Practical Guidance on Open Source and Commercial Automated Insulin Delivery Systems: A Guide for Healthcare Professionals Supporting People with Insulin-Requiring Diabetes

Lewis, Dana; Hussain, Sufyan

doi:10.1007/s13300-022-01299-9

Cited by 9 publications

(6 citation statements)

References 42 publications

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“…To help discussion with pwT1D or their careers, other factors that need consideration are listed in Table 6. 22 We recommend the use of independent resources such as the ABCD DTN-UK website (https://abcd.care/ dtn-educa tion/exper t-views -on-devices), that has a range of materials available to help support decision making by pwT1D or carers. 23,24 Supporting the user to choose a system that is best suited to their requirements is important for user satisfaction.…”

Section: System-what Do Hcps Need To Know About the System?mentioning

confidence: 99%

“…In Table S1, The CARES paradigm for HCL systems expected to become available in the UK soon is outlined. To help discussion with pwT1D or their careers, other factors that need consideration are listed in Table 6 22 …”

Section: Section 1—basics and Hcl System Selectionmentioning

confidence: 99%

“…This may provide a useful step‐by‐step approach to review patients in clinic. Top tips for pwT1D are provided in Table S5 22 …”

Section: Section 3: Important Considerations and Clinic Reviewmentioning

confidence: 99%

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UK's Association of British Clinical Diabetologist's Diabetes Technology Network (ABCD‐DTN): Best practice guide for hybrid closed‐loop therapy

et al. 2023

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This best practice guide is written with the aim of providing an overview of current hybrid closed‐loop (HCL) systems in use within the United Kingdom's (UK) National Health Service (NHS) and to provide education and advice for their management on both an individual and clinical service level. The environment of diabetes technology, and particularly HCL systems, is rapidly evolving. The past decade has seen unprecedented advances in the development of HCL systems. These systems improve glycaemic outcomes and reduce the burden of treatment for people with type 1 diabetes (pwT1D). It is anticipated that access to these systems will increase in England as a result of updates in National Institute of Health and Care Excellence (NICE) guidance providing broader support for the use of real‐time continuous glucose monitoring (CGM) for pwT1D. NICE is currently undertaking multiple‐technology appraisal into HCL systems. Based on experience from centres involved in supporting advanced technologies as well as from the recent NHS England HCL pilot, this guide is intended to provide healthcare professionals with UK expert consensus on the best practice for initiation, optimisation and ongoing management of HCL therapy.

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Section: System-what Do Hcps Need To Know About the System?mentioning

confidence: 99%

Section: Section 1—basics and Hcl System Selectionmentioning

confidence: 99%

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UK's Association of British Clinical Diabetologist's Diabetes Technology Network (ABCD‐DTN): Best practice guide for hybrid closed‐loop therapy

et al. 2023

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“…However, professional groups have issued statements advising healthcare providers against recommending DIY diabetes systems ( Jennings and Hussain 2020 ), and the FDA has warned against the use of unauthorized devices for diabetes management after a patient suffered an accidental insulin overdose ( Cortez 2019 ). Although commercial automated insulin delivery systems are gradually becoming available in some countries, some users still may opt for a DIY system because of its lower cost or a lack of local availability of a commercial system ( Lewis and Hussain 2022 ).…”

Section: Examples Of Diy Medical Movementsmentioning

confidence: 99%

Mapping the Landscape of Do-it-Yourself Medicine

Wexler

2022

Citizen Science: Theory and Practice

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The practice of medicine is typically conceptualized as remaining within the boundaries of a hospital or clinic. However, in recent years, patients have been able to gain access to information about medical research as it is ongoing. As a result, there has been a rise in do-it-yourself (DIY) medicine, where individuals treat themselves for medical conditions outside of clinical settings, often mimicking experimental therapies that remain inaccessible to the wider public. For example, in DIY brain stimulation, individuals suffering from depression build at-home electrical headsets using nine-volt batteries, mimicking an experimental neuroscience technique used in scientific laboratories. In DIY fecal transplantation, those with intestinal disorders like C. Difficile and inflammatory bowel disease transplant stool from donors into themselves with the aid of blenders and enemas. In the open Artificial Pancreas System movement, diabetes patients hacked together an artificial pancreas system from their glucose monitors and insulin pumps, years before such a system was approved by the United States Food and Drug Administration (US FDA). To date, scholarship on DIY medicine has largely been relegated to specific medical domains (e.g., neurology, gastroenterology, infectious disease). In this paper, however, I recognize DIY medicine as a cross-cutting phenomenon that has emerged independently across medical domains but shares common features. I map the varieties of DIY medicine across these domains and suggest that four key factors lead to their creation, growth, and uptake. In doing so, this essay sheds light on an understudied area of biomedical citizen science that is likely to grow substantially in the coming decades.

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“…Эти системы функционируют по принципу «сделай сам» (DIY, Do It Yourself ). Этот принцип предполагает, что пациент интегрирует свою инсулиновую помпу и систему для НМГ с внешним алгоритмом, который анализирует уровень глюкозы и управляет скоростью введения инсулина [3,4]. Несмотря на то что большинство некоммерческих систем АВИ-ЗК пока не зарегистрированы регуляторами в сфере здравоохранения, пациенты с СД применяют их по собственной инициативе.…”

Section: Introductionunclassified

Open source automated insulin delivery systems: benefits, limitations and challenges in diabetes care

Shishin,

Klimontov

2023

Diabetes mellitus

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Open source closed loop automated insulin delivery (CL-AID) systems are increasingly used in the treatment of diabetes. Assembled on a do-it-yourself (DIY) basis, these systems integrate insulin pumps, continuous glucose monitoring devices, and algorithms that control the rate of insulin delivery based on glucose levels. In this review, we consider the technological features of open source CL-AID systems (OpenAPS, AndroidAPS, Loop, etc.), advantages and barriers to their use in clinical practice. Advantages of open source CL-AID systems over commercially available ones included lower cost, a choice of devices, a wide range of user settings, as well as continuous improvement of algorithms. A growing body of evidence indicates that open source CL-AID systems, such as OpenAPS, AndroidAPS, and Loop, provide an excellent time in range with minimal risk of hypoglycaemia and increase treatment satisfaction in patients with type 1 diabetes. A wide range of settings makes open source systems an effective tool for managing diabetes in situations with rapidly changing insulin requirement. However, some technological, medical, legal and ethical issues associated with the use of non-commercial CL-AID systems still need to be addressed. Assembling the system requires skills in diabetes technology. The issue of cybersecurity is also relevant. Lack of official approvals, low awareness of medical professionals, and reimbursement issues are slowing down the introduction of the technology into clinical practice. The professional medical community at the international and national levels needs to determine its position regarding the use of open source CL-AID systems in the treatment of diabetes.

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Practical Guidance on Open Source and Commercial Automated Insulin Delivery Systems: A Guide for Healthcare Professionals Supporting People with Insulin-Requiring Diabetes

Cited by 9 publications

References 42 publications

UK's Association of British Clinical Diabetologist's Diabetes Technology Network (ABCD‐DTN): Best practice guide for hybrid closed‐loop therapy

UK's Association of British Clinical Diabetologist's Diabetes Technology Network (ABCD‐DTN): Best practice guide for hybrid closed‐loop therapy

Mapping the Landscape of Do-it-Yourself Medicine

Open source automated insulin delivery systems: benefits, limitations and challenges in diabetes care

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