INTEGRATED INSULIN PUMP AND CONTINUOUS GLUCOSE MONITORING TECHNOLOGY IN DIABETES CARE TODAY: A PERSPECTIVE OF REAL-LIFE EXPERIENCE WITH THE MINIMED™ 670G HYBRID CLOSED-LOOP SYSTEM

被引:30
作者
Aleppo, Grazia [1 ,2 ]
Webb, Kimberly M. [2 ]
机构
[1] Northwestern Univ, Div Endocrinol Metab & Mol Med, Feinberg Sch Med, 645 North Michigan Ave,Suite 530, Chicago, IL 60611 USA
[2] Northwestern Med Grp, Northwestern Med Diabet Training & Educ Program, Div Endocrinol Metab & Mol Med, Chicago, IL USA
关键词
DELIVERY-SYSTEM; HOME-USE; NOCTURNAL HYPOGLYCEMIA; ARTIFICIAL PANCREAS; GLYCEMIC OUTCOMES; RANDOMIZED-TRIAL; TYPE-1; ADULTS; THERAPY; FAT;
D O I
10.4158/EP-2018-0097
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Intensive glucose management with insulin pump and continuous glucose monitoring therapy in insulin-treated patients with diabetes poses many challenges in all aspects of daily life. Automated insulin delivery (AID) is the ultimate goal of insulin replacement therapy to reduce the burden of managing this condition. Many systems are being tested in the clinical research setting, and one hybrid closed-loop (HCL) system has received Food and Drug Administration (FDA) approval for use in type 1 diabetes patients above the age of 14 years. Methods: Literature review and clinical practice experience from the Diabetes and Technology Program at an academic medical center. Results: This review outlines recent advances in AID systems, focusing on the FDA-approved MiniMed (TM) 670G HCL system and the real-life experience 1-year post-release in an academic medical center with over 60 patients on this system. The unique challenges of adapting to this new system outside the clinical trial setting are highlighted, and a training protocol designed specifically for the onboarding of first-time users is described. Conclusion: HCL insulin therapy offers several advantages, at the same time posing unique challenges to the user. Systematic training of patients with diabetes transitioning to this system is essential for retention and success of use.
引用
收藏
页码:684 / 692
页数:9
相关论文
共 49 条
[1]   CLINICAL CONTROL OF DIABETES BY ARTIFICIAL PANCREAS [J].
ALBISSER, AM ;
LEIBEL, BS ;
EWART, TG ;
DAVIDOVAC, Z ;
BOTZ, CK ;
ZINGG, W ;
SCHIPPER, H ;
GANDER, R .
DIABETES, 1974, 23 (05) :397-404
[2]   REPLACE-BG: A Randomized Trial Comparing Continuous Glucose Monitoring With and Without Routine Blood Glucose Monitoring in Adults With Well-Controlled Type 1 Diabetes [J].
Aleppo, Grazia ;
Ruedy, Katrina J. ;
Riddlesworth, Tonya D. ;
Kruger, Davida F. ;
Peters, Anne L. ;
Hirsch, Irl ;
Bergenstal, Richard M. ;
Toschi, Elena ;
Ahmann, Andrew J. ;
Shah, Viral N. ;
Rickels, Michael R. ;
Bode, Bruce W. ;
Philis-Tsimikas, Athena ;
Pop-Busui, Rodica ;
Rodriguez, Henry ;
Eyth, Emily ;
Bhargava, Anuj ;
Kollman, Craig ;
Beck, Roy W. .
DIABETES CARE, 2017, 40 (04) :538-545
[3]   The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System [J].
Bailey, Timothy ;
Bode, Bruce W. ;
Christiansen, Mark P. ;
Klaff, Leslie J. ;
Alva, Shridhara .
DIABETES TECHNOLOGY & THERAPEUTICS, 2015, 17 (11) :787-794
[4]   Bolusing frequency and amount impacts glucose control during hybrid closed-loop [J].
Bally, L. ;
Thabit, H. ;
Ruan, Y. ;
Mader, J. K. ;
Kojzar, H. ;
Dellweg, S. ;
Benesch, C. ;
Hartnell, S. ;
Leelarathna, L. ;
Wilinska, M. E. ;
Evans, M. L. ;
Arnolds, S. ;
Pieber, T. R. ;
Hovorka, R. .
DIABETIC MEDICINE, 2018, 35 (03) :347-351
[5]   Optimized Mealtime Insulin Dosing for Fat and Protein in Type 1 Diabetes: Application of a Model-Based Approach to Derive Insulin Doses for Open-Loop Diabetes Management [J].
Bell, Kirstine J. ;
Toschi, Elena ;
Steil, Garry M. ;
Wolpert, Howard A. .
DIABETES CARE, 2016, 39 (09) :1631-1634
[6]   Safety of a Hybrid Closed-Loop Insulin Delivery System in Patients With Type 1 Diabetes [J].
Bergenstal, Richard M. ;
Garg, Satish ;
Weinzimer, Stuart A. ;
Buckingham, Bruce A. ;
Bode, Bruce W. ;
Tamborlane, William V. ;
Kaufman, Francine R. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 316 (13) :1407-1408
[7]   Threshold-Based Insulin-Pump Interruption for Reduction of Hypoglycemia [J].
Bergenstal, Richard M. ;
Klonoff, David C. ;
Garg, Satish K. ;
Bode, Bruce W. ;
Meredith, Melissa ;
Slover, Robert H. ;
Ahmann, Andrew J. ;
Welsh, John B. ;
Lee, Scott W. ;
Kaufman, Francine R. .
NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (03) :224-232
[8]   Effectiveness of Sensor-Augmented Insulin-Pump Therapy in Type 1 Diabetes [J].
Bergenstal, Richard M. ;
Tamborlane, William V. ;
Ahmann, Andrew ;
Buse, John B. ;
Dailey, George ;
Davis, Stephen N. ;
Joyce, Carol ;
Peoples, Tim ;
Perkins, Bruce A. ;
Welsh, John B. ;
Willi, Steven M. ;
Wood, Michael A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (04) :311-320
[9]  
Beta-Bionics, INTR ILET
[10]   Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes [J].
Brazeau, A. S. ;
Mircescu, H. ;
Desjardins, K. ;
Leroux, C. ;
Strychar, I. ;
Ekoe, J. M. ;
Rabasa-Lhoret, R. .
DIABETES RESEARCH AND CLINICAL PRACTICE, 2013, 99 (01) :19-23