DiSH-MT: Automated Insulin Delivery Systems go to School

Carla Cox, PhD, RDN, CDCES, CPT gave us a practical overview of the automated insulin delivery (AID) systems out today including some of the nuances, bells and whistles, and hiccups of each. We discussed how this technology should be available to all children diagnosed with diabetes and also that the backup approach – insulin via injections, and glucose from a glucometer, is still needed if/when technology fails. She shared great accounts of working with youth at camps, adventures, and other activities throughout her career and the world. Throughout her talk and discussion, her passion for making life with diabetes fulfilling and joyful was contagious.

Automated insulin delivery systems (AIDs) on the market today include Tandem TSlim and Mobi, Medtronic 780, Omnipod5, iLet, and DIY looping systems. All have some form of algorithm that allows the pump to deliver insulin to some extent based on continuous glucose monitor (CGM) sugar values.
The goal of improving diabetes technology and care for students with diabetes includes making sure they can live the life they want – they can do anything and be anything when they grow up (except for being in the military).
Hypoglycemia treatment on an AID is different – since the AID will be decreasing insulin delivered, the carb treatment doesn’t have to be a full 15 grams. Can start with a couple of glucose tabs or 5-10 grams of fast-acting carbs.
Camps are a fantastic way to learn about diabetes – not just for kids with diabetes, GREAT for anyone who cares for a child with diabetes! More than MYDA, there are a ton of great opportunities around the country.

Most AIDs have an exercise mode – this can be used 1-2 hours ahead of PE/exercise/sports or really any environment or activity when a student is at higher risk for low blood sugars. At camp or school, they may actually be used a lot!
If you are being asked to follow CGM data on a student with diabetes, and that is practical in your school setting, it is helpful to talk with your school administration, families, and diabetes clinic(s) for guidance on how to do this safely and reasonably. It’s worth ensuring a clear understanding that you are NOT responsible for following this child’s care outside school/work hours, etc.
You can always revert to insulin injections, blood glucose meters, and glucose tabs and keep students safe.
If you have a student who you think should have access to CGM or AIDs, and doesn’t, reach out to their clinic to troubleshoot with nurses/social workers.