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Digital Diabetes Management: Three Vignettes

Wearable glucose sensors, automated insulin delivery (AID), and smartphone technology “illustrate how digital health technology can aid providers caring for patients with diabetes,” authors write in a Wearable Digital Health Technologies in Medicine review article. They present vignettes on the use of diabetes technology in ambulatory patients with type 1 diabetes and type 2 diabetes and in an inpatient with type 1 diabetes undergoing hip surgery.

“The three vignettes showcase the transformative changes that glucose sensors and AID technology have made in the management of type 1 and type 2 diabetes,” the authors write. “However, the vignettes are not intended to provide a comprehensive review of the much broader landscape of digital technology for diabetes, which encompasses mobile health applications (apps) (mHealth, a name coined by Robert Istepanian), insulin-dose adjustments, and decision-making support, as well as glucose monitoring and AID. Considerable work is ongoing in many of these areas. For instance, thousands of mHealth apps are now available on smartphones; these apps address nutrition, physical activity, and diabetes management. There is little evidence that mHealth apps can improve glycemic control in persons with type 1 diabetes; however, there is some evidence of improved lifestyle modification in those with type 2 diabetes. Decision-making support tools such as cloud-based artificial intelligence can recommend adjustments in insulin doses for MDI insulin therapy or insulin pumps, but early clinical trials have not shown better glycemic control than that with the standard of care.”

Source: New England Journal of Medicine