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Feature Article

Technology & Diabetes Management Keep Coming Together

By Sarah Swarts, MD

We are seeing more and more technologies and opportunities to limit the annoyance of managing your diabetes. This includes new glucometers with more features, new pumps, a glucose monitoring patch and even some new smartphone apps.

Here’s a rundown of some of the new technologies:

Apps. As always, smart devices have an abundance of apps which allow individuals with diabetes to track food intake, calculate insulin, track exercise and blood glucoses. Some programs even allow individuals to scan a barcode from food and then that information is automatically added to their food diary. 

Newer glucometers. Some newer glucometers may be for you! Everyone is different and some people prefer less bells and whistles, while others like more frills. Basic meters give blood glucose readouts and some can be downloaded by health care provider offices. More advanced meters allow people to make notes on food, activity and insulin dosing; these also can be downloaded by provider’s offices.

Some meters already on the market give people with diabetes trend information (Verio or Insulinx meters, for example), and some will calculate insulin dosing with information from the patient (for example, Accu-Chek Aviva Expert). Other meters will link up with a smartphone device via Bluetooth (Accu-Chek Aviva Connect or the Verio Flex are examples). Basic meters are moving toward bigger readouts and color screens for improved visibility.

Work is continuing on a contact lens which can read blood glucoses as well but there is no information on when this will be ready for market.

Continuous glucose monitoring. There are a few CGM systems on the market. These devices sample the person’s blood glucose continuously over the course of a day. With each update, they become more user-friendly, smaller and more accurate. They not only can transmit to the user’s smartphone but can even transmit data to loved ones via a smartphone or a smart watch. In fact, a U.S. Food and Drug Administration (FDA) panel recently gave the recommendation that people with diabetes can use the data on the Dexcom CGM system to calculate insulin dosing.

New pumps and pump systems. Every year it seems that insulin pumps become more and more sophisticated. The newest Medtronic pump-CGM system to be released this fall will stop insulin delivery for low blood glucose and also predicts a low, so you can take preventive measures. Several “closed loop” pumps are being worked on as well: these systems would utilize a CGM to control the insulin pump and in theory would require very little input from the user.

New types of insulin and formulations. Novo Nordisk released a new basal insulin earlier this year, Tresiba (generic: degludec). It has a longer duration of action with fewer peaks. Several companies have released more concentrated insulins in pen form. For example, Lilly released U-500 in a pen earlier this year.

Glucose patch. This patch is not available in the U.S. yet, but hopefully it will be in the future. It is a patch worn on the skin, like the back of your arm, for up to two weeks with a small sensor that goes under the skin. The blood glucose is read by “swiping” the glucometer over the patch, just like at the grocery store!

New form of glucagon. This medication is used by some people with diabetes when they have very low blood glucoses. It has always been an injectable medication but an inhaled formulation may be coming to market in late 2016 or sometime in 2017.

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