Published online Jul 25, 2015. doi: 10.4239/wjd.v6.i8.999
Peer-review started: January 28, 2015
First decision: May 14, 2015
Revised: May 31, 2015
Accepted: June 30, 2015
Article in press: July 2, 2015
Published online: July 25, 2015
Processing time: 190 Days and 0.7 Hours
Technologies for diabetes management, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems, have improved remarkably over the last decades. These developments are impacting the capacity to achieve recommended hemoglobin A1c levels and assisting in preventing the development and progression of micro- and macro vascular complications. While improvements in metabolic control and decreases in risk of severe and moderate hypoglycemia have been described with use of these technologies, large epidemiological international studies show that many patients are still unable to meet their glycemic goals, even when these technologies are used. This editorial will review the impact of technology on glycemic control, hypoglycemia and quality of life in children and youth with type 1 diabetes. Technologies reviewed include CSII, CGM systems and sensor-augmented insulin pumps. In addition, the usefulness of advanced functions such as bolus profiles, bolus calculators and threshold-suspend features will be also discussed. Moreover, the current editorial will explore the challenges of using these technologies. Indeed, despite the evidence currently available of the potential benefits of using advanced technologies in diabetes management, many patients still report barriers to using them. Finally this article will highlight the importance of future studies tailored toward overcome these barriers to optimizing glycemic control and avoiding severe hypoglycemia.
Core tip: There have been many advances in the technologies associated with diabetes care in the last few years, which have resulted in new opportunities in the treatment of diabetes. Despite the encouraging results and the prospect of a fully automated closed loop system in the near future, metabolic control remains suboptimal in most patients with type 1 diabetes. Data from registries has recently shown that a large proportion of children with type 1 diabetes does not meet the age associated A1c targets across all countries, especially in the youth age. This editorial discusses the impact of these technologies on glycemic control and quality of life and attempts to address how to overcome barriers using these technologies to achieve improved metabolic control.