Latest Diabetes Tech News
Diabetes is a complex condition that requires constant monitoring and care. Fortunately, technology continues to evolve to make life easier for people with diabetes. In this blog post, we share some exciting updates on the latest developments in diabetes technology that can positively impact both patients and their caregivers.
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Continue reading below.
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1. Tandem Control IQ will work with Dexcom G7 and Libre this fall?(in US)?
"I think that we've carefully evaluated that Abbott sensor. And I think we feel very confident that it will perform very well with Control IQ. We plan on using the sensor data as soon as we initiate the sensor session to power the system and to actually inform Control IQ. So, we have confidence that the system is going to work well."?- John Sheridan (CEO Tandem) interview with Close Concerns
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Tandem's latest quarterly results (3-5-2023) mentioned that?in America, both the Dexcom G7 and the Libresensor were going to work with Tandem Control IQ by the fall of 2023.
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Please note that this?requires a software update, which will only be possible for insulin pumps that are?still under warranty.
However, we know that many people carry their pumps beyond their 4-year warranty. Thus, they will have to continue with the Dexcom G6.
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The question, of course, is?whether Control IQ's results will be the same with these new sensors.
In any case, Tandem has no intention of waiting for official studies or evaluations.
Based on the results they have seen, they are confident that the results will be just as good.
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2. Compare reimbursement of pumps and sensors with your neighbors
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"Cost-effectiveness studies in both T1D and T2D have shown that pump use is cost-effective in several countries, leading to improvements in quality-adjusted life-years. [...] There is a need for updated guidelines for the use of CSII and HCL in individuals living with T2D based on the emerging evidence, with identification of and recommendations for the people who would benefit the most, which would eventually form a basis for reimbursement and health policies." - dr. Johan Jendle Diabetes,?Obesity and Metabolism 2023
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Many individuals who require sensors and insulin pumps often feel disadvantaged when they are unable to obtain proper reimbursement for these vital medical devices.
In response to their concerns, a common counterargument is that they should appreciate what they have since the situation in other countries is even more challenging.
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But what about reimbursement for sensors and pumps in other countries?
That remains difficult to understand.
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Dr. Jendle of Sweden has made an attempt to map this out in his article "Clinical and cost-effectiveness to enable access to technology and meet the needs of payers."
Indeed, in this article you will find this?figure where you can clearly see in which European countries which technology is partially or fully reimbursed:
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For us, of course, it stands out that there are a lot of?errors?in the supposed reimbursement in Belgium and the Netherlands:
Indeed, in both?Belgium and the Netherlands,
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This shows, on the one hand, how difficult it is to get a view of reimbursement in the different European countries,
and on the other hand that there are very?big differences between the different countries.
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People in?Germany, Italy, Austria and Ireland?currently seem?to have the most access?to insulin pumps and sensors.
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Such data?may help to convince the healthcare facilities?of the underlying states to?offer CGM (and insulin pumps) reimbursement for anyone with diabetes?(on an intensive insulin regimen).
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3. New study: Omnipod pods do not appear to be damaged by CT scan
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“The?probability of an adverse event being caused by exposing?these devices to CT irradiation is extremely low, and it is?greatly outweighed by the clinical benefit of a medically?indicated CT examination.” -?FDA?Guidance?Interference between CT and Electronic Medical Devices
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Currently,?the instructions for sensors and insulin pumps?state that?these devices should not be used under an RX or CT.
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This is very?inconvenient because?because of this:
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So the question is whether it will hurt so much to have the sensor and/or insulin pump go under the RX or CT with us?
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Several studies happened in the past that could not show any significant effect of such X-rays:
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Dr. Dong of Texas has?now investigated this for Omnipod pods?as well (Dong et al. JDST 2023).
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This kind of data will?hopefully lead to the possibility of lifting the ban on sensors and insulin pumps under an RX and/or CT.
