Diabetes Technology: Science and Practice
We live in a century of technological revolution. Like every other sphere of our life, diabetes-related technology is moving forward with lightning speed. New and improved insulin administration devices, increased capacity for monitoring one's blood glucose levels, and the ability to communicate directly with the device supplying insulin as well as with the patient and his or her healthcare provider have changed the landscape of diabetes therapy forever.
However, diabetes technology is progressing faster than healthcare professionals can incorporate these advances into their practices. To bridge this gap, Diabetes Technology provides an historical overview of diabetes technology, addresses the clinical science of new and advancing technologies, and illustrates the use of diabetes technology in different treatment settings. This guide also explores the personal stories of healthcare providers who treat their own diabetes with modern diabetes technology.
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Table of Contents
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Part 1: Basic Skills and Fundamental Knowledge
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Chapter 1: The History and Future of Diabetes TechnologyByDavid C. Klonoff, MD, FACP, FRCP (Edin), Fellow AIMBEDavid C. Klonoff, MD, FACP, FRCP (Edin), Fellow AIMBE1Medical Director, Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA; Clinical Professor of Medicine, University of California, San Francisco, San Francisco, CA.Search for other works by this author on:
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Chapter 2: Infrastructure of Diabetes Clinics and Centers to Support Diabetes TechnologyByBoris Draznin, MD, PhD;Boris Draznin, MD, PhD1Division of Endocrinology, Diabetes, and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO.Search for other works by this author on:Michael McDermott, MDMichael McDermott, MD1Division of Endocrinology, Diabetes, and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO.Search for other works by this author on:
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Chapter 3: Insulin PumpsByEda Cengiz, MD, MHSEda Cengiz, MD, MHS1Associate Professor, Yale School of Medicine, New Haven, CT; Visiting Professor, Bahçeşehir University Faculty of Medicine, Istanbul, Turkey.Search for other works by this author on:
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Chapter 4: Status of Continuous Glucose Monitoring Technology in Clinical PracticeByClare O’Connor, MD, MPH;Clare O’Connor, MD, MPH1Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.Search for other works by this author on:Grazia Aleppo, MD, FACE, FACPGrazia Aleppo, MD, FACE, FACP1Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.Search for other works by this author on:
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Chapter 5: Apps for Diabetes Management and Communication between Patients and ProvidersByDavid Ahn, MDDavid Ahn, MD1Program Director, Mary and Dick Allen Diabetes Center, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.Search for other works by this author on:
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Chapter 6: Selecting Patients for Pumps and Continuous Glucose Monitoring: Who, Why, and Why Not?ByLauren Vincent, MD;Lauren Vincent, MD1Endocrinology Fellow, University of California, San Diego, CA.Search for other works by this author on:Steven V. Edelman, MDSteven V. Edelman, MD2Professor of Medicine, University of California San Diego, CA; Veterans Affairs Medical Center; Founder and director, Taking Control of Your Diabetes.Search for other works by this author on:
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Chapter 7: Starting Insulin Pump and Continuous Glucose Monitoring TherapyByAnne Peters, MDAnne Peters, MD1Director, Clinical Diabetes Program, University of Southern California, Professor of Clinical Medicine, Keck School of Medicine, University of Southern California, Westside Clinic, Los Angeles, CASearch for other works by this author on:
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Chapter 8: Interpretation of Meters, Pumps, and Continuous Glucose Monitoring DownloadsByKathryn Weaver, MD;Kathryn Weaver, MD1Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, WA.Search for other works by this author on:Irl B. Hirsch, MDIrl B. Hirsch, MD2Professor of Medicine, School of Medicine, University of Washington, Seattle, WA.Search for other works by this author on:
