The race is on in diabetes technology. Looping or shooting or some combination? Bigfoot or Beta Bionics or enriched MDI? Will you prefer a closed loop insulin pump using one of several CGM options combined with an algorithm that coordinates glucose readings and insulin doses? Will control be enhanced by combining insulin with glucagon, amylin, or a GLP-1? Might you inject insulin from a smart pen connected to a CGM that offers an enhanced dosing advisor? Or will it be something we don’t even know about yet?
As diabetes technology advances, questions and concerns also arise. Research suggests that only 50% of current insulin pump settings have a reasonably appropriate carb to insulin ratio. Some pumpers don’t use the bolus calculator and others prefer to use a default setting, such as 1u for 15 grams. Basal rate settings are also widely dispersed. Prior to starting an artificial pancreas system, pump settings have to be reasonable to succeed. Who is going to do this as the number of AP wearers continues to rise? Will the increasing utilization of plastic disposables and throwaway batteries in pumps and CGMs add to environmental damage? Lots of diabtech questions remain to be answered.
For early insight, here’s a comprehensive review from Diatribe that reports on the products and approaches for insulin delivery discussed at the Children with Diabetes Conference in July, 2018.