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The development of technology, for example in the field of information technology or biotechnology and genetic engineering, has been breathtaking in recent decades. Development has also been rapid in the field of diabetes technology. However, no “technical cure” for diabetes has yet been achieved. Patients and also diabetes experts ask themselves why the availability of modern technologies does not automatically become visible in medical technology. They feel a gap between high technology and diabetes technology. However, the development and marketing of any product is an ever-increasing challenge. This will be mastered the faster; the higher the general dissemination, the higher the amortization of investments will be. It is generally necessary to understand the multiple steps from the idea of a product to its application to people.

ZusammenfassungCGM mit Darstellung der aktuellen Glukosewerte (rtCGM) ist aktuell einer der wichtigsten diagnostischen Optionen in der Diabetologie. Es ermöglicht eine umfangreiche und unmittelbare Unterstützung und Erleichterung des Diabetesmanagements, besonders wenn eine Insulintherapie angewendet wird. Weiterhin stellt rtCGM den notwendigen Systempartner für die Steuerung der automatisierten Insulinabgabe in AID-Systemen dar. In Verbindung mit Smart-Pens unterstützt ein rtCGM die korrekte Durchführung des Insulinmanagements und erinnert an Bolusinjektionen.RtCGM-Daten sind heute das Fundament des personalisierten Datenmanagements und Alltagscoachings und stellen die Basis der Digitalisierung und telemedizinischen Intervention dar. Die Möglichkeit der interoperablen Nutzung ist aus therapeutischer Sicht eine zentrale Eigenschaft eines rtCGMs und kann zur Erweiterung der Indikationen, unabhängig von Diabetestyp oder Therapieform führen. Dies könnte auch den vorübergehenden oder intermittierenden Einsatz bei Menschen mit Typ-2-Diabetes ohne Insulinbehandlung betreffen. Kürzlich veröffentlichte internationale Leitlinien, z.B. der Amerikanischen Gesellschaft für klinische Endokrinologie (AACE) fordern auf der Basis umfangreicher Evidenz, dass die Glukosemessung mit einem rtCGM für alle Menschen mit Diabetes nutzbar und verfügbar sein sollte. Bereits in der Phase gestörter Glukosetoleranz kann ein rtCGM-System als Alltagscoaching oder Biofeedback bei Einbettung in ein Gesamtbehandlungskonzept unterstützen, mit dem Ziel aktiver und fundierter Handlungen des Anwenders im Diabetesalltag.Die Vielfalt der Nutzungsoptionen und die immer schnelleren technischen Innovationszyklen von rtCGM-Systemen wurden mit Blick auf aktuelle Anforderungen und die notwendigen Strukturanpassungen des Gesundheitssystems von einer rtCGM-erfahrenen Expertengruppe diskutiert. Ziel war es, konkrete Lücken in der Versorgungsstruktur sowie potenzielle Handlungsfelder in der Diabetologie zu identifizierten und mögliche Indikationserweiterungen für den Einsatz von rtCGM darzustellen. Dieses, sowie die Erkenntnisse und Schlussfolgerungen der Diskussionen werden in diesem Artikel dargestellt.

ZusammenfassungDie Glukose-„Messlandschaft“ in Deutschland deckt viele verschiedene Einsatzzwecke und -gebiete ab. Sie reicht von hochstandardisiert messenden Laboranalysesystemen mit einem großen Gesamtportfolio von Messgrößen bis hin zu einfachen Systemen für den Patientengebrauch. Aus klinischer Sicht muss die Qualität von Glukosemessungen ausreichend hoch sein, um die vorgesehenen Zwecke, also Diagnosestellung und Verlaufskontrolle, zu erfüllen.In der Heilkunde – also bei Messungen im Rahmen der Gesundheitsversorgung durch medizinisches Personal – definiert die Richtlinie der Bundesärztekammer zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen Vorgaben an die Qualitätssicherung. Es werden sowohl interne als auch externe (herstellerunabhängige) Qualitätskontrollen gefordert und mit spezifischen Vorgaben versehen. Diese Regelungen gelten demnach auch für alle Glukosemessungen in der Heilkunde, d. h. im Zentrallabor ebenso wie in der patientennahen Sofortdiagnostik.Bei dem Haupteinsatzgebiet von Glukosemessungen, der Verlaufskontrolle durch Patienten mit Diabetes im Rahmen der Blutglukoseselbstmessung, fehlen i. d. R. Kontrollen der Messqualität. Für das kontinuierliche Glukosemonitoring im interstitiellen Gewebe sind Qualitätskontrollen nach dem aktuellen technischen Stand sogar überhaupt nicht möglich. Hinzu kommt, dass eine regelmäßige herstellerunabhängige Kontrolle der Messqualität nicht vorgeschrieben ist. Ziel der Arbeit ist es, einen Überblick über die unterschiedlichen Glukosemesssysteme sowie praktische Aspekte und Probleme bei der Glukosemessung zu geben.

Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.

On July 21, 2021, Diabetes Technology Society convened the virtual Green Diabetes Summit. The event consisted of 23 representatives from key stakeholder groups based in both the United States and Europe. The purposes of the summit were to (1) provide background on the complexity of addressing sustainability-related issues, including waste management, of diabetes devices from many different perspectives along the products’ life cycle stages, and (2) determine the feasibility and role of a coalition of stakeholders to find solutions, particularly in the design, use, and proper disposal of diabetes devices used in home care that no one stakeholder can resolve on their own.

Journal of diabetes science and technology : JDST (2022). doi:10.1177/19322968221121660, Published by Sage Publishing, London

Travelers frequently eat at an airport before their flight. Travelers with diabetes also frequently need to lance their fingertips to check a blood glucose concentration and/or inject themselves with insulin. These actions generate medical sharps waste. Bloody sharps can be a source of needlestick injuries for other travelers or waste handlers if the waste is not safely disposed of. There are currently no guidelines or standards for medical sharps waste disposal in commercial airports or similar public places. We advocate for the establishment of guidelines for medical sharps waste disposal in commercial airports. These guidelines should include four elements: (1) design of sharps disposal bins, (2) placement of sharp disposal bins, (3) publication of locations with sharps disposal bins, and (4) safety protocols for both sharps disposal and handling sharps waste. In this article, we present the background and reasons behind our recommendation for establishing guidelines for medical waste disposal in commercial airports.

Background: Conventional home blood glucose measurements require a sample of blood that is obtained by puncturing the skin at the fingertip. To avoid the pain associated with this procedure, there is high demand for medical products that allow glucose monitoring without blood sampling. In this review article, all such products are presented. Methods: In order to identify such products, four different sources were used: (1) PubMed, (2) Google Patents, (3) Diabetes Technology Meeting Startup Showcase participants, and (4) experts in the field of glucose monitoring. The information obtained were filtered by using two inclusion criteria: (1) regulatory clearance, and/or (2) significant coverage in Google News starting in the year 2016, unless the article indicated that the product had been discontinued. The identified bloodless monitoring products were classified into three categories: (1) noninvasive optical, (2) noninvasive fluid sampling, and (3) minimally invasive devices. Results: In total, 28 noninvasive optical, 6 noninvasive fluid sampling, and 31 minimally invasive glucose monitoring products were identified. Subsequently, these products were characterized according to their regulatory, technological, and consumer features. Products with regulatory clearance are described in greater detail according to their advantages and disadvantages, and with design images. Conclusions: Based on favorable technological features, consumer features, and other advantages, several bloodless products are commercially available and promise to enhance diabetes management. Paths for future products are discussed with an emphasis on understanding existing barriers related to both technical and non-technical issues.

Background To benefit from real-time continuous glucose monitoring (rtCGM), users need practical skills and in-depth knowledge to analyze the glucose data appropriately and adapt insulin therapy accordingly. To assess the user’s knowledge about rtCGM, a psychometric knowledge test was developed and evaluated. Method Experts on the use of rtCGM systems defined central knowledge contents in a Delphi process and developed a knowledge test comprising 40 multiple-choice items. For test-statistical review, people with insulin-treated diabetes and members of diabetes teams answered the knowledge test. Results The 122 diabetes team members (age 46 (11) years; mean (SD)) and the 111 people with insulin-treated diabetes (age 42 (14) years, diabetes duration 20 (14) years, users of insulin pumps 64 %, previous usage of rtCGM 38 %, HbA1c 8.0 % [95 % CI 7.7–8.3] (64 mmol/mol [60–67]) had different levels of experiences using rtCGM systems. The internal consistency (Cronbach’s alpha) of the knowledge test was 0.92 for the whole sample, for people with diabetes 0.94, and for diabetes team members 0.84. Item difficulty ranged between 0.12 and 0.88 in people with diabetes and between 0.27 and 0.97 among diabetes team members. On average, people with diabetes answered 24.1 (9.9) items correctly, diabetes team members 29.2 (5.2) (p Conclusion The “rtCGM-Profi-Check” knowledge test provides high internal consistency, high selectivity, and content validity. It is suitable for objective, reliable, and valid assessment of the indispensable knowledge of people with diabetes to use different rtCGM systems successfully. The questionnaire is manufacturer-independent and is suitable to evaluate the needs and success of rtCGM education among persons with diabetes.

