What diabetes technology is right for me?

From newsroom.osfhealthcare.org

Key takeaways:

• Insulin pumps and continuous glucose monitors have come a long way, making at-home diabetes care easier.
• Your lifestyle, how much insulin you need and how comfortable you are with technology will determine which device is right for you. Include your health care provider and family in the conversation.
• It's important to maintain the devices. Follow your provider's instructions, and don't ignore error messages.

At-home technology for diabetes continues to evolve, giving people more peace of mind that the disease is in check while they enjoy their day. But how do you know you have the right device for your health and lifestyle? Jennifer Adcock, RN, BSN, CDCES, a certified diabetes care and education specialist at OSF HealthCare, has a roadmap. She says there are two main categories:

Insulin pumps: These deliver insulin into your body to mimic the body’s natural production. This helps keep blood sugar at a healthy level. Adcock says it looks like a cell phone clipped to your midsection.

“We have tubeless ones or ones with tubes. You would choose what works best for you,” Adcock says. “Some people are too active to be connected to that tube. So they would choose something like an Omnipod, which is a brand of tubeless insulin pump.”

How much insulin you need daily also plays a role in which device you choose, Adcock says, because some hold more insulin than others.

Continuous glucose monitors (CGMs): It’s a patch on your arm with a filament under the skin. It reads your glucose every few minutes, and the results are transmitted via Bluetooth to a receiver or cellphone. This can let you know in real time if your blood sugar is too high or too low, and you can take quick action to avoid a serious health issue.

“It’s a big improvement,” from the old way of pricking yourself throughout the day, Adcock says. The con, though, is that the device can be expensive if your insurance doesn’t cover it.

Decisions, decisions

Deciding which diabetes device to use should start with a talk with your health care team and loved ones. Beyond that, lifestyle choices might come into play. Do you not want to carry insulin shots with you all the time? A pump might be the way to go. Or conversely, do you struggle with technology and don’t have someone at the ready to help? Maybe a CGM isn’t the choice for you, and you use the old finger-prick method.

“Make sure you’re not afraid to ask questions of your health care providers. That’s what we’re here for: to help,” Adcock says.

Daily maintenance

Regardless of what you choose, it’s important to keep the devices working properly. If, for example, your CGM stops working unbeknownst to you, your blood sugar could spike or drop, and you could wind up in the hospital. So talk to your health care provider about a backup plan if your primary device fails.

“Make sure you’re using your device correctly and as ordered by your physician,” Adcock implores. “These devices will give you messages like ‘It’s time to change your pump site’ or ‘It’s time to change your CGM site.’ Make sure you’re not ignoring and avoiding those.

“A really neat feature of CGMs is that since they use Bluetooth, you can have a support person also connected. They can review your numbers in real time but not be in the same area,” Adcock adds.

https://newsroom.osfhealthcare.org/what-diabetes-technology-is-right-for-me/ 

What’s Next in Diabetes Care: Innovations and Insights

From beyondtype1.org

By Melanie Batchelor, MHS, RD, LDN, CDCES & Dan Trecroci 

The Advanced Technologies & Treatments for Diabetes (ATTD) Conference in Amsterdam was buzzing with breakthroughs across the diabetes spectrum. 

Here’s a simple wrap-up of three themes that stopped us in our tracks.

Theme 1: Looking beyond the type of diabetes

No longer one-size-fits-all, new tech and meds are tackling every type of diabetes.

For years, type 1 diabetes (T1D) and type 2 diabetes (T2D) lived in separate worlds, with different meds and tech. 

At ATTD, we saw those walls coming down. It’s less about the type and more about what helps.

Insulin pumps for type 2 diabetes

• Automated insulin delivery, once only for people with T1D, is now working wonders for folks with T2D as well. 
• In one study, A1c dropped from 8.2% to 7.3% in just 13 weeks. 
• People needed less insulin.

Insulin pumps during pregnancy

In the UK, women with T1D are using automated insulin pumps (aka automated insulin delivery—or AID—systems) throughout pregnancy—a time when blood sugar can be chaotic. 

The result? 

• More time in range.
• Healthier weight gain.
• Smoother transitions into postpartum. 

Moms loved the tech so much, they kept using it after giving birth.

CGMs for prediabetes

• People without diabetes are now trying out continuous glucose monitors (CGMs) like the new over-the-counter Dexcom Stelo. 
• Real-time data helps them understand how food, sleep and exercise impact blood sugar. 
• 84% of users with prediabetes said they’d give it a go.

