Small Patch Insulin Delivery | Tech Thursday

Picture Courtesy of UNC Healthcare

An exciting new insulin delivery system for people with type 1 and type 2 diabetes might be on the horizon!

Designed by Zhen Gu, Ph.D. and a team of researchers from the University of North Carolina, this new system, a small glucose-responsive insulin patch, could be the next generation of insulin delivery.

“We have designed a patch for diabetes that works fast, is easy to use, and is made from nontoxic, biocompatible materials,” said Dr. Gu, professor in the Joint UNC/NC State Department of Biomedical Engineering

Dr. Gu and colleagues have been researching this innovative new insulin delivery system for several years. The small patch, approximately the size of a quarter, could be placed anywhere on the body. Through glucose response technology, the patch could detect hyperglycemia and release insulin through micro-needles. The insulin response would bring the blood glucose level down to the target range and potentially keep it at target for up to 9 hours.

This is encouraging science for people using insulin for their diabetes management!

Click here and here for more information on the science behind this future technology of insulin delivery.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


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When it comes to insulin pumps, sensors, and calculations, many of us feel overwhelmed and unsure about diabetes technology management.

For those who want to feel more comfortable with diabetes technology, Coach Beverly has created a 2-part Technology Toolkit to provide you with critical information on insulin pumps, calculations, and continuous glucose monitors (CGMs).


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Taking care of ourselves, our families and our patients are our first priorities at this time.

It is very quiet in most neighborhoods this morning; no commuter cars on the streets, no school bus noises, no sounds of children playing. This desolate environment reminds us that there is a lot of unknown for all of us.

It is so important right now to make sure we are all prepared for social distancing and flattening the curve of the spread of this pathogen.

We want to offer a few resources for those living with diabetes to prepare for what’s ahead and how to manage stress during this time. Endocrinologists are urging people that use insulin to plan ahead and have extra supplies on hand.

Written by Catherine Cullinane RN, CDCES, our resident Tech Thursday Content Writer


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On February 19, 2020, Insulet announced that their Omnipod Horizon Automated Insulin Delivery (AID) System will be compatible with both the DexCom G6 and Abbott’s FreeStyle Libre 2 Continuous Glucose Monitors (CGM).

Two businesswomen work together on laptop

Abbott’s FreeStyle Libre 2 and the DexCom G6 will be compatible with the next-generation Omnipod Horizon AUD System, which will hopefully be released by the end of the year.

By offering a choice of integrated CGMS, this paves the way for greater consumer engagement when choosing interoperable systems.

The FreeStyle Libre 2  has not yet received iCGM (integrated CGM) classification by the FDA, although it received approval in Europe in 2018. This classification is mandatory to serve as a component in an interoperable hybrid closed loop system. The FreeStyle Libre 2 is currently under review by the FDA.

The Insulet Omnipod Horizon AID is still in studies but is expected to launch in late 2020.

The choice of an iCGM with the Omnipod Horizon system will be yet another step in providing options for intensive diabetes management. In the world of closed-loop insulin delivery and CGM’s, this is another step in the right direction in allowing for individualized approaches to care.

Read more by clicking here and here.


Want to learn more about Diabetes Technology?
Enroll in our Technology Toolkit.
On Sale Now!

When it comes to insulin pumps, sensors, and calculations, many of us feel overwhelmed and unsure about diabetes technology management.

For those who want to feel more comfortable with diabetes technology, Coach Beverly has created a 2-part Technology Toolkit to provide you with critical information on insulin pumps, calculations, and continuous glucose monitors (CGMs).


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Click here to view highly Rated Apps for Diabetes.

A new study, published by JAMA Network Open, found that people living with diabetes can benefit from using self-management apps on their computers and mobile devices.

These tools offer a platform for individuals to have more control over their care by increasing communication with their healthcare team, monitoring lab results and medication refills.

They found that by giving people living with diabetes access to a mobile and computer-based self-management tools, their medication adherence and glycemic control improved.

The study evaluated 111,463 individuals who already had an oral diabetes prescription at baseline with no insulin use from April 2015 to December 2017. Researchers evaluated medical adherence to oral medications by monitoring the “percentage of days covered” (PDC) and by measuring glycemic levels.

For computer-only access results were:

  • PDC increase of 1.16 (95% CI, 0.63 to 1.70) percentage points
  • HbA1c level change of -0.06 (95% CI, -0.08 to -0.03) percentage points

The study also tested the results for combining both computer-based and mobile access. They found that combining the two, they were able to see further improvements.

For computer and mobile access the results were:

  • PDC increase of 1.67 (95% CI, 1.10 to 2.23) percentage points
  • HbA1c level change of -0.13 (95% CI, -0.16 to -0.10) percentage points

As the JAMA Network Open suggests, “these functions are particularly useful for improving the quality of care for patients with chronic conditions, such as diabetes, that require ongoing self-management.”

