This is a guest post by Erin Poche at T1D Strong, a community dedicated to raising awareness about type 1 diabetes and empowering those who live with its challenges.
Diabetes technology is advancing faster than most of us can monitor. With continuous glucose monitoring (CGM) and devices like insulin pumps, smart pens, diabetes apps and watches, we can now keep blood glucose levels in much tighter ranges.
The time in range for individuals with diabetes is the percentage of time their blood sugar levels stay within the recommended window, improving their overall glycemic control, health and quality of life.
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Continuous Glucose Monitoring
Researchers and physicians have determined that wearing a continuous glucose monitor (CGM) is critical. These wearable devices provide real-time blood glucose readings and advise patients to increase or decrease their insulin doses. This is compared to the traditional finger prick with multiple daily injections from a blood glucose monitor (BGM).
Probably the most significant benefit of using the CGM, especially in individuals with hypoglycemia unawareness, is to protect against severe hypoglycemia (low blood sugar attacks) and hyperglycemia, which can both have detrimental consequences if left untreated. The American Diabetes Association (ADA) cites, “Diabetes technology has become an essential part of diabetes management.”
The international consensus on the use of CGMs is that numerous studies indicate improved glycemic control and living standards in T1D adults and children.
Even in the management of type 2 diabetes (T2D), CGMs are becoming more prevalent. The National Institutes of Health (NIH) reports that over the past decade, many advances in diabetes technology have focused on safer and more accurate glucose measurement and insulin delivery for T2Ds.
For example, Dexcom’s new over-the-counter CGM Stelo is now available without a prescription in the U.S. The Stelo is recommended for T2Ds who don’t require insulin. It displays blood glucose readings for up to 15 days through a smartphone app that a user’s healthcare team can download.
Insulin Pumps
When users pair their continuous glucose monitors to an insulin pump, the CGM data can automatically adjust insulin delivery, keeping an increasingly better time in range.
These two tools, also called an artificial pancreas, empower people with type 1 diabetes to live fuller, safer and healthier lives by enabling them to make informed choices about food intake, insulin dosage and physical activity.
ADA 2024 Scientific Sessions
At the recent ADA Scientific Sessions 2024, insulin pump manufacturers presented new Automated Insulin Delivery (AID) systems, proving users experienced improved target glucose range with fewer hypo- and hyperglycemic events. The new Tandem Mobi pump with Control-IQ AID showed improved time in range. The Mobi and t:slim X2 pumps integrate with iOS and Android phones and Dexcom G6 and G7 sensors.
Insulet makers also presented its Omnipod 5 system, which helps T2Ds who use insulin. Users experienced improved time in range and superior A1c results.
Additionally, Abbot unveiled its FreeStyle Libre 3 Plus, the world’s smallest and least invasive CGM sensor. It lasts 15 days and is compatible with most AID systems.
Beyond these valuable devices, there are much more ways to improve the time in range and level of comfort for people with type 1 and type 2 diabetes.
Smart Insulin Pens
The much-improved insulin pen renamed the ‘smart insulin pen,’ allows users to not only dial in insulin dosage but also calculate the dosage based on their blood glucose reading and carbohydrate intake.
It does much more by keeping track of insulin on board and providing alerts for insulin needed, as studies show these systems improve target glucose range. This information is also downloaded to your smartphone via Bluetooth to an app to share with your healthcare team.
Diabetes Apps
All of the information and diabetes technol therapy combined can be easily accessed through a diabetes application (app) like Health2Sync. The Health2Sync app is a free app that helps users manage their blood sugars, especially avoiding low glucose levels.
To improve target glucose range beyond your glucose meter, continuous glucose monitors and health tracking apps can analyze glucose data to show how blood sugar levels relate to diet, exercise and medication use. The generated reports track CGM metrics and allow users to compare pre-meal and post-meal blood glucose values to provide your healthcare team.
Users can determine a unique diabetes management plan and receive periodic summaries on CGM use, glucose control, target range and A1c test results.
Diabetes apps can track meals, exercise, sleep patterns and glycemic control in real-time. More importantly, this information can be downloaded to your healthcare team to provide TIR data to adjust your insulin intake.
How to Decide What’s Best for You
The endless choices surrounding your glucose management can be overwhelming when deciding which pump, CGM, smart pen or app to use. This is when your health care provider comes into play. These decisions don’t need to be rushed. Some manufacturers even provide free testing for a week or two to see if you like their device.
Your health insurance will also affect your decision. Ask your insurance company for a list of coverage options. Weigh your choices carefully and consider factors like your medical history, cost of living, lifestyle habits and overall health.
Remember, diabetes technology changes rapidly over time, so stay informed with updated reports on A1c results, resources, and tools to help you make the most informative decision about your diabetes care. Major clinical trials on insulin-dependent users demonstrate the advantages of diabetes technology usage, and it’s hard to dispute the impact on the future of diabetes management.