Gender equity in diabetes tech

• The Medtronic 780G insulin pump is helping both men and women stay in range—even during hormonal shifts like menstruation. 
• It’s adaptive, smart and proof that tech can help close the gender gap in diabetes care.
• Both men and women hit 72% time in range on the 780G pump.

• For women, the pump helped smooth out glucose swings during menstrual cycles.

GLP-1s for… everything?

• GLP-1 meds like tirzepatide and semaglutide are branching out.
• Originally for diabetes and weight loss, now they’re showing benefits for heart failure, sleep apnoea, joint pain and liver disease. 
  • Tirzepatide helps people with heart failure breathe easier and avoid hospital stays.
  • Semaglutide helps reduce knee pain and protects kidneys, even in people without diabetes.
    • It can even reverse prediabetes in some people—81% of those taking it had normal blood sugar again.
  • Survodutide (a new cousin of semaglutide) is helping with a liver condition called MASH.
  • Tirzepatide also significantly reduced sleep apnoea symptoms by more than 60%.

GLP-1s in type 1 diabetes? Yup.

Tirzepatide has shown promising benefits for people with T1D, including:

• Helping with weight loss.
• Improving glucose control.
• Enhancing kidney and heart health, even after accounting for weight loss.

This could be a major shift in how we think about GLP-1 use for T1D.

Bottom line: 

• We’re entering a new era where tools and medications are transitioning from one “type” of diabetes to another. 

• These advancements are even extending into other health conditions.

• The best tech or med? It’s the one that works for you.

Theme 2: TIR, TITR and the TING thing

Are we aiming for good blood sugars… or perfect ones?

We’ve all heard of time in range (TIR): the percent of time blood sugar stays between 70 and 180 mg/dL. 

Now, two new terms are popping up:

• TITR (Time in Tight Range): 70–140 mg/dL
• TING (Time in Normal Glycemia): 70–99 mg/dL

What’s normal blood sugar for someone without diabetes?

• A recent study looked at 153 people (ages 7 to 80) who don’t have diabetes.
• They spent 96% of the day in the “tight range” of 70–140 mg/dL.
• Another study found that
  • People without diabetes: only 15 minutes/day over 180 mg/dL.
  • People with prediabetes: about 45 minutes/day over 180 mg/dL.
  • People with diabetes: around 6.5 hours per day over 180 mg/dL (that’s about 27% of the time!).

Why this matters

• Some experts now wonder, should people with diabetes aim for tighter ranges too?
• The Medtronic 780G system shows that people with diabetes using tech can hit about 50% TITR.
• But if the target is 96% (like in people without diabetes), and someone gets 50%—is that a failing grade?

What makes it harder for people with diabetes?

That kind of pressure could actually make diabetes management harder.

Unlike someone without diabetes, people with diabetes have to juggle:

• Insulin doses
• Meals & snacks
• Hormones
• Illness
• Stress
• Sleep
• Exercise
• Technology

And all of this… every single day.

So being in the “normal” range all the time? Not always realistic.

Why doctors are talking about TING

• Studies show the more time in normal ranges, the lower the risk of complications.
• Some experts see TING as a more “precise” goal—others argue not everyone wants (or needs) to aim for perfection.

Theme 3: Toward a cure

It’s not sci-fi anymore—real people are already seeing real progress.

This year, one in four sessions at ATTD was focused on curing T1D.

And the energy was electric.

Here’s a peek at what’s happening in labs, hospitals and trials

Whole pancreas transplants

• Effective, but big surgery and lifelong meds. Only for a small number of people.

Islet cell transplants

• Instead of the whole pancreas, just the insulin-making cells are transplanted. 
• Some new versions include “shields” to protect them from immune attacks—no need for full immunosuppression.

Encapsulation devices

• Think of them as high-tech armour for new beta cells—they keep the bad stuff (like an immune system in attack mode) out and let the good stuff in.

Immune system reboot

• Researchers are developing ways to “retrain” the immune system so it stops attacking the pancreas in the first place.

A new era in diabetes care: Hope for the future

From expanding treatment options to ground-breaking research, progress is happening. 

With each breakthrough, we move closer to better care, improved quality of life and—one day—a cure.

https://beyondtype1.org/whats-next-in-diabetes-care-innovations-and-insights/