Diabetes and Technology

By Dawn Gardier,  M.S., B.A. Research Analyst I – What is Diabetes? – Diabetes is a serious condition that occurs when the pancreas (an organ that produces insulin in response to rises in blood sugar levels) is no longer able to make or produce insulin. This affects how a person’s body turns food into energy. In order for the foods eaten to be used as energy, insulin needs to be produced. Lack of insulin or abnormalities in insulin production, leads to high glucose levels in the blood, which is diabetes. Persons with diabetes have elevated levels of glucose in their blood which can lead to other health conditions such as heart disease, kidney disease and vision loss.

Are you at risk for future development of diabetes? – The Center for Disease Control and Prevention (CDC) estimates that there are over 37 million individuals or over 11% of the population with diabetes in the United States. (National Diabetes Statistic Report)[1]

Approximately 2,164,009 people in Florida or 12.5% of the adult population have been diagnosed with diabetes. The CDC estimated that an additional 546,000 people in Florida have diabetes but have not yet been diagnosed. Because the rate of diabetes also increases with age, we can assume that these numbers will be higher in older adults. (Diabetes Fact Sheet by state, American Diabetes Association, Assessed 10/31/22)[2]

There are two main types of diabetes; Type 1 diabetes, occurs when the body does not produce insulin at all. It usually occurs in children or young adults; however, it can occur at any age. Persons with type 1 diabetes must take daily insulin injects to sustain life because their bodies do not produce insulin.

The second one is Type 2 diabetes which is the most common type of diabetes. It is estimated, 9 out of 10 persons or about 90-95% of all diagnosed cases of diabetes is Type 2.

According to the Center for Disease Control and Prevention (CDC), there are certain risk factors associated with developing diabetes, such as having a family history of diabetes, being overweight, persons over the age of 45, having high blood pressure, not being physically active, had gestational diabetes (diabetes during pregnancy), are Black /African American, Asian, Native Hawaiian, Pacific Islander and Hispanic/Latino/Latinx). These risk factors, increases the likelihood of a person becoming susceptible to diabetes.[3]

THE GOOD NEWS – The good news is there are many options to help a person manage and stay in control of their diabetes regardless of the type. Over the years there have been many advantages to help people with diabetes stay in control of their diabetes. The first step is to talk to their primary care provider if they are experiencing any of these common signs associated with diabetes, frequent Urination, especially at night, extreme thirst, lose weight without trying, extreme hunger, blurry vision, numb or tingling hands or feet, fatigue, very dry skin, sores that heal slowly.

Monitoring diabetes with the use of technology – When a person hear technology, they may think about a smart phone, smart TV or even feel intimidated. But did you know that there is a modern technology designed to make a person who has diabetes life simpler by helping them keep track of their glucose level without the “finger pricks”? The newest technology today is called the artificial pancreas system.

What is the Artificial Pancreas?

The Artificial Pancreas Device System is a system of devices that closely imitates the glucose regulating function of a healthy pancreas.

Most Artificial Pancreas Device Systems consists of three types of devices already familiar to many people with diabetes: a continuous glucose monitoring system (CGM), an insulin infusion pump and a computer-controlled algorithm that connects the CGM and insulin infusion pump to allow continuous communication between the two devices. A blood glucose device (such as a glucose meter) is used to calibrate the CGM.[4]

Continuous Glucose Monitoring (CGM)

A CMG machine (a data senor and transmitter) is a small device that sits on the skin with a tiny hair-like sensor inserted under the skin as shown in the image below. This is part of the artificial pancreas system. From there, an electrode measures a person’s glucose levels within the tissue fluid rather than directly from their blood, entirely replacing the need for finger pricks—which is a huge relief for many. This device is used to constantly monitor their glucose levels day and night. [5]

Tracking Glucose Level in Real-Time

The CMG device is a great technology because a person and their health care provider can track their glucose levels in real time. They will be able to see how the foods they eat affect their glucose level and help them maintain a healthy lifestyle by taking note of their meals, physical activity, and medicines. Frequent blood sugar tests can tell a person whether they are keeping their blood sugar level in their target range.

Help Better Assess Health Needs

A doctor or health care provider will have the ability to download the glucose level data from the CMG device to review the glucose level trends during certain times of the day. That will help determine the right dosage of the medication being administered.

Lifesaving Alerts

A person and their health care provider will be able to determine the proper range of their glucose levels. If a person glucose level gets too high or too low, an alarm will sound. If their glucose level goes too low (hypoglycemia) or too high (diabetic coma) for an extended period, that could lead to serious health problems. A CGM device can prevent these from occurring.

Send the Data to a Family Member or Caregiver

A person can download data to a computer or smart device to see their glucose trends more easily. For example, they can choose to have their data go directly to their smartphone— or they can choose to share that data with a parent, partner, or caregiver. For example, their glucose drops dangerously low overnight, the CGM could be set to wake the caregiver in the next room.

What Devices are Approved by the FDA for Use?

Currently, two CGM models are approved for treatment decisions by the FDA. The Dexcom G6 Mobile and the FreeStyle Libre 3.  Another Device currently approved as a research device only is the iLet Bionic Pancreas which uses next-generation technology to automatically deliver insulin to patients with Type 1 diabetes.

These devices make it possible for a person to make changes to their diabetes care plan based on CGM results alone. With other models, a person must first confirm a CGM reading with a finger-stick blood glucose test before they take insulin or treat hypoglycemia.

Smart Insulin Pen

A smart insulin pen is a reusable injector pen with an intuitive smartphone app that can help people with diabetes better manage insulin delivery. This smart system calculates and tracks doses and provides helpful reminders, alerts, and reports. They can come in the form of an add-on to a person’s current insulin pen or a reusable form which uses prefilled cartridges instead of vials or disposable pens.[6]

Advances in measurement systems for diabetes self-monitoring in healthcare is a reality in our technology driven society today. Becoming an educated patient gives a person the power to become an active participant in their diabetes management and treatment.

[1] Centers for Disease Control and Prevention. (2022, January 18). National Diabetes Statistics Report. Centers for Disease Control and Prevention. Retrieved October 31, 2022, from https://www.cdc.gov/diabetes/data/statistics-report/index.html

[2] Centers for Disease Control and Prevention. (2022, January 18). National Diabetes Statistics Report. Centers for Disease Control and Prevention. Retrieved October 31, 2022, from https://www.cdc.gov/diabetes/data/statistics-report/index.html

[3] Centers for Disease Control and Prevention. (2022, April 5). Diabetes risk factors. Centers for Disease Control and Prevention. Retrieved November 1, 2022, from https://www.cdc.gov/diabetes/basics/risk-factors.html

[4] Center for Devices and Radiological Health. (n.d.). What is the pancreas? what is an artificial pancreas device system? U.S. Food and Drug Administration. Retrieved November 1, 2022, from https://www.fda.gov/medical-devices/artificial-pancreas-device-system/what-pancreas-what-artificial-pancreas-device-system

[5] U.S. Department of Health and Human Services. (n.d.). Continuous glucose monitoring. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved October 31, 2022, from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring

[6] Insulin pens. Insulin Pens | ADA. (n.d.). Retrieved November 1, 2022, from https://diabetes.org/tools-support/devices-technology/insulin-pens

By Trudy Gaillard, PhD, CDCES, FAHA; Dawn Gardier, MS, IS / Florida Statewide Registry for Aging Studies / Florida International University

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