Diabetes in the News: Automated Insulin Delivery, Semaglutide and Bariatric Surgery, and More

Automated Insulin Dose Selection May Have Benefits vs Manual Dose Calculation

A recent study in BMJ Quality & Safety touted such benefits as error reduction and faster insulin delivery of automated insulin dose selection for patients receiving care in intensive care unit settings, reports Pharmacy Times^®. Made possible by Smart Agent systems, health care providers could be freed up to focus their attention on other priorities when not constricted by having to perform manual dosing calcuations.

“Glucose management improves outcomes for critically ill patients; however, current insulin infusion protocols are work-intensive for nurses and may be error prone,” said study lead author Michael Rosen, PhD, MA, associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine, in a statement. This study took place at The Johns Hopkins Hospital.

Ninety percent of the nurses in the study, which took place from May to July 2018, deemed the systems easier to use compared with performing manual calculations, 75% considered them safer, and all said they trusted them after just 2 uses. In addition, no calculations errors were seen following the Smart Agent system use, but 20 did occur when manually calculating insulin dosage.

Weight Loss Seen With Semaglutide Plus Endoscopic Sleeve Gastroplasty

Results from a double-blind randomized study presented at Digestive Disease Week 2021 lay out the benefits of pairing minimally invasive endoscopic sleeve gastroplasty (ESG) with semaglutide, an incretin mimetic. Already known to stimulate weight loss, when paired with ESG, semaglutide resulted in greater results for the study group vs those who received a placebo in look-alike injector pens.

Patients in the semaglutide vs the placebo group lost more total body weight (26.7% vs 19.6%), more of their excess body weight to reach normal body mass index (BMI; 86.3% vs 60.4%), and more body fat (12.7% vs 9.0%), according to Pharmacy Times^®. Glycated hemoglobin levels also dropped by 0.95 compared with 0.61 in the control group. None of the patients in the study were candidates for invasive weight loss surgery.

Additional benefits of ESG include that it is possible at an earlier disease stage and lower BMI, whereas the invasive weight loss surgeries have strict requirements of BMIs of 35 kg/m2 plus comorbidities or a BMI above 40 kg/m2.

Higher Risk of Diabetes Seen Among Asian Americans

Two government agencies recently released their findings on a higher risk of diabetes among Asian Americans, reports Pharmacy Times®. In addition to the Census Bureau noting that Asian Americans have a higher risk of diabetes, HHS’s Office of Minority Health said they have a 40% greater chance of receiving a diabetes diagnosis compared with non-Hispanic Whites.

Possible causes for these higher risks include barrier to equitable health care, such as cultural and language differences and attitudes towards the Western health care system. Native Hawaiians themselves are twice as likely to be obese vs Whites while facing higher rates of diabetes.

Solutions to start to close the health disparity gap include: (1) expanding studies to investigate outcomes among more subgroups placed under the Asian American collective label than those typically studied (eg, individuals with Cambodian, Chinese, Filipino, Hmong, or Japanese heritage) and (2) educating interdisciplinary care teams about cultural competencies.