The ADA guidelines 2020 are a great way to ensure that you're using the latest technologies to help control diabetes. This includes SGLT-2 inhibitors and the Time in Range (TIR) technique, which is safer than carbohydrate-counting. There are also automated insulin delivery systems and continuous glucose monitors.
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SGLT-2 inhibitors are safer than carbohydrate-counting
Although the SGLT-2 inhibitors were initially approved as a therapy to reduce glucose levels, they have been shown to have unexpected benefits in the kidney and cardiovascular system. These benefits should be considered when determining a treatment regimen for type 2 diabetes. SGLT2 inhibitors inhibit the absorption of glucose by the proximal tubules of the kidneys and increase urine glucose excretion.
However, there are significant risks associated with SGLT-2 inhibitors. In addition to reducing glucose levels, these drugs may increase the risk of euglycemic ketoacidosis, which is a dangerous complication. This condition requires close monitoring to avoid serious side effects.
Moreover, a combination of a GLP-1 receptor agonist and a sodium/glucose cotransporter 2 inhibitor (SGLT2i) may be beneficial in patients with atherosclerotic cardiovascular disease. Both medications can help reduce cardiovascular complications, mortality, and disease progression in patients with diabetes. However, SGLT2i can also cause dehydration, hypotension, and genital infections.
Time in Range
Time in Range is a new concept in diabetes care that measures the percentage of time that a person stays within a pre-set blood glucose range. This new concept is useful for diabetic patients, as it makes adjusting diabetes treatment more manageable. This new concept has been applied to electronic devices, which can help educate patients about diabetes procedures and help decrease glycemic variability. Time in Range may also help improve glycemic control and decrease the number of complications that can occur as a result of diabetes.
While the ADA has long recommended a blood glucose test for diabetes patients, Time in Range is an additional measurement that is increasingly important. Previously, the ADA recommended that patients be tested for blood glucose levels two to four times per year, with an A1C test performed at least every six months. It was also recommended that people with diabetes undergo continuous glucose monitoring to better control blood sugar levels.
Continuous glucose monitors provide additional data that allow providers to see the entire picture of a patient's blood glucose management. This additional data is called Time In Range or TIR. While the HbA1c is the most studied parameter, it is still an incomplete picture. Research shows that patients with high TIR scores have less long-term complications, but more research is needed to prove that TIR has more benefits than HbA1c.
Continuous glucose monitor
The continuous glucose monitor (CGM) is a medically necessary device. This definition is based on a recent assessment by the California Technology Assessment Forum (CTAF). The device is considered safe and effective for adults with type 1 diabetes, adolescents and pregnant women who use intensive insulin regimens. Its use is also deemed medically necessary for younger individuals with type 1 diabetes and glycogen storage diseases.
Some health insurers, however, do not cover continuous glucose monitors. In addition, Aetna does not reimburse continuous glucose monitors that are used to remotely transmit test results to a computer or smart phone. Aetna also does not cover the price of the software that downloads test results from the continuous glucose monitor to a computer.
A recent review of the available data on the use of continuous glucose monitors in people with type 2 diabetes found that only five studies reported a reduction in HbA1c. The study sample size was small, and most studies were not specifically designed to demonstrate a reduction in HbA1C.
The use of a continuous glucose monitor may benefit patients with type 1 diabetes and type 2 diabetes who take insulin. The FDA-approved Guardian Real-Time (RT) Continuous Glucose Monitoring System by Medtronic sends glucose readings every five minutes. It provides up to 288 readings per day, and has expanded trend graphs that show the impact of exercise, diet, and lifestyle on blood glucose levels.
The new Dexcom G6 device was approved by the US Food and Drug Administration (FDA) in March. The new device has a more integrated insulin dosing system. The insulin pump automatically releases insulin into the bloodstream in response to a spike in blood glucose. Unlike the older Dexcom device, fingerstick glucose testing is not required.
The MiniMed Connect system is a wireless device compatible with the MiniMed 530G with Enlite and the Dexcom Paradigm Revel insulin pump. This device receives glucose information and transmits it wirelessly to a compatible smart device or browser-accessible website. Its information can be accessed and shared at any time.
Automated insulin delivery
Automated insulin delivery has the potential to improve the safety and efficacy of insulin therapy for diabetes. This technology uses data from a patient's CGM device to modify basal insulin delivery. While this system can prevent hypoglycemia and other health risks, it is also limited in its ability to measure and respond to changes in blood glucose.
In the United States, two automated insulin delivery systems are approved by the U.S. Food and Drug Administration (FDA). These systems have the potential to improve glycemic control and prevent hypoglycemia. This article aims to explain how these devices work and provide information for primary care and endocrinology providers. In general, diabetes is a disease of paradoxes. Modern medicine has solved the problem of type 1 diabetes, but it has yet to solve the problem of type 2 diabetes.
Automated insulin delivery systems are smart devices that assist diabetics with maintaining normal blood glucose levels. They use an algorithm to detect blood sugar levels and adjust insulin delivery accordingly. They are used primarily by people with type 1 diabetes, an autoimmune disease that destroys the pancreatic cells. Automated insulin delivery systems have the potential to reduce the mental burden of micromanaging blood sugar levels. They can improve the time a patient stays in range, reduce disease burnout, and even reduce the distress associated with managing diabetes.
Automated insulin delivery is considered safe, convenient, and cost-effective for diabetes patients. While the American Diabetes Association has not yet approved this technology, some small companies are working to develop it and bring it to the market. The American Diabetes Association is working to increase the quality of care for patients with diabetes. The organization's 2022 guidelines are designed to make diabetes care more personal.
Automated insulin delivery is one of the best ways to improve diabetes management. With a combination of continuous basal insulin delivery and automated insulin delivery, it can help patients control blood glucose levels and prevent hypoglycemia. In addition, this technology can be used in a control-to-range or control-to-target system.