, Forlenza GP. Review of the Omnipod ® 5 Automated Glucose Control System Powered by Horizon™ for the treatment of Type 1 diabetes. Ther Deliv 2020; 11:507-519. [PMID: 32723002 PMCID: PMC8097502 DOI: 10.4155/tde-2020-0055] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/17/2020] [Indexed: 12/21/2022] Open
Abstract
Type 1 diabetes (T1D) is a medical condition that requires constant management, including monitoring of blood glucose levels and administration of insulin. Advancements in diabetes technology have offered methods to reduce the burden on people with T1D. Several hybrid closed-loop systems are commercially available or in clinical trials, each with unique features to improve care for patients with T1D. This article reviews the Omnipod® 5 Automated Glucose Control System Powered by Horizon™ and the safety and efficacy data to support its use in the management of T1D.
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Affiliation(s)
- Erin C Cobry
- University of Colorado School of Medicine, Barbara Davis Center, Aurora, CO 80045 USA
| | - Cari Berget
- University of Colorado School of Medicine, Barbara Davis Center, Aurora, CO 80045 USA
| | - Laurel H Messer
- University of Colorado School of Medicine, Barbara Davis Center, Aurora, CO 80045 USA
| | - Gregory P Forlenza
- University of Colorado School of Medicine, Barbara Davis Center, Aurora, CO 80045 USA
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18
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Liberman A, Barnard-Kelly K. Diabetes Technologies and the Human Factor. Diabetes Technol Ther 2020; 22:S130-S140. [PMID: 32069154 DOI: 10.1089/dia.2020.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alon Liberman
- Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Petah Tikva, Israel
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19
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Zimmerman C, Albanese-O'Neill A, Haller MJ. Advances in Type 1 Diabetes Technology Over the Last Decade. EUROPEAN ENDOCRINOLOGY 2019; 15:70-76. [PMID: 31616496 PMCID: PMC6785958 DOI: 10.17925/ee.2019.15.2.70] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/20/2019] [Indexed: 12/17/2022]
Abstract
The past 10 years have witnessed rapid advances in the technology used to treat patients with type 1 diabetes (T1D). While the disease burden is still high, these advances have contributed to improvements in both glycaemic control and quality of life for many of those affected. New technologies allow for individualisation of care, as patients are able to work with their providers to determine which systems best fit their lifestyle and needs. In addition, thanks to improved glucose monitoring technologies, patients can now simultaneously improve glycaemic control and reduce hypoglycaemia, thereby mitigating risk for acute and chronic complications. Technological advances in T1D care are rapidly moving us toward increasingly automated devices, which offer the promise of reduced disease burden. In this article, we review advances in glucose monitoring, insulin and glucagon delivery, and the applications and algorithms seeking to integrate novel technologies.
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20
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Berget C, Messer LH, Forlenza GP. A Clinical Overview of Insulin Pump Therapy for the Management of Diabetes: Past, Present, and Future of Intensive Therapy. Diabetes Spectr 2019; 32:194-204. [PMID: 31462873 PMCID: PMC6695255 DOI: 10.2337/ds18-0091] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IN BRIEF Insulin pump therapy is advancing rapidly. This article summarizes the variety of insulin pump technologies available to date and discusses important clinical considerations for each type of technology.
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21
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Abstract
In this special section of JDST, patch-pump delivery systems ("patch pumps") are discussed. Patch pumps are novel insulin delivery systems that have emerged on the market; offering flexible insulin delivery options. These systems offer several advantages over conventional insulin pump delivery systems and are gaining popularity. Patch pumps are free of tubing, small, and lightweight. In this special section, the authors discuss both the simple and complex patch pumps currently available on the US market as well as those that are currently under development. Current technologies used to operate these pumps are discussed in detail, and potential promising technologies are presented. Available data on patient preferences, clinical trial data, and the future of patch pumps are discussed.
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Affiliation(s)
- Bithika Thompson
- Division of Endocrinology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Curtiss B. Cook
- Division of Endocrinology, Mayo Clinic Arizona, Scottsdale, AZ, USA
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22
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Pillalamarri SS, Huyett LM, Abdel-Malek A. Novel Bluetooth-Enabled Tubeless Insulin Pump: A User Experience Design Approach for a Connected Digital Diabetes Management Platform. J Diabetes Sci Technol 2018; 12:1132-1142. [PMID: 30304951 PMCID: PMC6232743 DOI: 10.1177/1932296818804802] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Medical device technology is evolving at a rapid pace, with increasing patient expectations to use modern technologies for diabetes management. With the significant expansion of the use of wireless technology and complex, securely connected digital platforms in medical devices, end user needs and behaviors have become essential areas of focus. METHODS This article provides a detailed description of the user-centered design approach implemented in developing the Omnipod DASH™ Insulin Management System (Insulet Corp., Billerica, MA) Bluetooth®-enabled locked-down Android device handheld controller (Personal Diabetes Manager, PDM). Key methodologies used in the PDM design are described, including how the science of user experience (UX) was integrated into new agile product development. UX methods employed included heuristic evaluations of insulin pumps, iterative formative usability testing, information architecture studies, in-home ethnographic visits, participatory design activities, and interviews. RESULTS Over 343 users participated in UX research and testing. Key design choices informed by UX research included updating the layout of critical data on the PDM home page, providing access to requested contextual information while a bolus is in progress, and creating an easy-to-understand visual of a 24-hour basal program. Task completion rates for comprehending information on the PDM home page were 87% or greater. The System Usability Scale result for the design prior to limited market release was 84.4 ± 13.4 (out of 100; n = 37). CONCLUSIONS The UX process described in this article can serve as a blueprint for medical device manufacturers seeking to enhance product development. Adopting UX research methodologies will help ensure that new diabetes devices are safe, easy-to-use, and meet the needs of users.
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Affiliation(s)
| | | | - Aiman Abdel-Malek
- Insulet Corporation, Billerica, MA,
USA
- Aiman Abdel-Malek, PhD, Insulet Corporation,
600 Technology Park Dr, Billerica, MA 01821, USA.
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