2/20/2023 0 Comments Virginia diabetes and endo![]() ![]() The control group used a study-provided continuous glucose monitor and either a personal or a study-provided insulin pump without an AID configuration - a commonly selected control group in this field. The authors attributed the apparent imbalance in group size to the large number of randomization strata without obvious baseline differences between groups. A total of 97 patients underwent randomization, 44 to use an open-source AID system (OpenAPS with modified AndroidAPS) and 53 to use sensor-augmented pump therapy (as a control group) for 24 weeks. 9 The trial enrolled children and adults between 7 and 70 years of age who were currently using an insulin pump but had no experience with an open-source AID system. In this issue of the Journal, Burnside and colleagues report the results of a randomized, controlled trial of one type of open-source AID system used in type 1 diabetes. The benefits of customizability for tailored glycemic control and the availability of open-source documentation have been balanced against perceived concerns about difficulty in configuration and maintenance, lack of regulatory approval, and the limited availability of trial data for evaluation. 8 Open-source technologies often permit customizations that are not available with the current commercially available systems. 7 Indeed, international guidelines are now being developed for the use of such configurations. These user-derived configurations were in use before the first commercial devices became available, and subsequent real-world and observational trials have confirmed their applicability. In response to such delays and limitations, open-sourced configurations, commonly known as do-it-yourself solutions, have allowed patients to program a system for their personal use by means of open-source documents maintained and supported primarily by other members of the type 1 diabetes community. Furthermore, the initial development of this technology has been slow, despite the availability of algorithmic solutions. The algorithm is central to insulin-dosing decisions, and a variety of mathematical approaches have proved to be successful.ĭespite the current availability of these systems, challenges remain, including limitations on customization, availability, access, and cost. ![]() The algorithm ties these two devices together to “close the loop” and uses data regarding insulin delivery and glucose levels to adjust insulin dosing, typically on a 5-minute iterative cycle. 1-6 These approaches are rapidly becoming the preferred mode of insulin delivery in glycemic management of type 1 diabetes and have an emerging role in other forms of diabetes.ĪID systems have at least three common components: an insulin pump, a continuous glucose monitor, and an algorithm that is often embedded directly into the pump or a mobile device. ![]() Across age ranges, these trials have shown consistently improved glycemic outcomes, including lower glycated hemoglobin values, lower frequencies of hypoglycemia and hyperglycemia, and improvement in patient-reported outcomes. Several such systems have been validated in clinical trials in both children and adults with type 1 diabetes and are commercially available in several countries. Recent advancements in diabetes management have included the development of automated insulin delivery (AID) devices, also referred to as closed-loop or artificial pancreas systems. The most trusted, influential source of new medical knowledge and clinical best practices in the world.Īchieving glycemic goals, particularly in patients with type 1 diabetes, is an ongoing challenge that has been met, in part, with a variety of device-related solutions. Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care. NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |