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141 intervention by patients. The APSs work through a combination of insulin pump, with continuous glucose monitoring and algorithm-directed insulin pump delivery. The insulin pump is in constant communication with continuous glucose monitoring to obtain current blood glucose estimates, and insulin release is adjusted accordingly to maintain blood glucose within the target range. Details of all recent insulin dosing (both basal and bolus) are maintained by the insulin pump. Clinical trials published to date have demonstrated both improved glycemic outcomes and improved healthrelated quality of life outcomes while simultaneously reducing the burden of self-management.2-4 Ready-to-use APSs currently offered by industry are either still in development or very expensive. As a result, a do-it-yourself movement of APS (DIY APS) has emerged. The DIY community can support progress in this area and accelerate the development of commercial automated insulin delivery (closed-loop) systems. The currently available DIY loop software options include Loop, Open APS, Android APS, and others, which are hybrid closed-loop systems.5-7 These systems use an Insulin pump therapy is reimbursed in Poland for all individuals with type 1 diabetes (T1D) under the age of 26 and is becoming an increasingly popular method of insulin delivery for this population of patients. The Pump School Education Initiative by Diabetes Poland (Szkoła Pompowa Polskiego Towarzystwa Diabetologicznego) organizes advanced training for doctors who treat patients with continuous subcutaneous insulin infusion. People with T1D have to regularly monitor their glucose levels, using either a glucose meter or a continuous glucose sensor, and adjust their insulin dose as required. Recent data have demonstrated that only a minority of adults and youth with T1D in the United States meet American Diabetes Association goals for glycated hemoglobin A1c levels. 1 Diabetes technology, including systems of semiautomatic (hybrid) or automatic insulin delivery, called an artificial pancreas (AP), has made considerable progress over recent decades. AP systems (APSs) may be considered as a promising therapeutic option for people with diabetes, as they enable insulin pumps to automatically administer insulin with only a limited SPECIAL ARTICLE

polskie archiwum medycyny wewnętrznej

Utilization of do-it-yourself artificial pancreas systems in the management of patients with type 1 diabetes: a position statement of the Pump School Education Initiative by Diabetes Poland