These results indicate that by offering web-based self-management tools to individuals, medication adherence and glycemic control can improve over time.

You can read more about this study here.


For a list of Highly Rated Apps for Diabetes, click here.


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A new series of recommendations from JDRF/UK has set out to help ensure people with type 1 diabetes can improve access to wearable technology to manage their diabetes.

JDRF Pathway to Choice program released a report capturing the barriers, motivations, and opportunities of people with type 1 diabetes regarding medical technology.

This program in the UK aims to build awareness and access to insulin pumps, CGM’s and Flash glucose meters for persons with type 1 diabetes.

The report has three recommendations;

  • More patient time spent with specialist healthcare educators.
  • Mandatory training covering type 1 diabetes technology for doctors and nurses.
  • Clinical commissioning groups to reach out to lower socio-economic groups that might be overlooked.

Karen Addington, JDRF UK’s Chief Executive states, “JDRF believes everyone who wants or would benefit from type 1 diabetes technology should gain access to it”.

As diabetes educators, nurses, doctors, dietitians, and care-givers, we support this effort in the UK for expanding access to technology that can assist people with type 1 diabetes for tighter, healthier glucose control.

Looking forward to the time that this access might be available for all persons with type 1 diabetes! 

Read more by clicking here.

Written by Catherine Cullinane RN, CDCES, our resident Technology Thursday Content Writer


Want to learn more about Diabetes Technology?
Enroll in our Technology Toolkit.
On Sale Now!

When it comes to insulin pumps, sensors, and calculations, many of us feel overwhelmed and unsure about diabetes technology management.

For those who want to feel more comfortable with diabetes technology, Coach Beverly has created a 2-part Technology Toolkit to provide you with critical information on insulin pumps, calculations, and continuous glucose monitors (CGMs).


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Tandem Diabetes Care announced the commercial USA launch of the t:slim X2 Insulin Pump with Control-IQ Technology.

The Tandem t:slim X2 with Control-IQ is a hybrid closed-loop insulin delivery system. 

The Tandem t:slim X2 with Control-IQ is  first and only system cleared to deliver automatic correction boluses in addition to adjusting insulin to prevent high and low blood glucose levels. The system integrates with the Dexcom G6 CGM which requires no fingersticks for calibration or diabetes treatment decisions. The goal is to increase time in range (70-180 mg/dL) for users.

Tandem President & CEO John Sheridan stated study participants and investigators have described Control-IQ Technology as “life-changing,” “easy to use,” and “a new standard of care in insulin therapy management.”

Control-IQ Technology system:

  • Adjusts insulin delivery to help prevent high and low blood glucose levels
  • Automatically delivers a correction bolus
  • Features Exercise and Sleep activities
  • Requires zero fingersticks with using the Dexcom G6 CGM

Other variables used in this hybrid closed system are:

  • insulin on board
  • predicting rise and fall of blood glucose levels
  • suspending basal rate if a drop in glucose level is predicted 
  • increasing basal rate if elevated blood glucose levels are predicted

Individual emails are being sent out to in-warranty t:slim X2 users for possible upgrades.

Technology is moving forward with improved automation and usability which is good news for people living with diabetes.

Read more here.


Want to learn more about Diabetes Technology?
Enroll in our Technology Toolkit.
On Sale Now!

When it comes to insulin pumps, sensors, and calculations, many of us feel overwhelmed and unsure about diabetes technology management.

For those who want to feel more comfortable with diabetes technology, Coach Beverly has created a 2-part Technology Toolkit to provide you with critical information on insulin pumps, calculations, and continuous glucose monitors (CGMs).


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Medtronic has recalled certain MiniMed 600 Series insulin pumps for delivering incorrect insulin dosing. Medtronic has recalled the following pump models:

Model 630G distributed Sept 2016 to Oct 2019
Model 670G distributed June 2017 to Aug 2019

The FDA has identified this as a Class I recall, the most serious type of recall.  Use of these devices may cause serious injuries or death.

Reason for Recall

Medtronic is recalling the specified insulin pumps due to a missing or broken retainer ring which helps to lock the insulin cartridge into place in the pump’s reservoir compartment.

If the cartridge is not locked firmly into place, under or over the delivery of insulin may occur, which could result in hypoglycemia or hyperglycemia. Severe hyperglycemia can result in a loss of consciousness, seizure, and death.

The firm has received a total of 26,421 complaints in which the device malfunctioned in this manner. The firm is aware of 2,175 injuries and 1 death.

Contact Information

Customers who have questions or need additional information or support about this recall should call the 24-hour Medtronic Technical Support at 877-585-0166.