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Chapter 9: Pumps and Continuous Glucose Monitoring in Children with DiabetesByJenise C. Wong, MD, PhD;Jenise C. Wong, MD, PhD1Department of Pediatrics and Madison Clinic for Pediatric Diabetes, University of California, San Francisco, CA.Search for other works by this author on:Gina Capodanno, MD;Gina Capodanno, MD1Department of Pediatrics and Madison Clinic for Pediatric Diabetes, University of California, San Francisco, CA.Search for other works by this author on:Saleh Adi, MDSaleh Adi, MD1Department of Pediatrics and Madison Clinic for Pediatric Diabetes, University of California, San Francisco, CA.Search for other works by this author on:
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Chapter 10: Physical Activity, Sport, and Recreation with Insulin Pumps and Continuous Glucose MonitoringBySheri R. Colberg, PhD, FACSM;Sheri R. Colberg, PhD, FACSM1Professor Emerita, Old Dominion University, Norfolk, VA.Search for other works by this author on:Gary Scheiner, MS, CDEGary Scheiner, MS, CDE2Owner and Clinical Director, Integrated Diabetes Services, LLC, Wynnewood, PA.Search for other works by this author on:
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Chapter 11: Continuous Glucose Monitoring and Insulin Pumps in the Management of Diabetes in PregnancyByJennifer M. Yamamoto;Jennifer M. Yamamoto1Department of Medicine, Division of Endocrinology and Metabolism, University of Calgary, Alberta, Canada.Search for other works by this author on:Helen R. MurphyHelen R. Murphy2Cambridge University Hospitals NHS Foundation Trust, Cambridge, U.K.; Women’s Health Academic Centre, Division of Women’s and Children’s Health, King’s College London, London, U.K.; Norwich Medical School, Bob Champion Research and Education Building, University of East Anglia, Norwich, U.K.Search for other works by this author on:
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Chapter 12: Practical Use of Insulin Pumps and Continuous Glucose Monitoring in the HospitalByKristen Kulasa, MD;Kristen Kulasa, MD1Division of Endocrinology, Diabetes, and Metabolism, University of California, San Diego, San Diego, CA.Search for other works by this author on:Patricia Juang, MD;Patricia Juang, MD1Division of Endocrinology, Diabetes, and Metabolism, University of California, San Diego, San Diego, CA.Search for other works by this author on:Robert J. Rushakoff, MDRobert J. Rushakoff, MD2Division of Endocrinology and Metabolism, University of California, San Francisco, San Francisco, CA.Search for other works by this author on:
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Chapter 13: Perioperative Continuous Subcutaneous Insulin Infusion UseBySandra Indacochea Sobel, MD;Sandra Indacochea Sobel, MD1Department of Medicine, Department of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, PASearch for other works by this author on:Mary Korytkowski, MD;Mary Korytkowski, MD1Department of Medicine, Department of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, PASearch for other works by this author on:Amy Donihi, PharmDAmy Donihi, PharmD2Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA.Search for other works by this author on:
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Part 2: Practical Application of Diabetes Technology
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Chapter 1: Benefits of Continuous Glucose Monitoring: A Case of BurnoutByAdriana Valencia, RD, CDEAdriana Valencia, RD, CDE1University of California–San Diego Medical Center, University of California, La Jolla, CA.Search for other works by this author on:
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Chapter 2: Technology-Facilitated Diabetes and Pregnancy ManagementByDonna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC;Donna Jornsay, MS, BSN, CPNP, BC-ADM, CDE, CDTC1Diabetes and Pregnancy Program, Mills-Peninsula Medical Center, Burlingame, CA.Search for other works by this author on:Lara DeLeuw, BSN, RN, CDELara DeLeuw, BSN, RN, CDE1Diabetes and Pregnancy Program, Mills-Peninsula Medical Center, Burlingame, CA.Search for other works by this author on:
