Insulin pumps, continuous sensors and the artificial pancreas: a transformation in juvenile diabetes care
In the last twenty years, the field of Type 1 Diabetes Mellitus (T1D) management has undergone unprecedented evolution thanks to the introduction of cutting-edge technologies. These developments have revolutionized disease treatment and self-management, significantly improving the quality of life of young patients and their families.
Insulin pumps: an innovative therapeutic approacha
One of the most significant innovations is the introduction of insulin pumps, known as CSII (Continuous Subcutaneous Insulin Infusion). This alternative therapy to multiple insulin injections offers intensive treatment through a continuous subcutaneous infusion, programmed according to individual needs. In addition to continuous dosing, it is possible to administer prandial and corrective insulin boluses, which help manage glycemic variations associated with meals.
This therapeutic modality, similar to the physiological secretion of insulin by the pancreas, offers many advantages over multiple injections. These include greater flexibility in meal planning, better night-time glycemic control and increased independence in disease management.
Continuous sensors: constant glucose monitoring
Another groundbreaking innovation is Continuous Glucose Monitoring Systems (CGMs) and Flash Glucose Monitoring Systems (FGMs). These systems consist of a glucose sensor inserted under the skin and a data transmitter, allowing for constant glucose monitoring.
The Glucose Sensor measures the glucose concentration in the interstitial space every 5 minutes, providing a detailed picture of glucose trends throughout the day. The data can be viewed in real time on a smartphone or external receiver, allowing patients and their caregivers to take early action to avoid excessive changes in blood sugar levels.
Artificial pancreas: a step towards autonomy
A major step forward is represented by the hybrid closed loop systems (HCL), which combine the functions of insulin pumps with continuous glucose monitoring. These devices, considered an advance of the artificial pancreas, can semi-automatically adjust insulin delivery based on predictions of hypoglycemia or hyperglycemia.
Thanks to a mathematical algorithm, the insulin pump is able to autonomously adjust the insulin delivery in response to the glycemic data detected by the sensor.
The most recent technological evolution for the treatment of Type 1 Diabetes in the developmental age consists of an advanced hybrid closed loop system (AHCL – Advanced Hybrid Closed Loop) which independently delivers correction boluses always on the basis of the integration between glycemic reading and insulin delivery mediated by a mathematical algorithm.
This represents an important step towards the goal of creating a real artificial pancreasfurther improving glycemic control and patients’ quality of life.
Positive results and promising future
Clinical studies and patient testimonials clearly demonstrate the benefits of these advanced technologies in the management of T1DM. Children and adolescents with Type 1 diabetes have experienced a significant improvement in glycemic control, a reduction in severe hypoglycaemic episodes and greater autonomy in disease control.
In particular, the integration between continuous sensors and insulin pumps is opening up new perspectives for the treatment of juvenile diabetes.
The Italian Society of Pediatric Endocrinology and Diabetology (SIEDP) and the International Society of Pediatric Diabetology (ISPAD – International Society for Pediatric and Adolescent Diabetes) have recently indicated the HCL and AHCL systems for all children and adolescents suffering from Type 1 Diabetes.
New technologies are revolutionizing the management of Type 1 Diabetes Mellitus, offering more effective treatment, constant glycemic monitoring and concrete aspiration of the artificial pancreas. These developments represent tangible hope for young patients and their families, promising a better life and better control of this complex disease.
InfoNurse editorial staff
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Source: NurseTimes