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Note on Technology-Internet

There are changes ahead

One of my favorite quotes is by Bill Gates: “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be lulled into inaction”. Continuous glucose monitors (CGMs) first appeared about 10 years ago, and the first two years certainly did not meet the hype that accompanied their introduction. This disappointment was mainly due to lack of accuracy, as well as discomfort with use, and probably a lack of experience in how to use them. But the industry kept producing incremental improvements over the ensuing ten years, and the last several years have shown how these more accurate monitors can be successfully coupled with insulin (and sometimes insulin-glucagon) pumps to achieve a type of artificial pancreas. The most encouraging aspect of these exciting new clinical trials is that there are not just one or two groups achieving success, but a number of different groups worldwide. Adoption may be slow during the next two years, but the next ten years will see the increasing spread of this technology in type 1 diabetes, along with an gradual extension to people with type 2 diabetes. We should be ready for a lot more action!

Full-text of one real world trial, released today, and the accompanying editorial.

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