title: Sensor-Augmented Insulin Pumps and Hypoglycemia Prevention in Type 1 Diabetes.
abstract: Hypoglycemia can lead to seizures, unconsciousness, or death. Insulin pump treatment reduces the frequency of severe hypoglycemia compared with multiple daily injections treatment. The addition of a continuous glucose monitor, so-called sensor-augmented pump (SAP) treatment, has the potential to further limit the duration and severity of hypoglycemia as the system can detect and in some systems act on impending and prevailing low blood glucose levels. In this narrative review we summarize the available knowledge on SAPs with and without automated insulin suspension, in relation to hypoglycemia prevention. We present evidence from randomized trials, observational studies, and meta-analyses including nonpregnant individuals with type 1 diabetes mellitus. We also outline concerns regarding SAPs with and without automated insulin suspension. There is evidence that SAP treatment reduces episodes of moderate and severe hypoglycemia compared with multiple daily injections plus self-monitoring of blood glucose. There is some evidence that SAPs both with and without automated suspension reduces the frequency of severe hypoglycemic events compared with insulin pumps without continuous glucose monitoring.
authors.affiliation: 1 Department of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark.|2 Danish Diabetes Academy, Odense, Denmark.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Steineck
authors.affiliation: 1 Department of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark.|2 Danish Diabetes Academy, Odense, Denmark.
authors.forename: Ajenthen
authors.initials: A
authors.lastname: Ranjan
authors.affiliation: 1 Department of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Nørgaard
authors.affiliation: 1 Department of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark.|2 Danish Diabetes Academy, Odense, Denmark.
authors.forename: Signe
authors.initials: S
authors.lastname: Schmidt
mesh_terms: D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: continuous glucose monitors; hypoglycemia; insulin pumps; insulin treatment; sensor-augmented pumps; type 1 diabetes