The future looks bright for people living with type 1
diabetes as advances in diabetes research and care were rolled out
around the world in the past year.
A recent article in HealthDay News listed the numerous
advances in equipment and medications.
Strides have been made in:
Probably the biggest and most anticipated news of 2017 was
the rollout of the so-called artificial pancreas in the US. (It is
not yet available in Australia).
Created by Medtronic, the MiniMed 670G
combines an insulin pump, a continuous glucose monitor and a
computer algorithm that measures blood glucose levels and then
delivers insulin automatically when those levels rise. Insulin
delivery is also temporarily suspended if blood glucose levels drop
The device isn't completely automated yet. People with
diabetes still need to know how to count the carbohydrates in their
food and enter that information into their insulin pump.
The device still requires people with diabetes to check
their blood glucose several times a day and enter that information
into the machine, which is known as "calibrating." The hope is that
future versions of the device won't require these steps.
Diabetes researchers believe that while the technology is
not yet fully automatic, it has opened the door to further
It is also worth noting that a number of other insulin
pump manufacturers and independent companies are working on their
own artificial pancreas systems. Competition helps drive innovation
and experts are expecting results on a fully automated artificial
pancreas in the next few years.
Improving heart health
Heart disease is a significant concern for people with
diabetes. New research has suggested that long-term use of
metformin could reduce the risk of heart disease in people with
type 1 diabetes.
Other medications have been linked to a reduced risk of
heart disease in people with type 2 diabetes. These include
Jardiance, Victoza and Invokana (note Invokana is not available on
the Pharmaceutical Benefits Scheme in Australia since
"Cardiovascular disease is the most deadly and expensive
complication of diabetes, and a number of recent studies have shown
that certain medications also have a strong protective effect
against cardiovascular disease in people at high risk for it," Dr
Competition in continuous glucose
The artificial pancreas wasn't the only innovation in
diabetes technology in 2017. Another glucose monitoring device was
approved for use by many countries, including Australia.
Made by Abbott and called the Freestyle Libre Flash
Glucose Monitoring System, this device has been in use in Europe
for several years.
The major difference in the Libre compared with Continuous
Glucose Monitoring (CGM) systems is that you have to request the
blood glucose information. Other devices on the market, from Dexcom
and Medtronic, send blood glucose information collected by a tiny
sensor inserted under the skin to a receiver every five minutes or
The Libre also uses a tiny sensor inserted under the skin
but the person with diabetes has to request the information be sent
to the receiver. In addition, the Libre also doesn't require any
fingerprick calibration as other devices on the market
Some people find the constant information provided by
continuous glucose monitors to be stressful and confusing. With the
Libre, you ask when you want the information. It's also cheaper and
flatter than other CGMs.
Novo Nordisk received FDA approval for a new insulin
called Fiasp, which is currently under regulatory review in
Australia. This insulin starts working in about 2.5
Currently, Novolog, another product from Novo Nordisk,
takes approximately five to 10 minutes to start working.
If people with type 1 diabetes inject insulin at least
five to 10 minutes before eating, their blood glucose levels may
spike too high after eating.
It's not always possible or even safe to pre-inject
insulin. For example, in a restaurant, you have no way of knowing
when your food might arrive, and if you pre-inject and your food is
late, you can have a dangerously low blood glucose
The shorter time it takes Fiasp to work could help prevent
spikes in blood glucose after eating, which ultimately leads to
better diabetes management.
How do Australians fare?
Most Australians with diabetes are aware that although we
have better access to cheaper insulin and top rate medical care
compared with some other countries, there is an area where
Australia is slipping behind.
Diabetes Queensland is lobbying the Federal Government to
subsidise Abbott's FreeStyle Libre Flash Glucose Monitoring System
under the National Diabetes Services Scheme in
In the past three months, both the UK and the US have
approved covering the cost of FreeStyle Libre under their
respective public health systems.
Abbott says that the FreeStyle Libre system is now being used by
about 400,000 people across more than 40 countries, and notes that
partial or full reimbursement for the system has been secured in 21
countries, including France and Japan.
Diabetes Queensland will report on the Australian Federal
Government's decision in the coming months.