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New Idea!
New Idea!
I have been using insulin pumps and continuous glucose monitors (CGMs) since before I can remember. These technologies have dramatically improved my health and quality of life, so I wonder how beneficial these devices could become. Could they be as effective as a biological cure?
As I started asking myself these questions, my insulin pump malfunctioned, causing an accidental insulin overdose of 19 units, the equivalent of eating 25 pieces of toast. After that miserable night of ambulances, IVs, headaches, and vomit, I emerged with a new goal: to make sure no one dies from diabetes technology malfunctions.
My newest idea for combating this problem is using total daily insulin dose, insulin delivery frequency, and CGM data to detect irregular diabetes-related behaviors. With real-time CGM data sharing platforms, I want to help develop a system that notifies the patient’s support network of these unusual behaviors before any significant damage occurs. I proposed this idea to SURF Stanford Medicine, and now we are collaborating to learn about how this system might work.
Here are some diabetes-related presentations I am particularly proud of!
Conference on Democracy Presentation with Ruby
Here's a "braided essay" I wrote for my final Golden Gate assignment. It's about Lucile Packard Children's Hospital and my experiences there
Project update as of the end of 2021
How the Loop algorithm works
Helpful background information as of the beginning of my sophomore year
Diabetes and COVID as of the end of my junior year
* some information may no longer be accurate
Here are some of my favorite MARC science news presentations and STEM projects I have done this year (completely separate from my project). Enjoy!
Some interesting research papers & articles
CGMs reduce the risk of complications and death, are relatively cost-effective, and increase life expectancy and quality-adjusted life.
Fonda SJ, Graham C, Munakata J, Powers JM, Price D, Vigersky RA. The cost-effectiveness of real-time continuous glucose monitoring (RT-CGM) in type 2 diabetes. Journal of diabetes science and technology. 2016 Jul;10(4):898-904.
Insulin pumps cost $6,000 initially out of pocket (without insurance) plus $3,000 - $6,000 annually, accounting for a huge financial barrier for many Americans. The article also goes over the advantages and disadvantages of insulin pumps, pens, and syringes.
Cafasso J. Insulin Pumps, Pens, Syringes, and More [Internet]. Healthline. 2020. Available from: https://www.healthline.com/health/type-2-diabetes/insulin-prices-pumps-pens-syringes#insulin-pens
84% of people recommended CGM (n = 278) and 98% recommended their insulin pump (n = 985). Also, 84% of people were very or partly satisfied with their insulin pumps, 65% of CGM users reported less fear of hypoglycemia, and 80% of people were very or partly satisfied with CGM.
Walsh J, Roberts R, Weber D, Faber-Heinemann G, Heinemann L. Insulin pump and CGM usage in the United States and Germany: results of a real-world survey with 985 subjects. Journal of diabetes science and technology. 2015 Jun 12;9(5):1103-10.
In a comparison study assessing the main reasons behind not trying CGM, 55.3% and 39.5% cited high expenses and lack of insurance coverage as answers, respectively, demonstrating that the main reason for not trying CGM is cost-related (n = 1,348). Preference-related factors were also barriers, mainly the perceptions that the CGM would be uncomfortable (35.5%) and the idea of having a device attached to the body (27.6%). However, the main reasons for stopping CGM use are preference-related, with 16/21 of the items on the study’s list being preference-related (n = 1,348).
Engler R, Routh TL, Lucisano JY. Adoption barriers for continuous glucose monitoring and their potential reduction with a fully implanted system: results from patient preference surveys. Clinical Diabetes. 2018 Jan 1;36(1):50-8.
Only 14 states have Medicaid CGM coverage for both type 1 and type 2 diabetes, while 16 states have no coverage.
Yan K. Medicaid and CGM: Who's Covered? [Internet]. diaTribe. 2020. Available from: https://diatribe.org/medicaid-cgm
A study shows that youth are more likely to use insulin pumps in the first year after their diagnosis when they have private insurance (37% vs. 7%), have a household income > $100K (50% vs. 15%), and identify as non-Hispanic whites (36% vs. 11%) (n = 254 vs. 758)
Lin MH, Connor CG, Ruedy KJ, Beck RW, Kollman C, Buckingham B, Redondo MJ, Schatz D, Haro H, Lee JM, Tamborlane WV. Race, socioeconomic status, and treatment center are associated with insulin pump therapy in youth in the first year following diagnosis of type 1 diabetes. Diabetes technology & therapeutics. 2013 Nov 1;15(11):929-34.
Loop Observational Study: Evaluating Do-It Yourself (DIY) Automated Insulin Delivery
For existing versus new Loop users, respectively, 94% and 91% are white, 89% and 85% have ≥ Bachelor’s degree, the average A1cs are 6.3% and 6.8%, and 100% have type 1 diabetes (n = 266 vs. 607)
Lum J. Loop Observational Study: Evaluating Do-It Yourself (DIY) Automated Insulin Delivery. Presentation presented at; 2020; Madrid, Spain.
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