ATTD Paris 2017 reflections
Smart Insulin pumps
Just got back from ATTD in Paris, and am still coming to terms with several days of immersion in the current state of diabetes technology. The biggest takeaway is that the “Artificial Pancreas,” or the “Closed Loop system,” or the “Hybrid Closed Loop system,” or perhaps the “Smart Insulin Pump,” well whatever you want to call it, it is here. Of course Medtronic has struck first, with an insulin pump that automatically adjusts Basal insulin rates, which is especially useful for night management. Everyone was showing slides demonstrating that their version was performing quite well. Of course most of these systems still require the user to manually input meals so as to get extra insulin. Though even this is being improved. There were examples of fully automated systems, while still far from perfect were offering reasonably good control.
Psycho-social aspects of diabetes management
ATTD is mostly about technology, and was glad to see some appreciation that the users of these systems should be considered. There is at times a tendency for technologists to see the human as the host of the algorithm, so luckily a few presenters addressed human factors. The diabetes illness Identity dimensions was particularly intriguing. The presenter A. Libermann noted that MDI users tended to see diabetes as more enriching and on the left side of the graphic, while pump users tended to be more on the right hand side and more engulfed by diabetes. This would be an intriguing study, as many of my tech crazy friends are still using MDI. Although on the bus to the airport I got a very convincing talk from a user of the Loop system with uses a Riley link to connect a Medtronic pump and a Dexcom CGM to provide impressive control. Think it might be time for me to start working on one of those!
There were quite a few presentations on digital decision support systems, although I unfortunately missed the Medtronic sugar IQ presentation. Sounds exciting, will post slides when I get them.
This Poster from the PEPPER project at Oxford-Brookes shows their work on a case based reasoning approach for diabetes management advice. They will be starting trials soon, so I eagerly await the results.
The slide titled replaying data showed another approach, feeding back acquired glucose results to make predictions for future results. And there was also an insulin dosing adjuster which appeared to work as well as a diabetes expert. Take that for what you will.
Of course such shows are never complete without a few highly dubious claims. My favorite was for another non-invasive CGM. haven’t fact checked this, but just have to same I am skeptical.