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Chapter 3: Effective Utilization of Continuous Glucose Monitoring in a Patient with Type 2 Diabetes and an A1C of 9.3%ByJane Jeffrie Seley, DNP, MPH, BC-ADM, CDE, CDTC;Jane Jeffrie Seley, DNP, MPH, BC-ADM, CDE, CDTC1NewYork–Presbyterian, Weill Cornell Medical Center, New York, NY.Search for other works by this author on:Naina Sinha Gregory, MDNaina Sinha Gregory, MD2Weill Cornell Medicine, New York, NY.Search for other works by this author on:
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Chapter 4: Coaching Insulin Pump Uploads When an Individual Inputs “Phantom Carbohydrates”ByMargaret Pellizzari, MBA, MS, RN, CDE, CDTCMargaret Pellizzari, MBA, MS, RN, CDE, CDTC1Program Coordinator, Pediatric Endocrinology, Cohen Children’s Medical Center, North-well Health, Lake Success, NY.Search for other works by this author on:
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Chapter 5: A Teenager with Chronic HyperglycemiaByNeesha Ramchandani, PNP, CDENeesha Ramchandani, PNP, CDE1New York University, Rory Meyers College of Nursing, New York, NY.Search for other works by this author on:
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Chapter 6: Adjustments in Insulin Pump Settings Can Improve Glycemic ControlByLaura Barba, NP, MS, CDELaura Barba, NP, MS, CDE1Division of Endocrinology, Diabetes and Metabolism, University of California–San Diego Health System, San Diego, CA.Search for other works by this author on:
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Chapter 7: Continuous Glucose Monitoring: Understanding Strategies to Simplify the Insulin Regimen in Older Patients with HypoglycemiaByMichelle Magee, MD, MBBCH, BAO, LRCPSI;Michelle Magee, MD, MBBCH, BAO, LRCPSI1MedStar Diabetes Institute, Washington, D.C.2MedStar Health Research Institute, Hyattsville, MD.3Georgetown University School of Medicine, Washington, D.C.Search for other works by this author on:Claudia Morrison, RD, CDE;Claudia Morrison, RD, CDE4MedStar Washington Hospital Center, Washington, D.C.Search for other works by this author on:Gretchen Youssef, MS, RD, CDEGretchen Youssef, MS, RD, CDE1MedStar Diabetes Institute, Washington, D.C.Search for other works by this author on:
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Chapter 8: Helping Patients Understand Predictive Technology with the Use of Professional Continuous Glucose MonitoringByLucille Hughes, DNP, MSN/Ed, CDE, BC-ADM, FAADE;Lucille Hughes, DNP, MSN/Ed, CDE, BC-ADM, FAADE1South Nassau Community Hospital, Oceanside, NY.Search for other works by this author on:Sara Madtes, RD, CDESara Madtes, RD, CDE2South Nassau Diabetes Education Center, South Nassau Community Hospital, Oceanside, NY.Search for other works by this author on:
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Chapter 9: The Power of a SampleByJean Unger, BSN, RN, CDE;Jean Unger, BSN, RN, CDE1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Lone Tree Medical Center, Lone Tree, CO.Search for other works by this author on:Shannon Christen, RD, CDEShannon Christen, RD, CDE1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Lone Tree Medical Center, Lone Tree, CO.Search for other works by this author on:
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Chapter 10: Practical Automated Insulin: Using a Hybrid Closed-Loop System in an Adolescent Boy with Type 1 DiabetesByLaurel H. Messer, RN, MPH, CDE;Laurel H. Messer, RN, MPH, CDE1Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO.Search for other works by this author on:Cari Berget, RN, MPH, CDE;Cari Berget, RN, MPH, CDE1Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO.Search for other works by this author on:Gregory P. Forlenza, MS, MDGregory P. Forlenza, MS, MD1Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO.Search for other works by this author on:
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Chapter 11: Using Hybrid Closed-Loop Technology to Minimize Hypoglycemia in Type 1 Diabetes while Maintaining Excellent Diabetes ControlByElizabeth A. Doyle, DNP, APRN, CDE, BC-ADM;Elizabeth A. Doyle, DNP, APRN, CDE, BC-ADM1Assistant Professor, Yale School of Nursing, West Haven, CT; APRN/CDE, Yale Pediatric Endocrinology, Yale New Haven Hospital, New Haven, CT.Search for other works by this author on:Beatrice C. Lupsa, MDBeatrice C. Lupsa, MD2Assistant Professor of Medicine, Endocrinology, Yale School of Medicine, New Haven, CT.Search for other works by this author on:
