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The New Edge of Diabetes Technology

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Christel Aprigliano

on 12 September 2015

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Transcript of The New Edge of Diabetes Technology

Christel Marchand Aprigliano
CEO, The Diabetes Collective
CGMs
Continuous Glucose Monitors utilize sampling of interstitial fluid to determine blood glucose levels. Sensor is inserted into subcutaneous tissue and measures for up to 7 days.
Continuous Glucose Monitoring
Medtronic Sof-Sensor
Medtronic Enlite (with 530g)
Dexcom G4
Insulin Pumps
Continuous Infusion Tubed
Continuous Infusion Tubeless
Continuous Infusion Patch
Artificial Pancreas
Uses CGM data, pump, and algorithm to control insulin (and in one pump, glucagon) to keep blood glucose levels within range.
Management
MySugr
Glooko
Glucose Buddy
One Drop
Calorie King
Figwee
Meal Memory
The New Edge of Diabetes Technology
Now
Next
Flash GM
Abbott Libre
Continuous GM
Medtronic Enlite 3(670G)
Dexcom G5
FDA Approved 8/2015!
Dexcom G6
Remote Glucose Monitoring
Now
Nightscout
Next
Remote Continuous
Glucose Monitoring
Tidepool (Real-Time)
Blip/Nutshell
All except Medtronic & Roche
Livongo
Accu-Check Connect
Continuous
Fingerstick
MiniMed Connect
Medtronic (Minimed)
Revel
530g System
Animas
Ping
Vibe
Tandem
t:slim
t:flex
t:slim G4
Omnipod
Accu-Chek
Spirit
Combo
Valeritas V-Go
V-Go Instant Savings Program. With the card, commercially insured patients pay $30 for their first prescription, and $30 or $80 for refills depending on insurance benefit.

www.go-vgo.com
The V-Go delivers insulin at a continuous preset basal rate and on-demand bolus dosing for adults with Type 2 diabetes requiring insulin.
Medtronic
530G
Medtronic
640G
Medtronic
670G
Bigfoot Medical
???
Bionic Pancreas iLet
[
]
670G
Apps
aka The Holy Grail
670G and iLet currently in clinical trials and expecting FDA approval by 2018.
iLet
w/Enlite
w/Enlite3
With Dexcom G5
Insulin Pump Pros and Cons
A1C and time in range
Multiple basal rates
Microbolusing (children)
IOB and correction factors
Freedom
Higher incidence of DKA/hypo
Failure rate (it's technology)
Cost factor
Not everyone can operate
PROS
CONS
Did you know?
Dean Kamen (the inventor of the Segway) also invented the first insulin pump.
NOW
CGM Pros and Cons
Snapshot vs. Movie
Trending/patterns
Alarms at low/high threshold
Peace of mind
Helicopters
MARD rate/accuracy
Expense
Medicare/Medicaid issue
False sense of security
Helicopters
Hydration
Alarm fatigue
Adhesive sensitivity
PROS
CONS
Devices
Timesulin
Genteel
Non-invasive CGM/Flash
Available DTC November 2015
No pricepoint yet
Unlimited strips $75/mth
Patch Pump J&J
FDA approval Q4 2015
Insulin Pumps
Note: Current integrated pump systems with Dexcom lag behind latest algorithm. One less device to carry, but not latest tech. So... it's filed under "NEXT" for NOW. (See what I did there?)
What can YOU do to help your patients and the diabetes community?
Clinical Trials
Let patients know
diaTribe
Inbox Info
Top patient blogs
Peer support
Online diabetes news
"The pulse"
We all hate this.
Raise your voice.
Type Zero Technologies (UVA Closed Loop)
Diabetes Assistant System (DiAs) runs a control algorithm on an Android smartphone that communicates with a Roche or Tandem insulin pump as well as a Dexcom G4 CGM, however algorithm is "pump agnostic"
"Treat-to-range" approach during the day, where users are responsible for setting meal boluses, while the system works to keep glucose within a designated range using incremental increases or decreases in basal rates as needed. Overnight, changes to "treat-to-target," (110-120 mg/dL)
Bigfoot Biomedical
Asante Snap Assets
Jeffrey Brewer, Brian Mazlish, and Lane Desborough
"homegrown" system
Ones to Watch...
Artificial Pancreas Pathway
Dexcom Share
Next
Next
www.DiabetesPAC.org
Non-partisan non-profit amplifying the diabetes patient voice on federal and state
issues in areas of safety, quality, and access.
Who the heck are you to talk about this topic?
Diabeticfeed
ThePerfectD
Diabetes Patient Advocacy Coalition
Speaker. Blogger. Diabetes Disrupter.
Atypical Advocate
MSc MIS, PWD
Far too much time on my hands and an insane curiosity toward diabetes tech.
How do you, as a CDE, decide with the patient how to manage diabetes with technology?
What are patients doing on their own to manage diabetes with technology?
Insulin Pumps
CGM
App Management
Devices that are "tech-y"
What "tech" can you use to help your patients?
NOW and NEXT
My Goals for Today:
NOW
Now
Cover These Topics:
Have you NOT take notes, except for this URL:
www.theperfectd.com/CFADE
Remote Glucose Monitoring
Next
www.theperfectd.com/CFADE
Full transcript