AID(„automated insulin delivery“)-Systeme in der Diabetologie

Insulin pumps and glucose sensors have been shown in registry data to be effective in improving diabetes therapy and reducing acute complications. Therefore, in pediatric diabetology, the use of at least one technical device is standard. The combination of both devices leads to the possibility of automated insulin delivery (AID) systems. Many AID systems have been tested in clinical trials and have proven safety and effectiveness. The supply situation in Germany currently only allows one system to be prescribed for people insured by public health insurance. Children younger than 7 years of age cannot currently be treated with this system. The reasons for this are legal hurdles and lack of certification by the manufacturers. CE certification can also lead to problems with insulin prescriptions. Open-source systems are nonregulated variants to circumvent existing regulatory conditions. There are risks here for both users and prescribers. For continued use, thorough knowledge of the features of each AID system is necessary on both the user and practitioner side. Complete automation does not work. For the evaluation of the AID therapy, the metric data of the glucose sensors, the “time in range” and the “glucose management index” are the recognized and suitable parameters because they allow consultation based on the real data from the daily life of people with diabetes. Since all glucose sensors are read out via cloud-based software or obtain the data directly automatically, this provides the ideal technical basis for telemedical care, which needs further development.