2023-10-17 21:12:52
The last decade has highlighted a reality characterized by the growing importance of digitalization in healthcare and the demonstration of its benefits in various therapeutic areas, including the management of diabetes. Evidence from real-world practice clearly shows one consistent finding: digital health products often outperform standard care in managing blood glucose control.
But how realistic is it to integrate these products into current healthcare practice? At the annual congress of the European Association for the Study of Diabetes (EASD) in Hamburg, speakers representing different automated insulin delivery systems (ASDI) loop closed spoke on the practical aspects and possibilities of integrating these cutting-edge technologies into routine diabetes care.
Data from several SADI studies, such as the MiniMed 780G and Omnipod 5, have consistently demonstrated superior glycemic control, compared to standard care. Javier Castaneda, representing the Medtronic MiniMed 780G system, spoke on the subject: “Users, numbering 10,012 and aged over 15, showed an 11% improvement in time spent in the range adequate (70–140 mg/dl) while respecting the recommended parameters, which increases the time spent in the therapeutic interval by 9 to 15 hours. » However, unlike clinical trials, the reality of user experience has shown variations in the application of these technologies, highlighting the need for further adjustments regarding glycemic range and goal calibration.
Emma Wilmot, a clinician and professor at the University of Nottingham, also showed how nearly 20,000 users of the Omnipod 5 automated insulin delivery system achieved a time spent in the therapeutic range of 70% or more; only 1.36% of patients reached subtherapeutic levels.
Further integration into health systems can support treatment monitoring and adherence. Speaking to Univadis.com, Emma Wilmot explained that “most systems automatically upload data to cloud systems. If this is not the case, they can be loaded manually during the consultation. We can then review the data with the patient and modify the settings according to their goals. »
Given the large number of SADIs available, physicians face the difficulty of choosing the product that best suits their patients. “I think each device has different advantages and disadvantages,” said Emma Wilmot. “As healthcare professionals, our job is to explain to people the pros and cons of each product. »
However, even with these advances, the question of accessibility and ease of use arises, prompting healthcare professionals to think more precisely regarding how these devices actually improve the quality of life of their patients by real situation. “Part of the satisfaction of my job is working with the person to find out what meets their particular needs and what we can do to get the best results,” Emma Wilmot said. However, it is not as easy as it seems. She went on to say that “people may not feel comfortable having all this stuff on them, but in five years it may be the norm.”
It is difficult to measure improvements in quality of life in research. Speaking at the EASD, Jolien De Meulemeester, from the University Hospital of Leuven, stressed that “the studies do not reflect how the devices are used in daily practice”. She presented research findings on diabetes-specific quality of life improvements following use of the MiniMed 780G System, with results demonstrating significant improvements in hypoglycemia fears, concerns and behavior in people with type 1 diabetes mellitus.
Despite promising results, it is imperative to review the potential barriers presented by these glucose monitoring digital health products: cost, access to Wi-Fi, and the level of technological skill required, to name a few. just a few. “If you and I were to buy a car, we would want to test drive it and make sure it was right for us. There are features that will suit different people depending on their needs, regardless of the model. The same goes for technology used in diabetes,” said Emma Wilmot.
New guidance on access to these closed-loop SADIs, set out by the UK’s National Institute for Health and Care Excellence, is expected to be published this month next to guide healthcare professionals working in the United Kingdom. However, healthcare professionals will need to take into account their patients’ preferences to ensure that the prescription of a digital health product is accessible to all patients and adapted to each of their needs.
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