The use of new technologies to improve glucose control in people with diabetes
In past decades, a rapid evolution of diabetes technology led to increased popularity and use of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) in the ambulatory setting for diabetes management, and recently, the artificial pancreas became available. Efforts to translate this technology to the hospital setting have shown accuracy and reliability of CGM, safety of CSII in appropriate populations, improvement of inpatient glycemic control with computerized glycemic management systems, and feasibility of inpatient CGM-CSII closed-loop systems. Several ongoing studies are focusing on continued translation of this technology to improve glycemic control and outcomes in hospitalized patients. In this talk, the evidence on how these technologies can improve clinical outcomes in both type 1 and type 2 diabetes will be discussed. Specifically, systems of artificial pancreas and of interpretation of glucose metrics will be discussed, including those in patients who are not on CSII. The experience of using an artificial decision supported system to interpret glucose anomalies and modify anti-hyperglycemic therapy, also through the use of a real-time telemedicine platform, will be also presented.