TY - JOUR

T1 - Combining Glucose Monitoring and Insulin Infusion in an Integrated Device

T2 - A Narrative Review of Challenges and Proposed Solutions

AU - Schoemaker, Michael

AU - Martensson, Anna

AU - Mader, Julia K.

AU - Nørgaard, Kirsten

AU - Freckmann, Guido

AU - Benhamou, Pierre Yves

AU - Diem, Peter

AU - Heinemann, Lutz

N1 - Publisher Copyright: © 2023 Diabetes Technology Society.

PY - 2024

Y1 - 2024

N2 - The introduction of automated insulin delivery (AID) systems has enabled increasing numbers of individuals with type 1 diabetes (T1D) to improve their glycemic control largely. However, use of AID systems is limited due to their complexity and costs associated. The user must wear both a continuously monitoring glucose system and an insulin infusion pump. The glucose sensor and the insulin catheter must be inserted at two different body sites using different insertion devices. In addition, the user must pair and manage the different systems. These communicate with the AID software implemented on the pump or on a third device such as a dedicated display device or smart phone application. These components might be developed and commercialized by different manufacturers, which in turn can cause difficulties for patients seeking technical support. A possible solution to these challenges would be to integrate the glucose sensor and insulin catheter into a single device. This would allow the glucose sensor and insulin catheter to be inserted simultaneously, eliminating the need for pairing, and simplifying system management. In recent years, different technologies have been developed and evaluated in clinical investigations that combine the glucose sensor and the insulin catheter in one platform. The consistent finding of all these studies is that integration has no adverse effect on insulin infusion and glucose measurements provided that certain conditions are met. In this review, we discuss the perceived challenges of such an approach and discuss possible solutions that have been proposed.

AB - The introduction of automated insulin delivery (AID) systems has enabled increasing numbers of individuals with type 1 diabetes (T1D) to improve their glycemic control largely. However, use of AID systems is limited due to their complexity and costs associated. The user must wear both a continuously monitoring glucose system and an insulin infusion pump. The glucose sensor and the insulin catheter must be inserted at two different body sites using different insertion devices. In addition, the user must pair and manage the different systems. These communicate with the AID software implemented on the pump or on a third device such as a dedicated display device or smart phone application. These components might be developed and commercialized by different manufacturers, which in turn can cause difficulties for patients seeking technical support. A possible solution to these challenges would be to integrate the glucose sensor and insulin catheter into a single device. This would allow the glucose sensor and insulin catheter to be inserted simultaneously, eliminating the need for pairing, and simplifying system management. In recent years, different technologies have been developed and evaluated in clinical investigations that combine the glucose sensor and the insulin catheter in one platform. The consistent finding of all these studies is that integration has no adverse effect on insulin infusion and glucose measurements provided that certain conditions are met. In this review, we discuss the perceived challenges of such an approach and discuss possible solutions that have been proposed.

KW - accuracy

KW - automated insulin delivery

KW - colocalization

KW - continuous glucose monitoring

KW - insulin delivery

KW - integration

U2 - 10.1177/19322968231203237

DO - 10.1177/19322968231203237

M3 - Review

C2 - 37798963

AN - SCOPUS:85173758958

JO - Journal of diabetes science and technology

JF - Journal of diabetes science and technology

SN - 1932-2968

ER -