For more information, please see this FDA Info Sheet

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Diabetes technology moves forward with the creation of an LED contact lens that can diagnose diabetes and assists with the treatment of diabetic retinopathy. A research team from Pohung University of Science and Technology in South Korea has developed a smart light-emitting diode (LED) contact lens for diagnosis of diabetes and treatment of diabetic retinopathy.

The contact lens will not be able to do a real-time blood glucose check but the lens could offer treatment for retinopathy. There is a possible commercialization in the future in collaboration with PIH Biomed and Stanford University.

On the same note: Apple’s science department has also been working on a contact lens to check a blood glucose level in real-time. It is considered to be one of their “secret” research projects from 2017.

As is often the case, a fingerstick BG would be the standard for the most accurate glucose levels for now. The potential for future developments is exciting!

We will keep an “eye” out for future developments in this exciting field of diabetes research.

Read more at Verdict Medical Devices & CNBC.


Welcome Catherine Cullinane RN, CDCES, our new Technology Thursday Content Writer!

Catherine has been a nurse for 30 plus years, and a Diabetes Educator for 20 years. Her passion is helping people empower themselves with behavioral change for optimal health. Type 1 diabetes management ( insulin pumps, CGMs, and new diabetes technology) is one of her major interests and focus.

Catherine has been a Program Coordinator for the American Diabetes Association’s Education Recognition Program in both Wyoming, and  San Francisco, California. She has worked in out-patient clinics, collaborated with hospital in-patient diabetes management, and is a pump and CGM trainer. 

She has traveled the world with her own insulin pump, and more recently a CGM. The latest and greatest in type 1 diabetes management continues to amaze her. Catherine loves to travel, rock climb, hike up mountains, read, cook and eat healthy foods.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Researchers may have developed a way for parents to avoid having to prick their babies with type 1 to check blood sugar. A sugar sensing pacifier collects saliva, tests the glucose levels, and wirelessly sends result to a receiver which the parent or caregiver can see.

This device was tested on adults first to see if the concept would work. Initial results were positive, showing changes in saliva sugar levels which corresponded to changes in blood sugar levels. Researchers noted that there was great correlation in the study and that they were able to tell when blood glucose was high with great accuracy.

The small parts involved in the pacifier, and the fact that saliva was tested after adults were instructed to brush their teeth (unlikely to be replicated in infants), may be barriers to a patent and this device getting on the market. Researchers are hopeful to find ways to overcome these and be able to offer the market a truly non-invasive option for babies with type 1.

More info here.


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The MiniMed 670G is the first FDA approved closed loop insulin delivery system. The pump in combination with a glucose sensor, provides and adjusts basal insulin based on an internal algorithm coupled with continuous glucose readings. This system has an added safety feature of suspending insulin delivery before blood sugars take a dive into dangerous territory.

Real world data is now being collected to evaluate user satisfaction and clinical outcomes. And the findings are positive, according to researcher Lisa T. Meade, PharmD, CDCES, professor of pharmacy at Wingate University in North Carolina.

Her research included a retrospective chart audit of adults with type 1 who used the Medtronic MiniMed 670G. The study evaluated A1c, time in range and user satisfaction. Of these, 33 participants completed a satisfaction survey after at least three months of use.

A1c Results
Based on the chart audit results, the average A1c in the study group dropped significantly. At six months it dropped by 0.9% vs. baseline (P=.015). At one year, the A1c dropped by 1.2% (P=.001) vs. baseline.

Time-In-Range and Satisfaction results
Based on the survey, the average satisfaction score was 3.79 (score range 1-5). These participants also experienced time-in-range benefits.

According to Meade, “We were encouraged with the mean time in range of 67%, but we also see room for improvement. The American Diabetes Association recommends the people using CGMs spend at least 70% of their time between 70 mg/dL and 180 mg/dL. Meade concluded that “The study did confirm the need for better office procedures to track patients starting on new technology and to ensure regular follow-up visits.”


Want to learn more about Diabetes Technologies? Join Coach Beverly for New Technology Toolkit – Earn 3.0 CEs Premiers August 20 & 23

When it comes to insulin pumps, sensors and calculation, many of us feel overwhelmed and unsure about diabetes technology management. Plus, with the vast amount of information, it may seem impossible to figure out what to focus on for our clinical practice and to prepare for the diabetes certification exam.

Coach Beverly invites you to enroll in our NEW Technology Toolkit Online Course Bundle, to keep you abreast of the rapidly changing world of Insulin Pump Therapy, Continuous Glucose Monitoring and calculations while preparing for exam success. 

If you want cutting edge information on diabetes technology, problem solving and using formulas to determine appropriate insulin dosing, we highly recommend this toolkit.


Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

References:

Healio Endocrine Today – Aug 10. 2019

Meade LT, et al. P811. Presented at: American Association of Diabetes Educators; Aug. 9-12, 2019; Houston.

Disclosure: Meade reports she is a certified pump trainer for Medtronic.

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