First, let’s look at getting older with Type 1 diabetes. Yup, put on your reading glasses and sit in your easy chair.
The New Complication: Aging with Type 1 Diabetes was reported on MyGlu.org, October 2017. And oh, this is interesting.
With incredible breakthroughs in diabetes technology, therapy and clinical care, people with type 1 diabetes (T1D) are living longer than ever. But as people age, they take on a whole separate host of challenges that are compounded by T1D. Many fear they will not have the self-reliance, care, support, or financial resources necessary to manage their blood sugar and continue to live well with diabetes in their golden years.
Last month, this concerning issue was presented at T1D Exchange’s Annual Meeting. Four individuals currently or soon facing this dilemma spoke on a patient panel, bringing to light a new complication of type 1 diabetes rarely discussed in a public forum. Read more: The New Complication: Aging with Type 1 Diabetes
Are broken hips more common in people with type 1 diabetes? was reported on Medivizor, 17 October 2017, from Diabetes Research and Clinical Practice. Oh no!!!
This study investigated the risk of hip fractures in people with type 1 diabetes (T1D) and the factors that contributed to this risk. It was determined that people with T1D have a higher risk of hip fractures. The risk was higher for people who were older, who had depressive symptoms, or who were taking medications for osteoporosis. Read more: Are broken hips more common in people with type 1 diabetes?
Should I Rely on Loved Ones for Diabetes Support? Here’s an interesting piece by Adam Brown, author of the book, Bright Spots & Landmines, 30 October 2017.
What role should family and friends play in my diabetes? Is this condition my burden to bear? How do I get support from loved ones, but avoid “diabetes police” territory? Read more: Should I Rely on Loved Ones for Diabetes Support?
Closed Loop Update from diaTribe.org, 4 November 2017:
The development of automated insulin delivery has many names – artificial pancreas, hybrid closed loop, Bionic Pancreas, predictive low glucose suspend – but all share the same goal: using continuous glucose monitors (CGMs) and smart algorithms that decide how much insulin to deliver via pump. The goal of these products is to reduce/eliminate hypoglycemia, improve time-in-range, and reduce hyperglycemia – especially overnight. Read more: Automated Insulin Delivery
Updated: November 4, 2017
US Products
| Company/Organization | Product | Latest Timing in the US |
|---|---|---|
| Medtronic | MiniMed 670G/Guardian Sensor 3 – hybrid closed loop that automates basal insulin delivery (still requires meal boluses) | FDA-approved and currently launching this fall to ~35,000 Priority Access Program participants in the US. Pump shipments to non-Priority Access customers will start in October, with sensors and transmitters to ship by the end of 2017 or early 2018. Medtronic is experiencing a global CGM sensor shortage that won’t resolve until spring 2018. |
| Tandem | t:slim X2 pump with built-in predictive low glucose suspend (PLGS) algorithm; Dexcom G5 CGM
t:slim X2 pump with built-in Hypoglycemia-Hyperglycemia Minimizer algorithm; Dexcom G6 CGM (including automatic correction boluses) |
Launch expected in summer 2018. Pivotal trial now underway, with FDA submission expected in early 2018.
Launch expected in the first half of 2019. Pivotal trial to begin in the first half of 2018. |
| Insulet | OmniPod Horizon: pod with built-in Bluetooth and embedded hybrid closed loop algorithm, Dash touchscreen handheld, and Dexcom G6 CGM
User will remain in closed loop even when Dash handheld is out of range |
Launch by end of 2019 or early 2020, with a pivotal study in 2018 |
| Bigfoot Biomedical | Smartphone app, insulin pump (acquired from Asante), and a next-gen version of Abbott’s FreeStyle Libre CGM sensor (continuous communication)
The smartphone is expected to serve as the window to the system and complete user interface |
Launch possible in 2020, with a pivotal trial expected in 2018 |
| Beta Bionics | Bionic Pancreas iLet device: dual chambered pump with built-in algorithm; hybrid or fully closed loop; insulin-only or insulin+glucagon; custom infusion set, Dexcom CGM
Likely to launch as insulin-only product, with glucagon to be optionally added later Currently using Zealand’s pumpable glucagon analog |
Insulin-only: possible US launch in the first half of 2020, with a pivotal trial to start in the beginning of 2019.
Insulin+glucagon (bihormonal) pivotal trial expected to start in the beginning of 2019. Timing of FDA submission and launch depend on a stable glucagon, among other things. |
European Products
| Company/Organization | Product | Latest Timing in Europe |
|---|---|---|
| Medtronic | MiniMed 640G/Enlite Enhanced – predictive low glucose management
MiniMed 670G/Guardian Sensor 3 – hybrid closed loop that automates basal insulin delivery (still requires meal boluses) |
Currently available in Europe
No timing recently shared. Approval was previously expected in summer 2017 |
| Diabeloop | Diabeloop algorithm running on a wireless handheld, Cellnovo patch pump, Dexcom CGM | Pivotal trial expected to complete in February/March 2018. Possible European launch in 2018 |
| Roche, Sensonics, TypeZero | Will use Senseonics’ 180-day CGM sensor, Roche pump and TypeZero algorithm | Pivotal trial expected to begin in Europe in early 2018 |
| Cellnovo, TypeZero | Cellnovo patch pump with integrated TypeZero algorithm; presumably a Dexcom CGM | Aims for a 2018 European launch. No pivotal trial details shared |
I think I have read about the Medtronic 690G pump. It has a new more aggressive algorithm which rumors include the meal bolus button. Something along the lines of entering when you have a meal and not the carbs consumed. If it comes to market it will be another advance.