scholarly journals Appearance of Do‐It‐Yourself closed‐loop systems to manage type 1 diabetes

2018 ◽  
Vol 48 (11) ◽  
pp. 1400-1404 ◽  
Author(s):  
Tien‐Ming Hng ◽  
David Burren
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself

scholarly journals Do‐it‐yourself closed‐loop systems for people living with type 1 diabetes

2020 ◽  
Vol 37 (12) ◽  
pp. 1977-1980 ◽  
Author(s):  
L. Dowling ◽  
E. G. Wilmot ◽  
P. Choudhary
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself

scholarly journals Do-It-Yourself (DIY) Systems in Diabetes: A Family and Provider Perspective

2020 ◽  
Vol 14 (5) ◽  
pp. 917-921 ◽  
Author(s):  
Malinda D. Duke ◽  
Ashley A. Fredlock
Keyword(s):  
Type 1 Diabetes ◽  
Patient Autonomy ◽  
Closed Loop ◽  
Healthcare Providers ◽  
Burden Of Care ◽  
Glucose Levels ◽  
Closed Loop Systems ◽  
Provider Perspective ◽  
Do It Yourself

Type 1 diabetes is a unique disorder, requiring constant and vigilant assessment of glucose levels, food/snacks consumed, activities and exercise, emotions and stress, hormonal influence, and illness. No other diagnosis is as intensive in terms of the “burden” of care that impacts the patient/family physiologically, cognitively, and psychologically. Several Do-It-Yourself (DIY) closed-loop systems currently exist and can provide options for patients and families looking to reduce the burden of type 1 diabetes. However, as the systems are not Food and Drug Administration approved, healthcare providers are faced with the decision of whether to support patients using DIY systems. This manuscript discusses the ethics of choice and patient autonomy from the perspective of patient/family and healthcare provider. A set of proposed guidelines for healthcare providers are also presented for consideration when interacting with a patient or family who desires to use a DIY system to help manage type 1 diabetes.

scholarly journals Do-It-Yourself (DIY) Closed Loop Systems: Perspectives of an Endocrinologist

2019 ◽  
Vol 14 (6) ◽  
pp. 1104-1106 ◽  
Author(s):  
Tien-Ming Hng
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself ◽  
Alternative Choice

Do-It-Yourself closed loop systems are becoming increasingly popular as an alternative choice for managing type 1 diabetes. In this commentary, the issues that are faced by both the clinician and the person with diabetes are discussed from my perspective.

Patients’ Experience of New Technologies and Digitalization in Diabetes Care in Germany

2021 ◽  
pp. 193229682110413
Author(s):  
Bernhard Kulzer ◽  
Lutz Heinemann ◽  
Timm Roos
Keyword(s):  
Type 1 Diabetes ◽  
Online Survey ◽  
Closed Loop ◽  
New Technologies ◽  
Personal Responsibility ◽  
Research Question ◽  
Advantages And Disadvantages ◽  
Closed Loop Systems ◽  
Do It Yourself

Background: Little is little known about how people with diabetes experience advancing digitization and new technologies in diabetes. Research question: What are the attitudes of people with diabetes (or, in the case of children with diabetes, their parents) toward digitization and advancing technology in diabetology? What significant advantages and disadvantages do they see, and how do they assess current developments of digitization in diabetology (eg, hybrid closed-loop systems, do-It-Yourself (DIY) closed-loop systems, data protection, and data donation)? Material and method: 3,427 people with diabetes (47.7% female, 65.6% type 1 diabetes (T1D), 25.5% type 2 diabetes (T2D), 8.1% parents of children with diabetes; 0.8% other type of diabetes, age 49.2 ± 19.3 years) were interviewed with an online survey. Results: Overall, survey participants had a very positive attitude toward digitization (82.6%) and considered the potential for optimizing diabetology through digitization to be very high (78.8%). The highest rated advantages of digitization were “greater personal responsibility and self-determination in therapy” (80.0%), “better quality of treatment” (80.0%), and “better communication with the doctor/diabetes team” (77.3%), while the highest rated disadvantages were the “error-proneness of digital applications” (35.9%), the “risk of misuse of patient data” (32.3%) and the “fear that digitization will replace the doctor in many cases” (31.1%). The possibility of evaluating and analyzing glucose data by means of software, and AID systems, and the possibility of improving the interoperability of the various applications are currently rated as the most significant topics. Conclusions: The vast majority of people with diabetes are very positive about new technologies in diabetology and expect that it will improve and simplify their diabetes therapy and reduce the burdens associated with diabetes. In particular, people with type 1 diabetes have high expectations for AID systems, viewing them as a kind of “technical cure” for their diabetes.

