The long-term benefits of intensive diabetes management are well established in the literature. However, the self-management of type 1 diabetes is often accompanied by various recurring daily challenges including unpredictable eating and physical activity patterns, fear of hypoglycaemia and variations in insulin requirements or insulin sensitivity. So, for some people living with type 1 diabetes, the stringent glycaemic management targets remain unrealisable, especially for the paediatric population.
Technological innovations like continuous glucose monitors (CGM) and smart insulin infusion pumps help to address some of these daily challenges and facilitate the management of type 1 diabetes. Recent hybrid closed-loop systems combine glucose-sensing with insulin delivery that mimics normal physiological responses – insulin is thus delivered in a glucose-dependent manner, while considering levels of insulin from previous dosing’s that are still ‘active’. This has been made possible by advanced algorithms linking the CGM and insulin delivery data, to automatically and appropriately adjust the amount of insulin delivered.
Evidence has shown that these advanced technologies can help to improve glycaemic control, general well-being and sleep, and reduce the self-management burden of diabetes. The clinical and psychological benefits of these technologies are also known, but we lack local guidelines on their use in type 1 diabetes, and funding remains a major barrier.