ZusammenfassungDie Messqualität eines Glukosemess-Systems muss ausreichend hoch sein, damit zuverlässige Messergebnisse im klinischen Sinne der Zweckbestimmung (z. B. Diabetes-Diagnose, -Verlaufskontrolle) erhalten werden. Für Glukosemessungen in der Heilkunde gilt die Richtlinie der Bundesärztekammer zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen, die Vorgaben zur internen und externen Qualitätssicherung macht. Nach Ansicht der Autoren besteht hier allerdings Verbesserungspotential, das anhand von Beispielen erläutert wird. Für Messysteme, die durch Patienten im Rahmen der Selbstmessung der Blutglukose eingesetzt werden, gibt es keine rechtlich bindenden Vorgaben zur Qualitätssicherung. Beim kontinuierlichen Glukose-Monitoring ist eine regelmäßige Überprüfung der Messqualität durch die Anwender derzeit technisch nicht möglich. Zudem fehlen in beiden Fällen regelmäßig wiederkehrende, herstellerunabhängige Untersuchungen der Messgenauigkeit, die zur Verbesserung der Messqualität beitragen könnten.

Aims: Are there differences in the attitudes of physicians, parents and people with diabetes (PwD) towards digitalization and new technologies in diabetes and how do these change from 20- 2021? Methods: In 20 and 2021, PwD and diabetologists in Germany were asked via online surveys about their attitudes and assessment of digitalization and new technologies in diabetology. 2019: 324 diabetologists (43% female, average age 52.2 years) and 3.427 PwD (47.7% female, 56.6% type 1 diabetes (T1D) , 25.5% type 2 diabetes (T2D) , 8.1% parents of children with diabetes; Ø 49.2±19.3 years) . 2021: 3diabetologists (48% female, average age 53.7 years) and 2.417 PwD (47.5% female, 57.8% type 1 diabetes (T1D) , 20.7% type 2 diabetes (T2D) , 19.0% parents of children with diabetes; Ø 47.7 years) . Results: Parents (T1D) (2019: 89.5% positive; 2021: 91.7%) PwD-TD1 (2019: 85.3%; 2021: 91.1%) have more positive attitudes towards digitalization than PwD-T2D (2019: 73.3%; 2021: 87.1%) or diabetologists (2019: 75.8%; 2021: 81.9%) . Within 2 years, positive attitudes increased in all 4 groups. There was a great agreement between all 4 groups regarding the most important topics for the future of diabetology: AID systems were in first place in the ranking, followed by interoperability of systems, software for analysing glucose data and artificial intelligence. Conclusions: PwD have very positive attitudes towards digitalization and new technologies in diabetes with only very small differences between TD1 and TD2. These are significantly higher than those of physicians. All groups have very high expectations for the further development of AID systems in particular. Disclosure B.Kulzer: Advisory Panel; Bayer AG, Bayer AG, Becton, Dickinson and Company, Becton, Dickinson and Company, Berlin-Chemie AG, Berlin-Chemie AG, Dexcom, Inc., Dexcom, Inc., Insulet Corporation, Novo Nordisk, Roche Diabetes Care, Sanofi, Sanofi-Aventis Deutschland GmbH, Research Support; Novo Nordisk, Roche Diabetes Care. N.Hermanns: Advisory Panel; Abbott Diabetes, Research Support; Becton, Dickinson and Company, Roche Diagnostics, Speaker's Bureau; Berlin-Chemie AG, Novo Nordisk, Sanofi. D.Ehrmann: Advisory Panel; Dexcom, Inc., Consultant; mySugr, Roche Diabetes Care, Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. T.Roos: None. L.Heinemann: Board Member; Lifecare, Inc., Consultant; Becton, Dickinson and Company, Roche Diabetes Care, Stock/Shareholder; Profil Institut für Stoffwechselforschung GmbH, Science Consulting in Diabetes GmbH.

