Doctors issue call to action to eliminate barriers to automated insulin delivery

Key opinion leaders issued a call to action to the diabetes community to recognize the importance of automated insulin delivery (AID).

A number of doctors issued this call, published by Mary Ann Liebert’s Diabetes Technology & Therapeutics, to implement the advances made in the AID technology space. They say pivotal trials and real-world data support the benefits of AID systems for those with type 1 diabetes, going beyond those of continuous glucose monitors (CGMs) when added to a regimen of multiple daily insulin (MDI) injections and/or conventional pump therapy.

The doctors say CGM development represents “one of the major advances in diabetes management.” These technologies, which pair with AID systems, provide a more complete glucose picture and peace of mind for users. However, the authors say CGM with MDI often proves insufficient in terms of achieving time-in-range (TIR) goals.

In their explanation, the doctors highlight real-world data from pivotal trials of AID systems that safely achieve TIR. They say AID users have a substantially reduced burden of diabetes management, thanks to the automation of insulin delivery.

“AID is an example of an intervention in patients with T1D in which the efficacy demonstrated in clinical trials has been confirmed when translated into clinical practice,” the doctors wrote. “As researchers and clinicians, we see the effectiveness of AID in our clinical practices and recognize access to the pump and CGM devices as the main barrier to achieving this benefit.”

More on the call to action to bring AID to more people with diabetes

The doctors say barriers continue to prevent access to AID, including costs. Such barriers exemplify “the implicit unconscious racial/ethnic biases about who can effectively use these systems,” they said.

“Reducing these barriers requires the commitment and action of everyone in the diabetes community to ensure that every PwT1D is offered an AID system, thereby enabling them to make a decision that is right for them,” the doctors say.

Recommendations from the authors of the call to action stated:The standard of care for glycemic management in youth and adults with T1D is an AID system. Accordingly:

1. All PwT1D and other patients with insulin-dependent diabetes must be given a choice to use an AID system at the time of diagnosis or as soon after diagnosis as possible.
2. The reason(s) for not giving a choice of using an AID system should be documented in the medical record.
3. The choice of device should be made based on the individual’s circumstances, preferences, and needs.
4. National health care systems should prioritize the provision of unfettered access to AID systems to democratize the known benefits of AID systems.

Current firms with FDA-approved AID platforms include companies such as Insulet, Tandem Diabetes Care, Medtronic, Beta Bionics and Sequel Med Tech.