MMPAD Milan Meeting Report
19 European Roadshow - Milan, 29 June 2018 MEETING REPORT ADVANCES IN TECHNOLOGY FOR DIABETES TREATMENT Presented by Dr. Riccardo Bonfanti – San Raffaele Hospital, Milan Technology is now an integral part of diabetes therapy. Reflection: Available technologies for the treatment of T1D • The conventional therapies of multiple daily injections (MDI) and self monitoring of blood glucose (SMBG) are now reserved for patients who; have difficulty communicating with the referring doctor; do not have access to continuous glucose monitoring (CGM) or "flash" (FGM) system; and patients unable to properly use the information and/or existence of language/cultural/psychological barriers • MDI multiple sensor for patients who are unable to carry an infusion pump, but are able to use a sensor • Continuous subcutaneous insulin infusion (CSII) and SMBG are not recommended in children; rather it is preferable, although it is not the best solution, to use CSII with FGM for those who are capable of using it • The Sensor Augmented Pump (SAP) represents the gold standard of insulin therapy in paediatrics and is indicated in the following patients: • <6 years at onset • with significant hypoglycaemic events • not in range for HbA1c • with high sensitivity to insulin • with neonatal diabetes • who are unable to use MDI daily • who do sport FGM represents the input level of technology in diabetes and can provide much more information on SMBG. It is indicated for all patients with T1D aged 4-6 years and able to carry the device for more than 70% of the time. The FGM FreeStyle Libre is easy to carry, but has also a high variability. The Libre reduces hypoglycaemia by 30%. A study presented at ADA 2017 demonstrated a significant increase in glycaemic time range and a reduction of 1.5% (highly significant) in HbA1c when using the Libre system. An extract from Dr. Bonfanti‘s presentation is available here
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