Objective: Patch pumps, i.e. tubeless insulin pumps, are an attractive alternative to conventional insulin pumps for people with type 1 diabetes and type 2 diabetes on insulin therapy. However, to date, the patient-related benefits of patch pumps are not well understood. Methods: A systematic review was conducted to summarize potential patient-relevant advantages and disadvantages of patch pumps and to assess relevant studies on patient-reported outcomes (PROs) . Relevant studies were identified by a systematic PubMed search. In addition, the reference lists of the respective articles and Google Scholar were checked for further references. English-language articles published before June 30, 2021, were included; no other publication date criteria were specified. Results: A total of 12 studies were included. The results of this analysis demonstrate that patch pumps improve quality of life, reduce diabetes-related symptoms, increase patient satisfaction, and are preferred by patients compared with conventional insulin pumps and daily multiple injection (MDI) therapy. However, several methodological limitations of the identified studies limit the power of this analysis. Conclusions: Despite the limited number of studies evaluating the benefits of patch pumps in relation to PROs, there is increasing evidence that people with diabetes prefer patch pumps compared to MDI and conventional pumps. It is notable that this aspect has been relatively understudied. More systematic studies evaluating the benefit of patch pumps in relation to PROs are needed. Disclosure B.Kulzer: Advisory Panel; Bayer AG, Bayer AG, Becton, Dickinson and Company, Becton, Dickinson and Company, Berlin-Chemie AG, Berlin-Chemie AG, Dexcom, Inc., Dexcom, Inc., Insulet Corporation, Novo Nordisk, Roche Diabetes Care, Sanofi, Sanofi-Aventis Deutschland GmbH, Research Support; Novo Nordisk, Roche Diabetes Care. G.Freckmann: Advisory Panel; Abbott Diabetes, Dexcom, Inc., Lilly, Roche Diabetes Care, Roche Diagnostics, Consultant; Ascensia Diabetes Care, Berlin-Chemie AG, Boydsens, Metronom, mySugr, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH, Research Support; Dexcom, Inc., Medtronic, Menarini Group, Roche Diabetes Care, Sanofi, Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc., Lilly, Novo Nordisk, Roche Diabetes Care, Terumo Corporation. L.Heinemann: Board Member; Lifecare, Inc., Consultant; Becton, Dickinson and Company, Roche Diabetes Care, Stock/Shareholder; Profil Institut für Stoffwechselforschung GmbH, Science Consulting in Diabetes GmbH. O.Schnell: Advisory Panel; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly, Roche Diabetes Care. R.Hinzmann: Employee; Roche Diabetes Care. R.Ziegler: Advisory Panel; Eli Lilly and Company, mySugr, Novo Nordisk, Roche Diabetes Care, Speaker's Bureau; A. Menarini Diagnostics, Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Glooko, Inc., Novo Nordisk, Roche Diabetes Care.

Aims: How do physicians assess AID-Systems in terms of their current and future importance for diabetes care? Methods: In 2021 3diabetologists in Germany (48% female, average age 53.7 years) were asked via online surveys about their current and future assessment of AID-Systems.The results were compared with the 20survey, in which 337 diabetologists (43% female, mean age 53.2 years) participated. Results: Currently, 58.6% (2020: 51.4%) of diabetologists consider AID-Systems to be important for diabetes care, in 5 years 89.3% (2020: 86.4%) . Diabetologists estimate that in approx. 9 years one in two PwD TD1 in Germany will be a user of an AID-System, and in approx. 17 years 90% will use an AID-System. Currently, they estimate that 57.6% of all PwD-TD1 are suitable for an AID-System. Diabetologists see the clearest impact of AID-Systems in an increased need for diabetes selfmangement education (78.9%) , but also in PwD becoming much more autonomous and empowered (62.8%) . Regarding possible negative effects of AID-Systems, diabetologists see only few risks: 20% fear that PWD will have less contact with the diabetes team, 16.9% are concerned that PWD will not be able to cope with the technological change. Only 7.9% fear that PWD will become riskier with AID-Systems, only 1.7% have fears that the diabetes team will become superfluous. Conclusions: Overall, diabetologists assess AID-Systems as a important innovation for diabetes care and that this will soon become the standard therapy for T1D. The effort for Diabetes self-management education and support is estimated to be relatively high, possible disadvantages relatively low. Disclosure L.Heinemann: Board Member; Lifecare, Inc., Consultant; Becton, Dickinson and Company, Roche Diabetes Care, Stock/Shareholder; Profil Institut für Stoffwechselforschung GmbH, Science Consulting in Diabetes GmbH. N.Hermanns: Advisory Panel; Abbott Diabetes, Research Support; Becton, Dickinson and Company, Roche Diagnostics, Speaker's Bureau; Berlin-Chemie AG, Novo Nordisk, Sanofi. D.Ehrmann: Advisory Panel; Dexcom, Inc., Consultant; mySugr, Roche Diabetes Care, Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. T.Roos: None. B.Kulzer: Advisory Panel; Bayer AG, Bayer AG, Becton, Dickinson and Company, Becton, Dickinson and Company, Berlin-Chemie AG, Berlin-Chemie AG, Dexcom, Inc., Dexcom, Inc., Insulet Corporation, Novo Nordisk, Roche Diabetes Care, Sanofi, Sanofi-Aventis Deutschland GmbH, Research Support; Novo Nordisk, Roche Diabetes Care.

