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Smart Insulin Pens: Understanding New Technology Options For Diabetes
The introduction of smart insulin pens, which represent a substantial development in the technology currently used to control diabetes, may benefit patients who are reliant on insulin by enhancing monitoring capabilities, accuracy, and convenience. This all-encompassing guide investigates these cutting-edge technologies and their influence on diabetes management.
What Are Smart Insulin Pens And How Do They Work?Smart insulin pens are digital devices that combine the conventional method of administering insulin with the most recent technological advancements. Several important characteristics are included in these complex tools:
The technology works by:
There are several benefits that smart insulin pens provide over conventional ways of insulin administration, including the following:
Improved Accuracy
Enhanced Data Management
Better Compliance
Safety Features
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Choosing The Right Smart Insulin Pen For Your NeedsConsider these factors when selecting a smart insulin pen:
Compatibility
Features
Practical Considerations
RELATED: Diabetes Gone Digital: 5 Ways to Use Tech to Manage Your Condition
How Smart Technology Can Enhance Diabetes ManagementSmart insulin pens contribute to comprehensive diabetes care through the following:
Data Integration
Pattern Recognition
Healthcare Collaboration
Quality of Life Improvements
Implementation Tips
Future Considerations
Introducing smart insulin pens is a big step forward in the technological advancement of diabetes care. These devices provide greater accuracy, improved data management, and superior treatment results because they combine the conventional methods of insulin administration with digital capabilities.
When contemplating the purchase of a smart insulin pen, it is important to collaborate closely with your healthcare team in order to choose the device that is most suitable for your lifestyle, degree of technological comfort, and the requirements of diabetes management. The advantages of this cutting-edge technology will be maximized via consistent training and the appropriate use of all of its capabilities.
It is important to remember that while smart insulin pens provide many benefits, they are instruments meant to supplement rather than replace accurate diabetes management techniques. Maintaining frequent medical checkups, adhering to medication programs that have been recommended, and engaging in healthy lifestyle choices continue to be critical components of effective diabetes management.
Smart insulin pens have the potential to greatly improve the day-to-day management of diabetes, leading to improved outcomes and an increased quality of life for those who are reliant on insulin. This improvement may be achieved by correct selection, training, and use of the pens.
Novel Diabetes Drugs Promise A New Era In Kidney Care
Sodium-glucose cotransport 2 (SGLT2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) may be among the most important advances in decades for patients with kidney disease. Although developed as diabetes treatments, these drug classes have demonstrated that they can slow progression of chronic kidney disease (CKD) even in patients without diabetes. The drugs have the potential to change the epidemiologic trajectory of kidney disease in the United States such that fewer and fewer patients may progress to kidney failure and the need for dialysis or a kidney transplant.
Numerous studies presented at the American Society of Nephrology's Kidney Week 2024 conference in San Diego, California, attest to a strong interest in how these medications can be used to improve kidney care and expand what is known about the various effects of these novel drugs. Studies demonstrated, for example, that use of SGLT2 inhibitors or GLP1-RAs in patients with CKD lower their risks for adverse events such as genitourinary infections, bone fractures, hypoglycemia, and volume depletion compared with non-use,5 and also lower the risks for hypo- and hyperkalemia in patients with type 2 diabetes compared with insulin glargine use.6
The conference also featured a number of studies of the subcutaneously administered GLP-1 RA semaglutide. In one study, Hiddo J. L. Heerspink, PhD, PharmD, of University Medical Center Groningen in The Netherlands, and colleagues demonstrated that overweight or obese patients with CKD but without diabetes who received 24 weeks of semaglutide treatment experienced a "robust and clinically meaningful reduction" in urine albumin-to-creatinine ratio (UACR).1
Other semaglutide-related presentations involved follow-up analyses of data from the phase 3 FLOW trial, which included 3533 patients with CKD and type 2 diabetes randomly assigned to receive semaglutide or placebo. The original trial findings showed that semaglutide significantly decreases the risk for major adverse kidney outcomes and cardiovascular events. At the conference, Katherine R. Tuttle, MD, professor of medicine at the University of Washington in Seattle, a member of the original FLOW research team, reported on a secondary analysis demonstrating that semaglutide significantly decreases the risk for major adverse kidney events regardless of CKD severity.2
Other research presented at the conference confirms the renal benefits of SGLT2 inhibitors. For example, Rochell Issa, MD, and colleagues at Cleveland Clinic in Ohio demonstrated that SGLT2 inhibitor treatment is significantly associated with a decreased risk for death among patients with advanced CKD. Previous research had shown that SGLT2 inhibitors decrease all-cause mortality among patients with type 2 diabetes, but it has been unclear whether this benefit extends to patients with advanced CKD, regardless of diabetes status, they noted.3
The investigators conducted a retrospective cohort study of electronic health records in the TriNetX Analytics Network. The study population included 40,000 patients with CKD stages 4-5D who were prescribed SGLT2 inhibitors. Among patients with CKD stage 4 or 5 pre-dialysis, SGLT2 inhibitor use, compared with non-use, was significantly associated with a 33%, 32%, and 33% lower all-cause mortality risk at 6 months and 1 and 5 years, respectively.