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Part 3: Real World Outcomes—Our Own Experiences
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Chapter 1: My 65 Years with Type 1 DiabetesByRobert H. Eckel, MDRobert H. Eckel, MD1Professor of Medicine, Division of Endocrinology, Metabolism and Diabetes, Division of Cardiology; Professor of Physiology and Biophysics, Charles A. Boettcher II Chair in Atherosclerosis; Vice Chancellor for Research, Interim, University of Colorado Denver Anschutz Medical Campus; Director Lipid Clinic, University of Colorado Hospital, Aurora, CO.Search for other works by this author on:
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Chapter 2: Resilience: How Technology Has Helped Me Flourish with Type 1 DiabetesByElizabeth Stephens, MDElizabeth Stephens, MD1Clinic Medical Director, Providence Endocrinology East and West and Diabetes Education; Affiliate Associate Professor, Department of Internal Medicine, Oregon Health and Sciences University Endocrinology Faculty, Medical Education Department, Providence Portland Medical Center, Portland, OR.Search for other works by this author on:
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Chapter 3: Personal Story with Type 1 Diabetes and TechnologyByAaron Michels, MDAaron Michels, MD1Associate Professor of Pediatrics, Medicine, and Immunology and Microbiology, Frieda and George S. Eisenbarth Clinical Immunology Endowed Chair, University of Colorado Anschutz Medical Campus, Aurora, CO.Search for other works by this author on:
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Chapter 4: My Life with Diabetes and TechnologyByJusten Rudolph, MDJusten Rudolph, MD1Director of St. Vincent Diabetes Center, Billings, MT.Search for other works by this author on:
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Chapter 5: Staying in the Game with Continuous Glucose Monitoring TechnologyByDavid M. Tridgell, MDDavid M. Tridgell, MD1Adult Endocrinology, Park Nicollet Clinic, St. Louis Park, MN.Search for other works by this author on:
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Chapter 6: Technophobe!ByMark R. Burge, MDMark R. Burge, MD1Department of Internal Medicine/Endocrinology, University of New Mexico Health Sciences Center, Albuquerque, NM.2Dr. Burge’s effort was partially supported by the UNM HSC, Clinical and Translational Science Center, NCATS grant # 8UL1TR000041.Search for other works by this author on:
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Chapter 7: Ramblings on Type 1 DiabetesByJordan Perlman, MDJordan Perlman, MD1Internal Medicine Resident, University of Washington, Seattle, WA.Search for other works by this author on:
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Chapter 8: From Purified Pork to Pumps: How Technology Has Impacted My Life with DiabetesByJennifer Sherr, MD, PhDJennifer Sherr, MD, PhD1Associate Professor, Pediatrics (Endocrinology), Yale University School of Medicine, New Haven, CT.Search for other works by this author on:
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Chapter 9: From Living in the Dark Ages to the Artificial PancreasBySteven Edelman, MDSteven Edelman, MD1Professor of Medicine, University of California–San Diego, Veterans Affairs Medical Center, San Diego, CA; Founder and Director, Taking Control of Your Diabetes, Solana Beach, CA.Search for other works by this author on:
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Chapter 10: My StoryByAaron Kowalski, PhDAaron Kowalski, PhD1President and Chief Executive Officer, JDRF, New York, NY.Search for other works by this author on:
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Chapter 11: My Own StoryByIrl B. Hirsch, MDIrl B. Hirsch, MD1Professor of Medicine, University of Washington, Seattle, WA.Search for other works by this author on:
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Chapter 12: Continuous Glucose Monitoring and Insulin Pump TestimonialByJeff Unger, MD, FAAFP, FACEJeff Unger, MD, FAAFP, FACE1Diplomate, American Board of Family Practice; Fellow, American Association of Clinical Endocrinologists; Assistant Clinical Professor of Family Medicine, University of California Riverside School of Medicine; Director, Unger Concierge Primary Care Medical Group; Director, Metabolic Studies; Catalina Research Institute, Rancho Cucamonga, CA.Search for other works by this author on:
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