Meeting Coverage ADA: Auto Off for Insulin Pump Boosts Safety

http://www.medpagetoday.com/MeetingCoverage/ADA/40027

CHICAGO -- An insulin pump that takes a break when the looped-in, continuous glucose monitor detects low glucose levels reduced nighttime hypoglycemia and prevented serious events, according to results of the ASPIRE trial in type 1 diabetes.

Action Points

An insulin pump that shuts off when the looped-in, continuous glucose monitor detects low glucose levels reduced nighttime hypoglycemia and prevented serious events.

Note that the insulin pump was not associated with increasing glycated hemoglobin values.

The mean severity and duration of nocturnal hypoglycemia fell by 38% as measured by area-under-the-curve compared with the same device without the software (P<0.001), Richard Bergenstal, MD, of the International Diabetes Center at Park Nicollet in St. Louis Park, Minn., and colleagues found. Overall glucose control didn't suffer, they reported here at the American Diabetes Association meeting and simultaneously online in the New England Journal of Medicine.

No severe hypoglycemia occurred with devices set to suspend insulin dosing for 2 hours after hitting the 70 mg/dL glucose threshold compared with four events among patients whose pumps did not have the extra programming.

"That's probably one of the first studies ever to show no severe hypoglycemia," Bergenstal told reporters at a press conference.

"This idea of automating insulin, putting some 'brains' in the pump, is really something worth continuing to explore," he added. "This is the beginning."

These findings with the new feature, part of the MiniMed 530 G system now under FDA review, might actually make patients more willing to try more aggressive therapy, suggested press conference moderator Anne Peters, MD, of the University of Southern California in Los Angeles.

"Hypoglycemia is their limiting step, it's what makes them afraid of tight glycemic control," she commented in an interview with MedPage Today. "Reducing it, and even the perception that you have less, will make people potentially feel more confident, and I really think that matters."

Its about time this was available in the US. The rest of the world has had this pump/cgm combo for > 1.5 years and the only sensor with the VEO that has the shut off feature has been available worldwide for nearly three years.

Question for all T1Ds. why are we not aloud to get current technology for T1D management when it is still current?

It is unnerving to think how may US residents with T1D have died with untreated hypoglycemia in the last three years, while non-us residents are being saved daily from death due to untreated hypoglycemia.

I am a Canadian Veo pumper and use CGMS ...I think MR W. is correct ...time to speak up and out ! I did purchase 5 Enlite sensors ; unfortunately 2 of which I was unable to insert ..I watched the DVD , thought I knew how to do the process and was not successful. I now also have watched the youtube http://www.youtube.com/watch?v=i2nHCGqJvw4 Hubby promised to be on stand by ...I was shaking too much ..process different fronm the SofSensor