Advancing Insulin Care in Diabetes: Tech and Tips


Jennifer Green, MD, discusses the benefit of relatively new innovations including continuous glucose monitoring and smart insulin pens.

The diabetes field celebrated the 100th anniversary of the insulin discovery last year—a landmark innovation not only in endocrinology and cardiometabolic disease, but medicine overall. A full century later, the impact of insulin therapy is ineffable in diabetes management.

That is not to say the field is deprived of any other innovations.

Last month, diabetes experts and specialists from the Duke Health collaborated with HCPLive on a State of the Science Summit program titled, “Institutional Perspectives in Type 2 Diabetes: Contemporary Approaches to Insulin Treatment.”

The paneled presentation was led by chair Jennifer Green, MD, diabetologist and professor of medicine at Duke University Medical Center.

In the second segment of an interview with HCPLive, Green discussed the 3 classes of technology that have delivered innovation for modern type 2 diabetes care.

Starting with insulin pumps, Green described the needs of the various patients with unstable or inadequate glycemic control, despite use of an intensive subacute insulin regimen. “Particularly if they have problems with hypoglycemia at transition to insulin, delivery through an insulin pump would always be a reasonable consideration,” Green said.

Green also praised the accessibility and benefit of continuous glucose monitoring devices for patients with ≥1 daily insulin injection. “I do think in many circumstances these are incredibly important from a safety perspective,” she said. “But I think the real advantage is in alerting people to hypoglycemia, particularly in patients who don’t manage hypoglycemia well. They can be life-saving devices, frankly.”

Lastly, Green described smart insulin pens as capable of working in concert with glucose sensors to provide real-time, accurate insulin doses. “That can be very, very helpful in reviewing someone’s data to really understand what was administered and what might not have been administered so that the regimen can be changed safely and effectively,” she said.

Finally, on the subject of navigating these armaments for the appropriate patient, Green discussed the benefit of the American Diabetes Association (ADA) Standards of Care.

“They do offer a condensed version which is geared toward primary care doctors in general,” Green said. “I would also say to really discuss your patients who have a need for diabetes specialty care with those diabetologists, endocrinologists or other specialists who they go to to provide that care so that it’s a learning experience.”

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