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Ask Dana: What are “smart pumps” and automated insulin delivery (AID) systems and how do I choose the right one for me?

QUESTION:

Dear Dana,

Over the past few months, I have thought about making changes to my diabetes management. I want it to be easier and have read about the new “smart” pumps on the market.  I’m not sure what that is and how it could help my blood sugars. When I start to read about new pumps, I get overwhelmed and not sure how to decide on a new technology.  Can you give me some advice on how to get started on my search?

– Todd Blankenship, Seattle, WA

ANSWER:

Dear Todd,

Yes, the world of diabetes technology is becoming fast-paced with many new devices on the market and some exciting products that will soon be available.  Continuous glucose monitors (CGM) continue to become more accurate and require less calibrations from fingersticks.  Insulin pumps are also becoming “smarter,” meaning they will communicate with a programmed CGM and manipulate insulin delivery though a programmed algorithm.  These “smarter,” combined systems are called automated insulin delivery (AID) systems.

To date, there are three FDA-approved systems that are covered by insurance and a “Do It Yourself” version of an AID system that has an active grassroots community supporting the building of the system.  All of these systems require the use of a CGM, insulin pump and proprietary algorithm for the system.

Automated insulin delivery (AID) systems

AID systems can provide a certain level of “hands-off” approach to your diabetes management and help reduce the daily burden of diabetes.  However, it is important to understand that this technology can also add another layer of complexity to your diabetes management.  If you are not comfortable with the new technology and how it manages your blood sugar, an AID system can add additional stress and worry.  The AID systems do not take away some of the basics in diabetes management: you will still need to maintain charges on devices, insulin still needs to be filled in reservoirs, infusion sets can still have cannulas that kink.   It is also important to remember that an AID system may have limitations when you are exercising or experience illness.  Additional steps may be needed to help you manage blood sugars during those times.

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When deciding on diabetes technology to use, remember to check what your insurance will cover and how much your out-of-pocket expenses will be.  Some insurance companies cover insulin pumps and CGMs under pharmacy benefits while others consider pumps and CGMs under medical supplies.  Navigating insurance coverage can be a learning experience as well!

Another consideration for diabetes technology may be how much training and support you may need until you get comfortable with a new system.  The DIY systems, of course, do not have a customer support phone number for technical advice but there is a supportive community on social media.  The three FDA-approved systems, however, do have 24/7 technical support.

Looking into diabetes technology can be similar to shopping for a car – do you want a sunroof, do you need 4-wheel drive?  Each AID system has its own unique options that might be important to you.  Comparisons between the systems can be overwhelming at first but if you can identify what is important to you in a system, it can make your exploration a bit easier.

Investing the time to learn about each unique system is worthwhile.  An AID system is not a cure but it can certainly make your life a lot easier.  If you need more information about how technology can help your diabetes management, give one of the IDS providers a call. We can help guide you in making this choice and help you get comfortable with a new system.

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