Technological News in Treatment and Control of Type 1 Diabetes
Author: Konstantinova, Maia М., Savova, Radka Hr., Arshinkova, Margarita A.
1 Department of Pediatrics, Medical Faculty, Medical University, Sofia
This is a short review of new technologies in the treatment and control of diabetes mellitus. The Health Insurance System in Bulgaria started reimbursement of the insulin pump-consumables in 2016 and it is necessary for further information to be provided by the Bulgarian Society of Endocrinology to evaluate the advantages and disadvantages of pump treatment. On the other hand continuous glucose monitoring (CGM) is coming into practice. The opportunity to monitor the glycemic variations from distance through the internet-based platform of Nightscouts is extremely helpful for parents. The initial idea was to prevent night hypoglycemia. Later on this platform proved to be valuable for the actual adaptation of the therapy irrespective of the insulin treatment − pump or injections. In this review the special features of insulin pump treatment are discussed as well as the new modifications of the pumps and their connection to CGMs aimed at preventing hypoglycemia. The latest news concerns the Medronic MiniMed 670G system approved by the FDA in 2016. This system consists of a hybrid closed loop which changes the basal insulin rate according to the actual variations of the glucose values beyond the periods of eating. The patient still has to help the system with manual introduction of the amount of carbohydrates and confirmation of the eating boluses. The system then requires two calibrations daily of blood glucose measured by a glucometer. This is why the system is called “hybrid” and is the next step to an “artificial pancreas”.
Key word: insulin pump, glucose sensor, hybrid closed loop,