Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

Author:

Phillip Moshe12ORCID,Nimri Revital12ORCID,Bergenstal Richard M3ORCID,Barnard-Kelly Katharine4ORCID,Danne Thomas5ORCID,Hovorka Roman6ORCID,Kovatchev Boris P7ORCID,Messer Laurel H8ORCID,Parkin Christopher G9ORCID,Ambler-Osborn Louise10,Amiel Stephanie A11ORCID,Bally Lia12ORCID,Beck Roy W13ORCID,Biester Sarah5,Biester Torben5ORCID,Blanchette Julia E1415ORCID,Bosi Emanuele16,Boughton Charlotte K17ORCID,Breton Marc D7ORCID,Brown Sue A718ORCID,Buckingham Bruce A19ORCID,Cai Albert20,Carlson Anders L3ORCID,Castle Jessica R21ORCID,Choudhary Pratik22ORCID,Close Kelly L20,Cobelli Claudio23ORCID,Criego Amy B3,Davis Elizabeth24ORCID,de Beaufort Carine25ORCID,de Bock Martin I26ORCID,DeSalvo Daniel J27ORCID,DeVries J Hans28ORCID,Dovc Klemen29ORCID,Doyle Francis J30,Ekhlaspour Laya31ORCID,Shvalb Naama Fisch1ORCID,Forlenza Gregory P8,Gallen Geraldine11,Garg Satish K8,Gershenoff Dana C3,Gonder-Frederick Linda A7ORCID,Haidar Ahmad32,Hartnell Sara33,Heinemann Lutz34ORCID,Heller Simon35,Hirsch Irl B36ORCID,Hood Korey K37ORCID,Isaacs Diana38ORCID,Klonoff David C39,Kordonouri Olga5,Kowalski Aaron40,Laffel Lori10ORCID,Lawton Julia41,Lal Rayhan A42ORCID,Leelarathna Lalantha43ORCID,Maahs David M19ORCID,Murphy Helen R44,Nørgaard Kirsten45,O’Neal David46,Oser Sean47ORCID,Oser Tamara47ORCID,Renard Eric48ORCID,Riddell Michael C49ORCID,Rodbard David50ORCID,Russell Steven J51,Schatz Desmond A52ORCID,Shah Viral N8ORCID,Sherr Jennifer L53ORCID,Simonson Gregg D3ORCID,Wadwa R Paul8ORCID,Ward Candice54,Weinzimer Stuart A53ORCID,Wilmot Emma G5556ORCID,Battelino Tadej29ORCID

Affiliation:

1. The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel , 49202 Petah Tikva , Israel

2. Sacker Faculty of Medicine, Tel-Aviv University , 39040 Tel-Aviv , Israel

3. International Diabetes Center, HealthPartners Institute , Minneapolis, MN 55416 , USA

4. Southern Health NHS Foundation Trust , Southampton , UK

5. AUF DER BULT, Diabetes-Center for Children and Adolescents, Endocrinology and General Paediatrics , Hannover , Germany

6. Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge , Cambridge , UK

7. Center for Diabetes Technology, School of Medicine, University of Virginia , Charlottesville, VA 22903 , USA

8. Barbara Davis Center for Diabetes, University of Colorado Denver—Anschutz Medical Campus , Aurora, CO 80045 , USA

9. CGParkin Communications, Inc. , Henderson, NV , USA

10. Joslin Diabetes Center, Harvard Medical School , Boston, MA 02215 , USA

11. Department of Diabetes, King’s College London , London , UK

12. Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern , Bern , Switzerland

13. Jaeb Center for Health Research Foundation, Inc. , Tampa, FL 33647 , USA

14. College of Nursing, University of Utah , Salt Lake City, UT 84112 , USA

15. Center for Diabetes and Obesity, University Hospitals Cleveland Medical Center , Cleveland, OH 44106 , USA

16. Diabetes Research Institute, IRCCS San Raffaele Hospital and San Raffaele Vita Salute University , Milan , Italy

17. Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, University of Cambridge Metabolic Research Laboratories , Cambridge , UK

18. Division of Endocrinology, University of Virginia , Charlottesville, VA 22903 , USA

19. Division of Endocrinology, Department of Pediatrics, Stanford University, School of Medicine , Stanford, CA 94304 , USA

