Diabetes technology refers to the hardware, gadgets, and software that people with diabetic use to help them control their blood glucose levels, avoid diabetes complications, lessen the burden of living with diabetes, and enhance their quality of life. Traditionally, diabetes technology has been separated into two categories: insulin delivered through syringe, pen, or pump, and blood glucose monitoring via meter or continuous glucose monitor. More recently, diabetes technology has evolved to include hybrid devices that monitor glucose and dispense insulin, some of which are automated, as well as software that acts as a medical device and assists with diabetes self-management. When used correctly, diabetes technology may enhance people’s lives and health; yet, the complexity and fast development of the diabetes technology environment can also be a barrier to patient and provider adoption.
Technology for insulin delivery:
1. Insulin syringes and pens:
Ø Insulin syringes or insulin pens may be used to provide insulin to patients with diabetes who need it, depending on the patient’s desire, insulin type and dose schedule, cost, and self-management abilities.
Ø For individuals with dexterity challenges or visual impairment, insulin pens or insulin injection aids may be used to help them administer correct insulin dosages.
Ø The most common syringe sizes are 1 mL, 0.5 mL, and 0.3 mL, allowing doses of up to 100 units, 50 units, and 30 units of U-100 insulin, respectively.
Ø There are smart pens available that allow you to download the entire data along with programmable insulin dosages.
2. Insulin pumps:
Ø Individuals with diabetes who have had success with continuous subcutaneous insulin infusion should be able to continue receiving it regardless of third-party payer.
Ø The majority of adults, children, and adolescents with type 1 diabetes should be managed with extensive insulin treatment, which may include numerous daily injections or the use of an insulin pump.
Ø The continuous subcutaneous insulin injections or pumps are able to deliver rapid acting insulin throughout the day to help manage blood glucose levels.
Ø The insulin pumps use tubing to deliver insulin through cannula. Some pumps are attached to skin for direct delivery without tubing.
Ø Insulin pump therapy may be explored for all children and adolescents, particularly those under the age of seven.
3. Self-monitoring of Blood Glucose levels:
Ø Most patients on intensive insulin regimens (multiple daily injections or insulin pump therapy) should monitor their glucose levels with self-monitoring (or continuous glucose monitoring) before meals and snacks, at bedtime, occasionally postprandially, before exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycemic, and before performing critical tasks such as driving.
Ø Self-monitoring of blood glucose, when recommended as part of a comprehensive teaching programme, can aid in treatment decisions and/or self-management for patients who require fewer frequent insulin injections.
Ø When ordering blood glucose self-monitoring, make sure patients receive continuous teaching as well as regular evaluations of technique, outcomes, and their ability to use data from blood glucose self-monitoring to change therapy. Continuous glucose monitoring, therefore, necessitates comprehensive and continuing diabetes education, training, and support.
Ø This device helps in controlling intensive glycemic levels on diabetes complications. It is a complementary method for glucose assessment. These integrated results become useful tools in guiding medical nutritional therapy, physical activity, preventing hypoglycemia and adjusting insulin doses.
4. Continuous Glucose Monitors:
Interstitial glucose is measured via CGM (which correlates well with plasma glucose). CGM devices are divided into two categories. The majority of CGM devices are real-time CGMs, which show glucose levels in real time and feature alerts for hypoglycemia and hyperglycemic excursions. The intermittently scanning CGM (isCGM) device, which is only approved for adult usage, is the second option. The isCGM system, which will be explored in further detail below, does not have any alerts and simply communicates on demand. It is said to be less expensive than systems with automated notifications.
The CGM device allows to examine patient’s data with more precision to aid in achieving glycemic index. This device can be considered for children, adolescents and adults in order to improve glycemic control without an increase in hypoglycemia.
5. Real-time continuous glucose monitor use in Youth:
The data in real-time continuous glucose monitor in youth consist of findings from RCT and small observational studies along with analysis of data collected. The real time CGM can be considered for children and adolescents having type 1 diabetes along with the usage of multiple injections daily or continuous subcutaneous insulin infusion, in order to improve glucose control and reduce the risk for hypoglycemia.
6. Real-time continuous glucose monitor use in adults:
Ø In adults, when CGM is used properly in conjunction with intensive insulin regimens, it becomes a useful tool in lowering A1C levels to adults with type 1 diabetes who are unable to meet their glycemic targets.
Ø It becomes a useful tool for the adults with hypoglycemia unawareness and frequent hypoglycemic episodes.
Ø It is useful for pregnant ladies with type 1 diabetes for their neonatal outcomes.
7. Automated insulin delivery:
The insulin doses are adjusted based on glucose values, which is now feasible with automated insulin delivery systems consisting of three components: an insulin pump, a continuous glucose sensor, and an algorithm that determines insulin delivery. Based on the system’s output on sensor glucose values, the insulin delivery can also be increased or decreased. This technology helps in lowering the risk of exercise related hypoglycemia and has psychosocial benefits.
Thus, the interference of technology in glucose monitoring systems and its delivery has played an important and major role in controlling diabetes. When technology is merged with a holistic approach in diabetes reversal, the process becomes easier and also gaining trust on the ancient medicinal system.