Welcome to the ATTD 2022 Interactive Program
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A Bionic Fully Automated Intraperitoneal Insulin Delivery System: the EU Project FORGETDIABETES
Abstract
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The last decade has seen important developments in closed-loop subcutaneous (sc) sensing and insulin delivery closed-loop systems. However major limitations of subcutaneous insulin delivery still exist, including the hyper-insulinemia due to the non-physiologic sc route and need for meal announcement. FORGETDIABETES introduces a radically new approach to Type 1 Diabetes (T1D) treatment, by developing a fully-implantable, fully-automated bionic invisible pancreas (BIP) based on physiological intraperitoneal (ip) hormone delivery, thus enabling an optimal glycemic control. BIP will free individuals with T1D from therapeutic actions and from the related psychological burden. BIP will become a life-condition (like contact lens), allowing T1D patients to live just as everybody else. An interdisciplinary team with top experts in micronano mechatronics, control engineering, biomaterials, endocrinology, surgery and behavioral sciences has been assembled to develop a long-lasting system relying on a physiological glucose sensing and hormone delivery, orchestrated by personalized adaptive algorithms with advanced self-diagnostic capabilities. Pump refilling through a weekly oral recyclable drug pill will free T1D subjects from the burden of treatment actions. Wireless power transfer and data transmission to cloud-based data management system round-up to a revolutionary treatment device for this incurable chronic disease. In this project, the key technologies enabling BIP will be developed. Furthermore, extensive in vivo preclinical experiments along with massive in silico testing will establish the prototype system, paving the way to the ambitious first-in-human inpatient trial of BIP. This paradigm will revolutionize diabetes treatment and stimulate an innovation ecosystem including research bodies, SMEs, patient organizations, diabetes societies and clinicians.Patch pumps: what are the advantages for people with diabetes
Abstract
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Objective: Patch pumps, i.e. tubeless insulin pumps, are an attractive alternative to conventional insulin pumps for people with type 1 diabetes and type 2 diabetes on insulin therapy. However, to date, the patient-related benefits of patch pumps are not well understood. Methods: A systematic review was conducted to summarize potential patient-relevant advantages and disadvantages of patch pumps and to assess relevant studies on patient-reported outcomes (PROs). Relevant studies were identified by a systematic PubMed search. In addition, the reference lists of the respective articles and Google Scholar were checked for further references. English-language articles published before June 30, 2021, were included; no other publication date criteria were specified. Results: A total of 12 studies were included. The results of this analysis demonstrate that patch pumps improve quality of life, reduce diabetes-related symptoms, increase patient satisfaction, and are preferred by patients compared with conventional insulin pumps and daily multiple injection (MDI) therapy. However, several methodological limitations of the identified studies limit the power of this analysis. Conclusions: Despite the limited number of studies evaluating the benefits of patch pumps in relation to PROs, there is increasing evidence that people with diabetes prefer patch pumps compared to MDI and conventional pumps. It is notable that this aspect has been relatively understudied. More systematic studies evaluating the benefit of patch pumps in relation to PROs are needed.
Flash glucose monitoring with the FreeStyle Libre 2: Results from the FLASH-UK randomised controlled trial (on behalf of the Study group)
Abstract
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Objectives
To evaluate whether intermittently scanned continuous glucose monitoring (isCGM) with optional alarms (FreeStyle Libre 2) improves glycaemia as measured by HbA1c and sensor-based gluco-metrics, patient reported outcome measures (PROMS) and cost-effectiveness compared with self-monitoring of blood glucose (SMBG).
Design
Flash UK is a multicenter, open-label, two arm, parallel, randomised controlled trial delivered in 7 specialist hospital diabetes clinics and 1 primary care centre.
Participants
156 people with Type 1 diabetes, age 16 years and over treated with either multiple daily insulin injections or insulin pump therapy with HbA1c 7.5%-11% were randomised.
Interventions
Participants were randomised (1:1) to the FreeStyle Libre 2 (n=72) or standard care with SMBG (n=69). Participants were reviewed at 4, 12 and 24 weeks post-randomisation. Education and treatment optimisation was provided to both groups at randomisation, 4 and 12 weeks. Participants in the SMBG arm wore blinded glucose sensor (Freestyle Libre Pro) during the last 2 weeks of the study; all participants wore a 2-week blinded sensor prior to randomisation. All study visits were conducted either in-person or virtually owing to the COVID-19 pandemic.
Main outcome measures
The primary outcome was HbA1c at 24 weeks, analysed by intention to treat. Secondary outcomes included glucose time in range (3.9 to 10mmol/l), time below and above range and glucose variability. PROMS included EQ-5DL-5L, Type 1 Diabetes Distress Scale, Diabetes fear of injecting and self-testing, Diabetes Eating Problem Survey, Diabetes Treatment Satisfaction, Patient Health Questionnaire and The Glucose Monitoring Satisfaction Survey. Economic evaluation included healthcare resource use, insulin usage and Freestyle Libre 2 utilisation.
Results & Conclusion
Results and conclusions will be presented during the 15th International Conference on Advanced Technologies & Treatments for Diabetes, April 27 to 30th Barcelona, Spain and Online.