Fifteen-year Study Shows Major Gains In Diabetes Technology Use And Patient Outcomes

A caller study led by researchers astatine nan Johns Hopkins Bloomberg School of Public Health recovered large increases successful nan usage of continuous glucose monitoring and insulin transportation devices by children and adults pinch type 1 glucosuria complete a 15-year period, pinch corresponding jumps successful optimal blood-sugar control.

For their study, nan researchers utilized a ample nationalist database of de-identified physics wellness records to analyse astir 200,000 individuals pinch type 1 glucosuria crossed 5 three-year periods from 2009 to 2023. The investigation squad tracked individuals' take of continuous glucose monitoring and insulin pump devices, arsenic good arsenic humor tests. 

From nan 2009–2011 play to nan 2021–2023 period, nan proportionality of individuals nether 18 pinch optimal glucose power roseate from 7% to 19%-a 171% increase-while nan proportionality of adults pinch optimal power roseate from 21% to 28%-a 33% increase. The researchers utilized a modular humor trial for nan percent of hemoglobin bound by glucose (HbA1c) to measurement glucose control. A trial consequence beneath 7% is recommended to forestall semipermanent complications.

From nan first play to nan past period, nan proportionality of type 1 glucosuria patients utilizing continuous glucose monitoring devices roseate from 4% to 82% among youths nether 18-a much than twentyfold increase-and from 5% to 57% among adults-more than a tenfold increase. The proportionality of patients utilizing insulin pumps during these periods roseate from 16% to 50% among youths and 11% to 29% among adults. The concurrent usage of some devices besides accrued dramatically during this period, from 1% to 47% among youths and from 1% to 22% among adults.

The study was published online August 11 in JAMA Network Open.

Improving glucose power successful patients pinch type 1 diabetes has been challenging, truthful these large increases are breathtaking for nan field. These improvements person apt been driven by nan wide take of caller monitoring and transportation technologies."

Michael Fang, PhD, MHS, study first author, adjunct professor successful nan Bloomberg School's Department of Epidemiology

About 2 cardinal Americans, including 304,000 children and adolescents, person been diagnosed pinch type 1 diabetes, according to nan American Diabetes Association. The once-fatal autoimmune upset typically strikes successful puerility erstwhile immune cells, often triggered by a viral infection, mistakenly onslaught and swipe retired insulin-producing cells successful nan pancreas.

Insulin, discovered and introduced clinically successful nan 1920s, was a game-changer for individuals pinch type 1 diabetes. The modular curen progressive insulin injections aft meals. This kept patients alive, but glucose power was not ever unchangeable aliases reliable. In caller decades, continuous humor glucose monitoring devices and insulin pumps person allowed patients to optimize humor glucose levels passim nan day. 

The sample utilized for nan study totaled 186,590 individuals pinch type 1 diabetes, including 159,737 adults and 26,853 patients nether 18. 

The findings varied by title and security type, pinch non-Hispanic achromatic patients and those pinch commercialized wellness security having higher rates of exertion take and glucose control. Among individuals under 18 successful nan 2021–2023 period, 21% of non-Hispanic achromatic patients had glucose control, versus 17% of Hispanic and 12% of non-Hispanic Black patients. 

The researchers opportunity that policies that make it easier for type 1 glucosuria patients to entree devices specified arsenic continuous glucose monitoring devices could thief trim these disparities.

"While we should beryllium celebrating nan improvements, we must retrieve that astir patients pinch type 1 glucosuria don't person optimal glucose control, and location is simply a batch of room for improvement," says study elder author Jung-Im Shin, MD, PhD, subordinate professor successful nan Bloomberg School's Department of Epidemiology.

Support for nan investigation was provided by nan National Heart, Lung, and Blood Institute (K24 HL152440) and nan National Institute for Diabetes and Digestive and Kidney Diseases (K01 DK138273, R01 DK115534, R01 DK139324).