Seit Jahrzehnten wird daran geforscht, Alternativen zur lebenslangen Insulintherapie
zu finden – bis heute ohne durchschlagenden Erfolg. Eine spürbare Entlastung der Menschen
mit Diabetes mellitus Typ 1 ist auch mittelfristig eher durch moderne Diabetestechnologien
zu erwarten, insbesondere durch die Kombination und Kopplung von rtCGM-Systemen (real
time continuous Glucose Monitoring) und Insulinpumpen, basierend auf speziellen Algorithmen.
Die AID-Therapie (automated Insulin Delivery) ist Gegenstand der vorliegenden Arbeit.
Abstract
Reaching individual glycemic targets remains a challenge for people with type 1 diabetes
despite chronic improvements in devices and diabetes technology. Whereas rtCGM (real
time continuous glucose monitoring) systems have been a game changer in the development
of diabetes technologies only a small group of patients experienced significant benefits
due to insulin pump therapy (continuous subcutaneous insulin infusion; CSII). Manual
insulin pump therapy has now been further developed into semi-automatic systems. These
are called automated insulin delivery systems (AID systems). An algorithm adjusts
the insulin delivery of the insulin pump semi-automatically based on the sensor data
and patient input. The article gives a summary over differences and similarities of
the AID-systems available in Germany in September 2023. One of the major similarities
is the clinical result of better glycemic control and fewer hypoglycemic events, especially
at nighttime. Time in range increases – in real life and in clinical trials – by about
10–15% on average. As is known from other interventions, with AID therapy the extent
of improvement is even greater when initial glycemic control is poor, so this patient
group should not be excluded from AID therapy. Furthermore, AID-therapy may help reducing
the burden of disease (hypoglycemia fear, general diabetes distress, regimen distress
etc.). In conclusion this article might provide help and support diabetes teams and
health care providers to understand this promising technology for reducing the glycemic
load and, consequently, the risk for diabetes complications. Despite ongoing improvements
in technology, diabetes education and mentoring people with diabetes will be the key
for success in diabetes treatment – for patients and care providers.
Schlüsselwörter
Nüchternglukose - Typ-1-Diabetes - Insulinpumpe/CSII - Algorithmus - Automatisierte
Insulin Anpassung - Hypoglykämie
Keywords
Fasting Glucose - Type 1 Diabetes - Insulin pump therapy - Algorithm - Automated
Insulindelivery - Hypoglycemia
