The Intersection of Carbohydrate Insulin Coverage, Delivery System Technology, and Glucose Sensing: The Need for Critical Thinking

Technology in Diabetes Mellitus has been available in the form of insulin pump delivery systems for almost 40 years and glucose sensing technology for over 20 years. It is just the last 10 years there have been broad adoptions of both pumps and personal sensors and more recently integrated delivery systems that are bringing us closer to physiologic dynamic control of diabetes that strives to replicate glucose control similar to persons without diabetes (who have normal glucose control mechanisms). Data from this technology is part of routine clinical practice in anyone caring for persons with diabetes especially in the type 1 space. This is a new avenue for clinical research but also a new area of challenge for providers and staff caring for patients with this technology. There is slowly emerging research that focuses on this clinical data specifically available from personal sensors. This discussion will briefly review what this looks like in clinical practice and a sampling of data from research in this new technology. Then we will discuss how providers, educators, patients, and other stakeholders should work as a team to focus on critical thinking as an essential skill set.