Aims: More and more people with diabetes (PwD) are paying attention to the waste associated with new technologies and want more sustainable concepts for waste prevention and a positive ecological footprint. So far, there are little results on the importance people with diabetes attach to the issue of sustainability and environmental compatibility. In an online survey, we wanted to determine the extent of these wishes and ecological needs of PwD. Methods: PwD in Germany were asked via online surveys (2.417 PwD; 47.5% female, 57.8% type 1 diabetes (T1D) , 20.7% type 2 diabetes (T2D) , 19.0% parents of children with diabetes; Ø 47.7 years) . Results: For more than half of all respondents, the topic of packaging waste is important (54.5%) , two out of three respondents say they would like to see more reusable utensils in diabetes therapy (67.1%) . However, the amount of packaging waste in diabetes technologies does not seem to be a decision criterion for most PwD when selecting modern technologies - this is only significant for 15% (TSD 21,9%) . Overall, there were only slight differences between the groups of PwD. Conclusions: Ecological aspects are becoming increasingly important in diabetes therapy: most PwD are concerned about the issue of packaging waste in diabetes technologies and would like to see more recyclable utensils for their diabetes therapy. Although the number of respondents who consider the amount of packaging waste to be a decisive criterion for the choice of a diabetes technology is low - among people with type 2 diabetes, however, this is already around one in five persons. Disclosure L.Heinemann: Board Member; Lifecare, Inc., Consultant; Becton, Dickinson and Company, Roche Diabetes Care, Stock/Shareholder; Profil Institut für Stoffwechselforschung GmbH, Science Consulting in Diabetes GmbH. D.Ehrmann: Advisory Panel; Dexcom, Inc., Consultant; mySugr, Roche Diabetes Care, Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. T.Roos: None. N.Hermanns: Advisory Panel; Abbott Diabetes, Research Support; Becton, Dickinson and Company, Roche Diagnostics, Speaker's Bureau; Berlin-Chemie AG, Novo Nordisk, Sanofi. B.Kulzer: Advisory Panel; Bayer AG, Bayer AG, Becton, Dickinson and Company, Becton, Dickinson and Company, Berlin-Chemie AG, Berlin-Chemie AG, Dexcom, Inc., Dexcom, Inc., Insulet Corporation, Novo Nordisk, Roche Diabetes Care, Sanofi, Sanofi-Aventis Deutschland GmbH, Research Support; Novo Nordisk, Roche Diabetes Care.

Continuous subcutaneous insulin infusion (CSII) therapy is becoming increasingly popular. CSII provides convenient insulin delivery, precise dosing, easy adjustments for physical activity, stress, or illness, and integration with continuous glucose monitors in hybrid or other closed-loop systems. However, even as insulin pump hardware and software have advanced, technology for insulin infusion sets (IISs) has stayed relatively stagnant over time and is often referred to as the “Achilles heel” of CSII. To discuss barriers to insulin pump therapy and present information about advancements in, and results from clinical trials of extended wear IISs, Diabetes Technology Society virtually hosted the “Improving the Patient Experience with Longer Wear Infusion Sets Symposium” on December 1, 2021. The symposium featured experts in the field of IISs, including representatives from Steno Diabetes Center Copenhagen, University of California San Francisco, Stanford University, Medtronic Diabetes, and Science Consulting in Diabetes. The webinar’s seven speakers covered (1) advancements in insulin pump therapy, (2) efficacy of longer wear infusion sets, and (3) innovations to reduce plastics and insulin waste.

