Perspectives on Diabetes Care

Diabetes and Technology–Oh My!

Sep 8, 2015, 16:28 PM

What a technology whirlwind is occurring in the world of diabetes. It is truly an exciting time – just hard to keep up with it all!

I was truly excited as I left the ADA meeting this year in Boston. It is the first time I have truly believed that the Artificial Pancreas is going to happen in the not too distant future. I can close my eyes and almost weep at the thought of children playing without constant finger sticks to check on potential highs and lows. I realize it is not a cure – but it is a much improved way to make life easier and safer for the thousands of people who are dependent on an external supply of insulin.

In addition, technology is rapidly making life more manageable. The release of the Dexcom G5 mobile is wonderful. One of my college patients is so excited to add this to her diabetes management system. Of course, she NEVER forgets her cell phone – but does forget the receiver now and then! It also provides an option for sharing. I believe this will be particularly useful for parents that are worried about kids and sleepovers – or spouses while traveling alone. And of course, their G4 now has the share option available.

The Vibe Animas system now incorporates the Dexcom CGMS on the pump screen for easy reading. I was, however, disappointed that the glucometer is no longerable to send the BG to the pump and dose with this new model. However, that may be a small exchange for the “movie” picture of BG on the screen.

The Tandem is soon to announce their Dexcom integration as well. So there will be 3 insulin pumps with the integrated CGM option. Tandem has recently introduced the Tandem flex – with a cartridge that can hold up to 480 units with maximum bolus of 60 units: a great option for patients with high levels of insulin resistance.

Medtronic has led the field with its automatic suspend system (530G with Enlite sensor), which is particularly useful for those with hypoglycemia unawareness. Past research using CGM suggests that many people sleep through hypoglycemia. The automatic suspend temporarily prevents the continuous delivery of insulin and allows the individual’s body to return to a normal range by allowing endogenous glucose production to return the individual to a normal blood glucose without external glucose intake. In addition, Medtronic now has the phone interface as well, called Minimed connect. CGM data can be viewed on an iPhone and information can be shared as desired.

The OmniPod insulin pump system, the only tubeless pump available in the United States, has made major improvements in the past few years. The ability to move freely without a tubing tether has been a real attraction for some individuals. Look for new updates on this product as well.

We all hope for a cure for diabetes, but along the way, technology is helping to improve the quality of life for individuals with diabetes and enhance the safety of insulin delivery. I am excited to help share the options that are available with my patients, and to help advocate for coverage so that the opportunity to manage diabetes more precisely, while enhancing safety, is available to all who chose to use it.

Hope you are keeping up with all the options. If this is not an area of focus in your practice, consider referring to a diabetes educator that is well versed in the options for patients and can provide them with all the “magic” that is available. You can work as a team to enhance the safety and quality of life for your patients.