20. The diaTribe Foundation/Close Concerns , San Diego, CA 94117 , USA

21. Harold Schnitzer Diabetes Health Center, Oregon Health & Science University , Portland, OR 97239 , USA

22. Diabetes Research Centre, University of Leicester , Leicester , UK

23. Department of Woman and Child’s Health, University of Padova , Padova , Italy

24. Telethon Kids Institute, University of Western Australia, Perth Children’s Hospital , Perth , Australia

25. Diabetes & Endocrine Care Clinique Pédiatrique DECCP/Centre Hospitalier Luxembourg, and Faculty of Sciences, Technology and Medicine, University of Luxembourg, Esch sur Alzette, GD Luxembourg/Department of Paediatrics, UZ-VUB , Brussels , Belgium

26. Department of Paediatrics, University of Otago , Christchurch , New Zealand

27. Division of Pediatric Diabetes and Endocrinology, Baylor College of Medicine, Texas Children’s Hospital , Houston, TX 77598 , USA

28. Amsterdam UMC, University of Amsterdam, Internal Medicine , Amsterdam , The Netherlands

29. Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, UMC - University Children’s Hospital, Ljubljana, Slovenia, and Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia

30. Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University , Cambridge, MA 02138 , USA

31. Lucile Packard Children’s Hospital—Pediatric Endocrinology, Stanford University School of Medicine , Palo Alto, CA 94304 , USA

32. Department of Biomedical Engineering, McGill University , Montreal , Canada

33. Wolfson Diabetes and Endocrine Clinic, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK

34. Science Consulting in Diabetes GmbH , Kaarst , Germany

35. Department of Oncology and Metabolism, University of Sheffield , Sheffield , UK

36. Department of Medicine, University of Washington Diabetes Institute, University of Washington , Seattle, WA , USA

37. Stanford Diabetes Research Center, Stanford University School of Medicine , Stanford, CA 94305 , USA

38. Cleveland Clinic, Endocrinology and Metabolism Institute , Cleveland, OH 44106 , USA

39. Diabetes Research Institute, Mills-Peninsula Medical Center , San Mateo, CA 94010 , USA

40. JDRF International , New York, NY 10281 , USA

41. Usher Institute, University of Edinburgh , Edinburgh , UK

42. Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine , Stanford, CA 94305 , USA

43. Manchester University Hospitals NHS Foundation Trust/University of Manchester , Manchester , UK

44. Norwich Medical School, University of East Anglia , Norwich , UK

45. Steno Diabetes Center Copenhagen and Department of Clinical Medicine, University of Copenhagen , Gentofte , Denmark

46. Department of Medicine and Department of Endocrinology, St Vincent’s Hospital Melbourne, University of Melbourne , Melbourne , Australia

47. Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus , Aurora, CO 80045 , USA

48. Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, and Institute of Functional Genomics, University of Montpellier, CNRS, INSERM , Montpellier , France

49. School of Kinesiology & Health Science, Muscle Health Research Centre, York University , Toronto , Canada

50. Biomedical Informatics Consultants LLC , Potomac, MD , USA

51. Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA

52. Department of Pediatrics, College of Medicine, Diabetes Institute, University of Florida , Gainesville, FL 02114 , USA

53. Department of Pediatrics, Yale University School of Medicine, Pediatric Endocrinology , New Haven, CT 06511 , USA

54. Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK

55. Department of Diabetes & Endocrinology, University Hospitals of Derby and Burton NHS Trust , Derby , UK

56. Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham , Nottingham, England , UK

Abstract

Abstract The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past 6 years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage.

Publisher

The Endocrine Society

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism

Reference150 articles.

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3. Closed-loop insulin therapy improves glycemic control in adolescents and young adults: outcomes from the international diabetes closed-loop trial;Isganaitis;Diabetes Technol Ther,2021

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5. Improved glycemic outcomes with Medtronic MiniMed advanced hybrid closed-loop delivery: results from a randomized crossover trial comparing automated insulin delivery with predictive low glucose suspend in people with type 1 diabetes;Collyns;Diabetes Care,2021

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