Time in range for multiple technologies in type 1 diabetes: a systematic review and network meta-analysis

2020 ◽  
Author(s):  
Anthony Pease ◽  
Clement Lo ◽  
Arul Earnest ◽  
Velislava Kiriakova ◽  
Danny Liew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Closed Loop ◽  
Meta Analysis ◽  
Management Strategies ◽  
Glucose Testing ◽  
Closed Loop Systems ◽  
Percent Time ◽  
Time In Range

<b>Background: </b>Time-in-range is a key glycaemic metric, and comparisons of management technologies for this outcome are critical to guide device selection. <p><b> </b></p> <p><b>Purpose: </b>We conducted a systematic review and network meta-analysis to compare and rank technologies for time in glycaemic ranges.</p> <p> </p> <p><b>Data sources: </b>We searched All Evidenced Based Medicine Reviews, CINAHL, EMBASE, MEDLINE, MEDLINE In-Process and other non-indexed citations, PROSPERO, PsycINFO, PubMed, and Web of Science until 24 April, 2019.</p> <p> </p> <p><b>Study selection: </b>We included randomised controlled trials <u>></u>2 weeks duration comparing technologies for management of type 1 diabetes in adults (<u>></u>18 years of age), excluding pregnant women. </p> <p> </p> <p><b>Data extraction: </b>Data were extracted using a predefined template. Outcomes were percent time with sensor glucose levels 3.9–10.0mmol/l (70–180mg/dL), >10.0mmol/L (180mg/dL), and <3.9mmol/L (70mg/dL). </p> <p><b> </b></p> <p><b>Data synthesis: </b>We identified 16,772 publications, of which 14 eligible studies compared eight technologies comprising 1,043 participants. Closed loop systems lead to greater percent time-in-range than any other management strategy and was 17.85 (95% predictive interval [PrI] 7.56–28.14) higher than usual care of multiple daily injections with capillary glucose testing. Closed loop systems ranked best for percent time-in-range or above range utilising surface under the cumulative ranking curve (SUCRA–98.5 and 93.5 respectively). Closed loop systems also ranked highly for time below range (SUCRA–62.2). </p> <p><b> </b></p> <p><b>Limitations: </b>Overall risk of bias ratings were moderate for all outcomes. Certainty of evidence was very low.</p> <p><b> </b></p> <p><b>Conclusions: </b>In the first integrated comparison of multiple management strategies considering time-in-range, we found that the efficacy of closed loop systems appeared better than all other approaches. </p>

Efficacy of advanced hybrid closed loop systems for the management of type 1 diabetes in children

2021 ◽  
Author(s):  
Lucia FERRITO ◽  
Stefano PASSANISI ◽  
Riccardo BONFANTI ◽  
Valentino CHERUBINI ◽  
Nicola MINUTO ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems

scholarly journals Women’s Experiences of Day-and-Night Closed-Loop Insulin Delivery During Type 1 Diabetes Pregnancy

2018 ◽  
Vol 12 (6) ◽  
pp. 1125-1131 ◽  
Author(s):  
Conor Farrington ◽  
Zoe Stewart ◽  
Roman Hovorka ◽  
Helen Murphy
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Closed Loop ◽  
Insulin Delivery ◽  
Peace Of Mind ◽  
Women’S Experiences ◽  
Closed Loop Systems ◽  
Women's Experiences

Aims: Closed-loop insulin delivery has the potential to improve day-to-day glucose control in type 1 diabetes pregnancy. However, the psychosocial impact of day-and-night usage of automated closed-loop systems during pregnancy is unknown. Our aim was to explore women’s experiences and relationships between technology experience and levels of trust in closed-loop therapy. Methods: We recruited 16 pregnant women with type 1 diabetes to a randomized crossover trial of sensor-augmented pump therapy compared to automated closed-loop therapy. We conducted semistructured qualitative interviews at baseline and follow-up. Findings from follow-up interviews are reported here. Results: Women described benefits and burdens of closed-loop systems during pregnancy. Feelings of improved glucose control, excitement and peace of mind were counterbalanced by concerns about technical glitches, CGM inaccuracy, and the burden of maintenance requirements. Women expressed varied but mostly high levels of trust in closed-loop therapy. Conclusions: Women displayed complex psychosocial responses to day-and-night closed-loop therapy in pregnancy. Clinicians should consider closed-loop therapy not just in terms of its potential impact on biomedical outcomes but also in terms of its impact on users’ lives.

scholarly journals Benefits and Challenges of Current Closed-Loop Technologies in Children and Young People With Type 1 Diabetes

2021 ◽  
Vol 9 ◽  
Author(s):  
Julia Fuchs ◽  
Roman Hovorka
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Closed Loop ◽  
Age Groups ◽  
Future Research ◽  
Pediatric Age ◽  
Children And Young People ◽  
Closed Loop Systems ◽  
Current Systems

Recent advances in diabetes technology have led to the development of closed-loop insulin delivery systems for the management of type 1 diabetes. Several such systems are now commercially available for children and young people. While all available systems have been shown to improve glycaemic control and quality of life in this population, qualitative data also highlights the challenges in using closed-loop systems, which vary among different pediatric age-groups. Very young children require systems that are able to cope with low insulin doses and significant glycaemic variability due to their high insulin sensitivity and unpredictable eating and exercise patterns. Adolescents' compliance is often related to size and number of devices, usability of the systems, need for calibrations, and their ability to interact with the system. Given the speed of innovations, understanding the capabilities and key similarities and differences of current systems can be challenging for healthcare professionals, caregivers and young people with type 1 diabetes alike. The aim of this review is to summarize the key evidence on currently available closed-loop systems for children and young people with type 1 diabetes, as well as commenting on user experience, where real-world data are available. We present findings on a system-basis, as well as identifying specific challenges in different pediatric age-groups and commenting on how current systems might address these. Finally, we identify areas for future research with regards to closed-loop technology tailored for pediatric use and how these might inform reimbursement and alleviate disease burden.

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