At these same respective time points, SGLT2 inhibitor use among patients with CKD stage 5 on dialysis (CKD 5D) was significantly associated with a 41%, 41%, and 49% lower all-cause mortality risk.
Further, a study by investigators at the University of Utah School of Medicine in Salt Lake City may help nephrologists decide whether an SGLT2 inhibitor or GLP-1 RA is the better choice for patients with type 2 diabetes and CKD. Given a paucity of data from head-to-head comparisons of these drug classes, Sydney Elizabeth Hartsell, MD, and colleagues conducted an emulated clinical trial involving a national cohort of 26,624 veterans with type 2 diabetes and CKD. Of these, 12,996, 3799, and 9829 initiated SGLT2 inhibitors, GLP1-RAs, and insulin glargine, respectively.4
In weighted analyses, compared with patients on GLP1-RAs, those on SGLT2 inhibitors had a significant 39% reduced risk of CKD progression — a composite a 50% or greater decline in estimated glomerular filtration rate (eGFR) or progression to stage 5 CKD (eGFR less than 15 mL/min/1.73 m2) — and 12% reduced risk of a composite of CKD progression or death, Dr Hartsell's team reported.
The findings from these studies and ongoing research could help shape how nephrologists manage CKD. SGLT2 inhibitors and GLP-1 RAs could significantly impact CKD epidemiology, "but only if CKD awareness, detection, and intervention are prioritized by health systems and policy makers, which is required to move expeditiously from evidence generation to implementation," said Dr Tuttle, Executive Director for Research at Providence Inland Northwest Health in Spokane Washington. "If we get it right, the number of cases of people with CKD who die or progress to kidney failure could be dramatically reduced."
Use of the medications "could also open greater opportunity to receive a kidney transplant for those who do reach kidney failure because of a shift in the supply-demand ratio," Dr Tuttle said.
Research suggests nephrologists have been slow in adopting these medications to manage CKD. As for why, Dr Tuttle noted that this relates to health system and policy priorities. "What gets measured and paid for is what gets done," she said. "In addition, intensive educational efforts are needed to train nephrologists, and other clinicians, to effectively implement these new therapeutic regimens. The field has undergone a complete sea change in the past several years."
Disclosure: The semaglutide studies were supported by Novo Nordisk. Please see the original references for a full list of disclosures.
Diabetes Can Damage Retinas: An Expert Explains How
People with diabetes face a number of health challenges related to their chronic condition, and loss of vision due to retinal damage is one of them. Photo by Adobe Stock/HealthDay News
People with diabetes face a number of health challenges related to their chronic condition, and loss of vision due to retinal damage is one of them.
"Diabetes can silently damage a person's most precious sense, their sight, before symptoms even appear. That's why everyone with diabetes should focus on their eyesight and receive regular dilated eye exams," said Dr. J. Michael Jumper, president of the American Society of Retina Specialists (ASRS).
However, there have been significant advances in early detection and treatment of diabetic retinopathy, Jumper added in an ASRS news release.
"Losing sight from diabetes-related eye disease is not a foregone conclusion," Jumper said. "There is hope, including advances in early detection and treatment spearheaded by retina specialists that can help people with diabetes enjoy healthy vision for a lifetime."
The ASRS is encouraging people with diabetes to learn more about the ways their condition can affect their eye health.
Nearly 40 million Americans have diabetes, and nearly half of those folks will develop diabetic retinopathy. In that condition, diabetes causes damage to the blood vessels of the retina.
Factors that can increase a diabetic person's risk of developing diabetic retinopathy include:
Poor control of blood sugar levels
High blood pressure
Kidney disease
Elevated cholesterol
Pregnancy
Many with diabetic retinopathy might have the condition a long time without symptoms, the ASRS says. By the time symptoms occur, substantial damage to vision might have already happened.
Symptoms can include:
Blurred or distorted vision
Difficulty reading
Spots or "floaters" in vision
A shadow across the field of vision
Eye pressure
Difficulty with color perception
Blurred or double vision
Dilated eye exams can help detect diabetic retinopathy by allowing a better view of retinal tissue, the ASRS says.
There also are many advanced technologies that ophthalmologists use to track retinal health.
These include:
Optical coherence tomography, which provides highly detailed cross-sectional images of the retina
Fundus photography, which takes photos to document diabetic retinopathy
Fluorescein angiography, which uses a dye injected into the bloodstream to track blood flow within the retina and the rest of the eye
There are also many treatments available for people with diabetic retinopathy, including eye injections, laser treatments and surgery.
Eye injections involve anti-VEGF drugs, which block a protein that promotes the growth of blood vessels into the retina. Newer formulations of these drugs allow people to receive fewer injections per year, the ASRS says.
More information
The National Eye Institute has more on diabetic retinopathy.
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