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In practice, sensors and insulin pumps are already sometimes left on, as also indicated in?this guideline?for the mylife Loop system
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4. Average TIR of 75% in Polish children and adolescents on a closed-loop
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"This population-based study shows that the HCL technology is superior to other treatment modalities in CGM-derived parameters and should be considered as a treatment of choice in all CwD fulfilling the indication criteria." - dr. Zdenek Sumnik?Horm Res Paediatr 2023
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We know that closed-loop systems systematically give better glycemic results than treatment with insulin pens or a manual pump.
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Until now, however, there were?no large real-world studies comparing the different treatments.
We usually used results from different studies to arrive at a comparison, e.g.
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In Poland, a complete?national diabetes registry was now analyzed for the first time.
This allowed the?glycemic results of different treatments to be compared in 1 population.
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For?this study, 2021 data were analyzed from all?children and adolescents <19 years of age who had type 1 diabetes for >1 year.
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A total of?3251?children and adolescents were included and divided according to the therapy they were using:
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It then looked at the HbA1c, time in range (TIR) and glucose risk index (GRI).
Click here to see the results of TIR & TBR.
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As expected, the best results are obtained with a closed-loop system, with an average TIR of 75%, significantly better than the other groups.
It is notable, however, that the other groups do better than previous estimates, and glycaemia results in the children in Poland are generally very good!
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This study shows that?closed-loop technology is superior to other forms of insulin delivery?and should be the preferred treatment in all children who meet the indication criteria of closed-loop systems.
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In addition to this Polish study, a?similar analysis appeared recently at a large American center.
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5. A fully closed-loop system with AndroidAPS
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"Our pilot study showed that FCL might be a realistic mode of treatment for people with T1D." - dr. Petruzelkova?Pancreas4ALL Randomized Pilot Study?
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The concept of a completely closed-loop system, where you no longer have to enter carbs or meals, is getting closer and closer.
AndroidAPS, an open-source closed-loop algorithm, has made great progress in recent months, and more and more people are using it without entering their meals.
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Tim Street did an?interview with n=93 AndroidAPS users in January 2023, and it showed that
It was noticed that there was no clear difference between the mean TIR in these 3 groups.
Note: only the TIR was surveyed here, which may not give a complete picture of glycaemic control.
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Meanwhile, there are several ways to make it easier to handle meals when using AndroidAPS.
These include using
To get good results without entering carbohydrates, most people do use?faster-acting insulin?(eg Lyumjev) and a?low-carb diet.
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Also?published?this month was the?Pancreas4ALL study, already briefly discussed at?ISPAD 2022.
Here, in n=16 adolescents with type 1 diabetes on AndroidAPS, glycemic control for?3 days during admission?was compared between
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A regular version of AndroidAPS was used, led by Milos Kozak, the lead developer of AndroidAPS:
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There were no significant differences in glycaemic control between groups
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Dr Petruzelkova concluded from this that it is possible to use AndroidAPS as a fully closed-loop system.
Of course, this was a very small study, and further research is needed before this can be recommended.
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The evolution of diabetes technology never stands still, and open-source closed-loop systems play an important role in this progress.
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In addition to the developments already mentioned, people using open-source closed-loop systems are constantly testing?new strategies.
These innovations aim to further refine the algorithms and improve the functionality of the system.
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The enthusiasm and dedication of developers to further improve open-source closed-loop algorithms are obvious.
They are working hard to optimize their performance and increase their functionality.
If you want to stay on top of the latest developments, we recommend following?Tim Street of Diabettech.
He is an authority on diabetes technology and regularly shares updates on his own exciting experiments and discoveries in this field.
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The future of diabetes technology is promising, and open-source closed-loop systems are also playing a crucial role in the drive to improve the quality of life for people with diabetes.
Stay tuned to find out what's possible in this rapidly evolving landscape of innovative solutions.
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If you are looking for which closed-loop systems are currently available and what the main advantages and disadvantages are, download the overview of the 10 best closed-loop systems?here.
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Kind regards,
Inge