With type 1 diabetes (T1D), it can be hard to predict how your actions will impact your glucose. That’s because every day is different, and there’s a combination of factors at play. What worked like a charm yesterday may not work today. While there are countless reasons, managing T1D is challenging at best — and that’s why the technology you use matters. 

“Embarrassment and fatigue made a lot of my decisions early on,” explained Kris Leeper, who was sent home with a vial of insulin, a pack of needles, and a blood glucose monitor after his T1D diagnosis in 2013 in Kingsport, Tennessee. It wasn’t until years later and having been labeled as “uncontrolled” that he was finally offered affordable, life-changing T1D tech solutions. 

Since then, various automated insulin delivery (AID) systems have become mainstream in the diabetes tech space, automatically adjusting insulin delivery in response to real-time continuous glucose monitor (CGM) results and trends. Statistically speaking, people are experiencing marked improvements thanks to AID systems.  

While AID systems are not a cure, they are a preferred treatment tool that minimizes the daily burden by maximizing hands-off efforts. Let’s take a closer look. 

 

What is an AID system? 

Automated insulin delivery (AID) systems are based on the foundational components of traditional insulin pump therapy — but with a new set of features. As the name implies, they help “automate” some functions you’ve been doing manually. In turn, this helps decrease nonstop decision-making and improves quality of life factors. 

Insulin pumps deliver insulin through a bolus (dose for carbs and/or a correction) and by basal (a continuous flow of background insulin). A smart AID system takes this a few steps further, adjusting these rates automatically in response to CGM data. Functionality is similar but varies a bit from brand to brand. 

For those unfamiliar with AID systems, they’re made of three parts: an insulin pump, CGM, and an algorithm (or “brain” of the system). They work together to improve Time in Range and to decrease hypoglycemic (low glucose) events. 

AID systems:  

  • Detect glucose changes that lead to automated responses 
  • Calculate necessary insulin so you don’t have to 
  • Give basal and bolus corrections to increase Time in Range 
  • Decrease the risk of life-threatening hypoglycemia (low glucose)

 

This tech can be life-changing given that T1D is managed differently from person to person, no two days are exactly the same, and sometimes efforts don’t produce expected results. 

 

What does science have to say? 

Research has specifically looked at the AID systems’ role in diabetes management and quality of life factors. Studies suggest AID systems help to: 

  • Improve Time in Range 
  • Lower A1C values 
  • Decrease the risk of hypoglycemia 
  • Lighten the mental burden associated with T1D 

 

Studies also show these systems are safe and effective at achieving personal glucose targets. While its use is becoming more widespread, diabetes tech isn’t offered equally to everyone. That’s because there are significant barriers and inequities in their distribution. In other words, not everyone has access to this technology.  

An estimated 1.7 million people in the U.S. live with T1D, and diagnosis rates continue to rise. Numbers are highest among Asian/Pacific Islander, Hispanic, and non-Hispanic Black populations. This is troubling, given these are also minoritized communities. 

 

Accessing T1D technology 

While diabetes tech advancements are improving outcomes, disparities persist, especially in minoritized communities. Socioeconomic, racial, and ethnic disparities unjustly affect T1D tech distribution and its use.  

Technology is simply not reaching everyone who could benefit from it.  

Moreover, tech use is less common in people who don’t receive care from an endocrinologist, so geographic disparities also exist.  About 50% of adults living with T1D receive care from a primary care provider. These rates will continue to rise with the expected shortage of endocrinologists. 

Providers may not have broad exposure to emerging tools or have an implicit bias in who they prescribe them to. Generally, when a person is provided the tools, results are similar across all racial and ethnic groups, regardless of social determinants of health. 

If someone isn’t offered the technology or lacks insurance coverage, they’re often left behind. That said, having the tools isn’t enough either. A person with T1D will need education and ongoing support to reap the full benefits of T1D technologies. 

 

 

Real-world outcomes

When Kris Leeper began receiving care from a new physician after his family moved to Virginia Beach, he was introduced to insulin pumps and pens, which, up to this point, he hadn’t seen or heard of before.  

After years of failed attempts to find affordable, supportive solutions, in 2020, Leeper was finally able to upgrade to the MiniMed™ 770G through the Medtronic Access Program. “Regardless of my insurance coverage, I was able to access the latest diabetes tech and an all-in-one solution,” said Leeper.  

Now on the MiniMed™ 780G system, which offers Meal Detection™ technology, “For the first time in 7 years, I felt optimistic about my diagnosis and had a sense of relief,” said Leeper. “In April 2024, my daughter was born, and I can honestly say diabetes wasn’t my first and last thought of the day like it had been before. If I don’t bolus the right amount, the Meal Detection™ technology and autocorrections have saved me from hours of high blood sugar.” 

“My first year of being a dad has been amazing. I don’t know how I would have survived if it wasn’t for diabetes technology — it’s changed my complete outlook on T1D.” 

 

EDITOR’S NOTE: This content was developed independently by T1D Exchange and was supported by a contribution from Medtronic.