Health Plus
September 13, 2019

​Dr. Shichun Bao, Associate Professor of Medicine and Diabetes Technology Program Leader in the Endocrinology Divison of the Eskind Diabetes Clinic, shares information on the amazing technological advances in diabetes treatment and blood sugar management.

Begin Transcript

Bridgette Butler:  Welcome to this edition of the Vanderbilt Health and Wellness wellcast.  I am Bridgette Butler with Health Plus.  Diabetes technology is a rapidly expanding area.  Here to speak with us about the exciting technological advances in diabetes treatment and blood sugar management is Dr. Shichun Bao, Associate Professor of Medicine and Diabetes Technology Program Leader in the Vanderbilt Endocrinology Division in the Eskind Diabetes Clinic.  Welcome, Dr. Bao.
 
Dr. Shichun Bao:  Thanks for having me.
 
Bridgette Butler:  Dr. Bao, to start, what is diabetes?
 
Dr. Shichun Bao:  Diabetes is a disease in which our body's ability to produce or respond to insulin is impaired, resulting in abnormal carbohydrate metabolism, therefore leading to elevated glucose in our blood and urine, and there are two main categories of diabetes, as you know - type 1 and type 2.  Type 1 is due to impaired insulin production from our pancreas, which usually has juvenile onset and the treatment is insulin, versus type 2, the main type of diabetes, usually adult onset, which accounts for about 80% to 90% of diabetes is due to the body's utilizing insulin capability being impaired.  It is the terminology called "insulin resistance," and it can be treated with oral medication.  Of course, late stage may also need to be treated with insulin.
 
Bridgette Butler:  How can technology be used to help patients and providers manage diabetes?
 
Dr. Shichun Bao:  Diabetes technology is a really expanding arena, and over the past two to three years, the FDA has approved multiple new diabetes technology devices that can help patients track their sugar easier without a finger stick and track their insulin administration and also help regulate the insulin administration much better as well as the data sharing.  All that is just very exciting.
 
Bridgette Butler:  Is that technology used more for type 1 diabetes or type 2 diabetes, or both?
 
Dr. Shichun Bao:  Perhaps more in type 1 diabetes.  We are talking about those new insulin pumps, what we call a "hybrid closed-loop system," or artificial pancreas, that uses a sensor or continuous glucose monitoring and augmented pump that the sugar can be monitored every five minutes throughout the day and night without the needle fingerstick and the pump can use the data and automatically adjust insulin delivery.  So, that is more for type 1, but the continuous glucose monitoring can definitely be used both in type 1 and type 2 or any type of diabetes, although some insurances will require the patient be on insulin to approve it because of the cost, I guess.  There are also smart insulin pens and, you know those apps, and Bluetooth glucose meters.  Every aspect of technology is really just booming.
 
Bridgette Butler:  What are some of the newest technologies being used to manage diabetes?
 
Dr. Shichun Bao:  The main newest technologies are new insulin pumps, as we just mentioned those sensory-augmented pumps that auto regulate insulin delivery as your glucose level changes.  When sugar is high, it will automatically deliver more insulin.  When your sugar is lower, it will automatically slow down insulin delivery or even shut off insulin when your sugar is very low.  So, the benefit of using this to really minimize the super high or super low glucose by auto regulation, and these are the insulin pumps.  There is also continuous glucose monitoring without the fingerstick.  Your sugar can be monitored every five minutes throughout the day and the night, and the data can be shared with your provider, with your family, friends, at your preference, and then the next category would be the smart insulin pen, which can also track your sugar, track your insulin delivery, and kind of alert you - oh, it's time to change your insulin cartridge, and kind of like that, and then of course, these apps and the software can help all the data connect together and share with the provider and the family and loved ones.
 
Bridgette Butler:  That is incredible.  So, it is not only managing the blood sugar but it is also alerting you and sharing information where you want it to be shared and coordinating a lot of important information.
 
Dr. Shichun Bao:  Exactly, exactly, yeah.
 
Bridgette Butler:  That's great.  Which types of technology require a prescription order from, say, my healthcare provider in order to use them?
 
Dr. Shichun Bao:  The majority of technology does require a prescription.  We are talking about insulin pumps, continuous glucose monitoring, smart insulin pens ... those all require a prescription, mainly for safety and education purpose.  There are some devices, like those Bluetooth-enabled-enabled glucose meters, that you can purchase without a prescription, available at Amazon and others, you know, WalMart, but the majority of those do require a prescription, and we have a technology clinic at our Eskind Diabetes Center that can help a patient to choose what is the best device for them and then we help, you know, educate them, train them, and help them monitor the data and do a lot of things.
 
Bridgette Butler:  That's a wonderful service.
 
Dr. Shichun Bao:  Yes.
 
Bridgette Butler:  Thank you so much for speaking with us today about what are some very exciting technology advancements in diabetes and blood sugar management.
 
Dr. Shichun Bao:  My pleasure.  Thanks so much.
 
Bridgette Butler:  Thanks for listening.  If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the "Contact Us" page on our website at www.vumc.org/health-wellness.