Highlights of the ATTD 2020 Congress

The annual ATTD conference (Advanced Technologies & Treatment for Diabetes) was held from February 19 to 22, 2020 in Madrid (Spain). This conference presents the latest research in terms of technologies and therapies for the treatment of diabetes.

Here is some news that caught the attention of the BETTER team:

  • A new artificial pancreas in development. Company E. Lilly presented data from a new artificial pancreas combining a new small insulin pump (DEKA company), a continuous blood glucose meter (DEXCOM G6) and a phone application. The performance during this 48-hour study, which involved 20 adult participants, was good, with 85% of the time spent within glycemic target (4 to 10 mmol / L) over 24 hours. This figure rose to 97% at night.  In addition, the time spent in hypoglycemia (below 4.0 mmol / L) was low, averaging 3.1% of the time over 24 hours and 0.8% during the night. Authors Amy K. Bartee, & al
  • Limit missed doses of insulin at mealtime. A study tested an app on the Apple Watch which has  demonstrated a significant reduction in the number of insulin boluses forgotten at mealtime in teenagers. The application detects arm movements compatible with eating a meal as well as the rapid rise in blood sugar measured by a continuous blood glucose meter, and therefore allows the person to receive a warning to avoid forgetting. The app detected the missed insulin doses 18 min earlier than the continuous blood glucose meter, and this resulted in a 0.5% drop in glycated hemoglobin (A1C). Authors Rayhan Lal & al
  • Nasal glucagon. A study has shown that this form of glucagon intended to treat severe hypoglycaemia is much easier to administer than the conventional injectable form. A caregiver could administer this emergency treatment, even without having received prior training. In fact, the study demonstrated that around 90% of caregivers were able to administer nasal glucagon with or without prior training. In comparison, only 16% were able to administer injectable glucagon after receiving training, and none were able to do so without training. Authors Christopher J. Child, & al
  • Intimate life with diabetes and technology. Over 60% of people living with type 1 diabetes report a negative impact of diabetes on their intimate relationships. Management linked to technologies (continuous blood glucose sensors, insulin pump catheters), but also the marks left by injections, etc., seem to contribute to this. Over 40% of men and 60% of women would like to find resources to help them. Authors Amy Winchcombe & al
  • Using trend arrows to prevent exercise-induced hypoglycaemia. Continuous blood glucose meters display trend arrows that help predict changes in blood sugar. An Italian research team showed that in addition to reducing insulin doses before physical activity, taking into account trend arrows to adjust carbohydrate intake also reduces the risk of hypoglycemia induced by physical activity. Author Ivana Rabbone & al
  • How many capillary blood glucose levels are required to benefit from a continuous blood glucose meter? Some insurance companies and healthcare professionals believe that only people who take multiple capillary blood glucose measurements would benefit from a continuous blood glucose meter.  An American study including more than 7000 participants confirmed that people living with type 1 diabetes who use a continuous glucose meter reduce the number of hypoglycaemia and hyperglycaemia, regardless of the number of capillary glycaemia they used to measure. Authors Matthew S. Kerr & al
  • Is there a level of knowledge necessary to benefit from a continuous blood glucose meter? Some insurance companies and health care professionals believe that only people who have a very good level of knowledge about type 1 diabetes can benefit from a continuous blood glucose meter. A Belgian study including nearly 900 participants revealed that this perception is wrong. In fact, the benefits obtained from continuous glucose monitors were not shown to be influenced by a person’s level of knowledge. However, the average level of knowledge was high in this study. Knowing more is certainly helpful, but not necessarily crucial to enjoying the benefits of continuous blood sugar reading. Authors B Broos & al
  • Insulin Lispro (Humalog) modified to make it super fast. This insulin contains an additional molecule to make its absorption faster. A study of 200 participants, half of whom used conventional insulin and half of whom used modified insulin, demonstrated that the modified form led to better blood sugar levels after meals. This improvement in blood sugar after a meal allowed for an additional 43 minutes to be spent within glycemic target (4.0 to 10.0 mmol / L) over 24 hours, without increasing the time in hypoglycemia. Authors J Bue- Valleskey & al
  • Making more correction boluses when using a pump makes it easier to reach blood sugar targets. An insulin pump company analyzed the relationship between blood sugar levels and the number of daily insulin boluses (meals and corrections) using upload data. The number of boluses observed in more than 4000 people was an average of 5.2 per day. The percentage of time spent within target (4 to 10 mmol / L) increased with the number of boluses from 39% (3 boluses per day), to 55% (8 boluses or more per day). On the other hand, the time spent in serious hypoglycemia (less than 3.0 mmol / L) decreased from 2.8% (3 bolus per day) to 1.7% (8 bolus or more per day). The decrease in time spent in hypoglycemia despite the higher number of boluses per day suggests that people who administer many boluses are also likely very involved and have a high level of knowledge in the management of type 1 diabetes. Authors Irl B. Hirsch & al
  • Freestyle Libre continuous blood glucose meter: the number of daily scans affects blood sugar management. In approximately 23,000 people using the Freestyle Libre reader in Spain, there was an average of 13 scans per day. According to the data observed, the greater the number of scans, the less the blood sugar varied, the less time there was in hypoglycemia and the more time there was in the glycemic targets. This study also reported that the average number of capillary blood sugar levels was one blood sugar level every 2 days. Authors Fernando Gomez-Peralta & al

The BETTER project brings together patient partners who live or whose children live with type 1 diabetes, researchers, health professionals and decision-makers to advance research, improve clinical practices, treatments and quality of life for people living with type 1 diabetes.

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