Es sollte geklart werden, welche Einstellung Menschen mit Diabetes zur Digitalisierung und fortschreitenden Technologisierung in der Diabetologie haben, welche Vor- und Nachteile sie sehen und wie sie aktuelle Entwicklungen der IT (Informationstechnologie) in der Diabetologie einschatzen. Es wurden 3427 Menschen Personen mit Diabetes online befragt. Die Teilnehmer der Umfrage haben insgesamt eine sehr positive Einstellung zur Digitalisierung (83 % positiv/sehr positiv) und schatzen deren Potenzial zur Optimierung der Diabetologie als sehr hoch ein (79 % positiv/sehr positiv). Als groste Vorteile der Digitalisierung wurden eine „bessere Behandlungsqualitat“ (80 %), eine „grosere Eigenverantwortung und Selbstbestimmung in der Therapie“ (80 %) und „mehr Unterstutzung bei Therapieentscheidungen“ (78 %) genannt. Die grosten Nachteile sind die „Fehleranfalligkeit von digitalen Anwendungen“ (36 %), die „Gefahr des Missbrauchs von Patientendaten“ (32 %) und die Befurchtung, dass „durch die Digitalisierung in vielen Fallen der Arzt ersetzt wird“ (31 %). Als bedeutsamste Themen eingeschatzt werden aktuell AID-Systeme (AID: „automated insulin delivery“), die Moglichkeit der Auswertung und Analyse von Glukosedaten mittels Software sowie eine Verbesserung der Interoperabilitat der verschiedenen Anwendungen. Menschen mit Diabetes stehen neuen Technologien in der Diabetologie sehr positiv gegenuber und verbinden mit diesen grose Hoffnungen, dass sich ihre Diabetestherapie verbessert, vereinfacht und sich die Belastungen im Zusammenhang mit der Erkrankung verringern. Besonders Menschen mit Typ-1-Diabetes bzw. deren Eltern haben hohe Erwartungen an AID-Systeme und erhoffen sich dadurch eine deutliche Verbesserung der Diabetestherapie.

The increasing prevalence of diabetes, combined with a growing global shortage of health care professionals (HCP), necessitates the need to develop new approaches to diabetes care delivery to expand access to care, lessen the burden on people with diabetes, improve efficiencies, and reduce the unsustainable financial liability on health systems and payers. Use of digital diabetes technologies and telehealth protocols within a digital/virtual diabetes clinic has the potential to address these challenges. However, several issues must be resolved to move forward. In February 2020, organizers of the Advanced Technologies & Treatments for Diabetes Annual Conference convened an international panel of HCP, researchers, patient advocates, and industry representatives to review the status of digital diabetes technologies, characterize deficits in current technologies, and identify issues for consideration. Since that meeting, the importance of using telehealth and digital diabetes technologies has been demonstrated amid the global coronavirus disease (COVID-19) pandemic. This article summarizes the panel's discussion of the opportunities, obstacles, and requisites for advancing the use of these technologies as a standard of care for the management of diabetes.

Diabetes technology is a dynamically evolving field. Sometimes the pace of evaluation of new diabetes technologies does not keep pace with its dynamic development. This leads to a dilemma: either the evaluation lags behind the developing technologies or diabetes technologies are used without sufficient evaluation. This situation is known as the Catch 22 dilemma. The aim of this paper is a discussion of ideas for a timely assessment, taking account of the speed of technological development and the need for evidence and safety improvement.

Digital health management is increasingly pivotal in the care of patients with diabetes. The aim of this review was to evaluate the clinical benefits of using smart insulin pens with connectivity for diabetes management. The search was performed using PubMed and PubMed Central on May 15, 2019, to identify publications investigating the use of insulin pens. Studies evaluating insulin pens with connectivity via Bluetooth/Near Field Communication, with an associated electronic device enabling connectivity, or with a memory function were included in the review. Nine studies were identified in the search. Overall, these studies lacked data on smart insulin pens with a connectivity function, with eight of the available studies investigating only pens with a memory function. The studies focused primarily on assessing patient preference, usability, and technical accuracy. The number of studies assessing clinical outcomes was small ( n = 3). However, the majority of studies ( n = 8) reported that patients preferred smart insulin pens because they increased confidence with regard to diabetes self-management. These results suggest a lack of published data regarding smart insulin pens with connectivity for the management of diabetes. However, the available published data on usability and patient preference suggest that the use of smart insulin pens holds promise for improving and simplifying diabetes self-management.