Do-It-Yourself (DIY) vs. Commercial Closed-Loop Systems for Managing Type 1 Diabetes
Friday, June 23, at 5:30 p.m. PT
Ballroom 20A-C
San Diego Convention Center
(Livestream Available)
Presentation: DIY Is an Essential Option in Type 1 Diabetes Management
Dana M. Lewis
Independent Researcher,
OpenAPS
What is your presentation about?
This presentation explores the scientific evidence for open-source automated insulin delivery (AID) systems, demonstrating the potential to enable improvements in A1C and time-in-range (TIR), reduce hypoglycemia, and also improve the quality of life of people living with diabetes. There are years of research and nearly a decade of real-world data supporting the use of open source AID: in fact, there are now multiple randomized control trials establishing safety and efficacy, including one that was published in the New England Journal of Medicine. People with diabetes should be supported in accessing their choice of diabetes technology, including the options of open source automated insulin delivery. In some geographic areas, open source AID may be the only affordable and/or available option for people with diabetes, and this presentation will help the audience understand that safety and efficacy in AID and user choice are not mutually exclusive.
What makes this topic important in 2023?
Open-source automated insulin delivery systems have been in existence for almost a decade, but many providers are still unaware of them as an option, or how they might support patients choosing to access these systems. Providers may also not be up to date on the latest evidence, including the many randomized control trials (RCTs) that have established the safety and efficacy of various open-source AID systems for people living with diabetes.
How did you become involved with this area of diabetes research or care?
I helped develop the first open source AID system (OpenAPS) and have been using it successfully for nearly a decade. I also became the first person to study and publish on open-source AID systems, leading the way for the now dozens of ongoing studies and collaborations worldwide that have been evaluating the safety and efficacy of various open source AID systems for people living with diabetes.
How do you think your presentation will impact diabetes research or care?
I hope this presentation and the resulting discussion around options in AID for people with diabetes spur health care providers to continue to learn and update their knowledge with the most recent evidence regarding all types of AID, but especially including open source AID. I also hope it will help providers consider their important role in introducing technology options to all people with diabetes. Past research shows that subconscious biases around technical literacy and/or glycemic outcomes on previous therapies plays a role in preventing newer technology or therapy options from being discussed with or offered to people with diabetes. This has been true of pump and CGM, among other diabetes therapies, and this pattern will likely hold true for AID technology unless we make a conscious effort to break these patterns. The data from this presentation shows that in open-source AID, all individuals with type 1 diabetes, irrespective of their engagement with previous self-care and/or previous glycemic outcomes, stand to benefit from AID.
What are you most looking forward to at the 83rd Scientific Sessions?
I’m excited to continue discussions about the role open-source AID can play in the lives of people living with diabetes, including in making it possible to evaluate the outcomes of new-onset medication for people with diabetes. AID reduces the ‘noise’ and makes it possible to understand, for the first time, how some medications impact glucose levels for people with diabetes. One such example is pancreatic enzyme replacement therapy (PERT) for people with diabetes and exocrine pancreatic insufficiency (EPI). I’m also presenting a poster (1304-P) about the prevalence of exocrine pancreatic insufficiency in both type 1 and type 2 diabetes and am looking forward to kickstarting new research collaborations to improve the screening and treatment of EPI for people living with diabetes.