Insulin pump therapy plus glucose sensing for continuous glocose monitoring in children with type 1 diabetes: What will come next?

The first instrument that measured blood sugar “continuously” appeared 15 years ago. Since then, subcutaneous glycemic sensors have made it possible to obtain continuous blood glucose measurements, giving physicians or patients real-time pictures of the levels of sugar in the blood. The quality of the technology has substantially improved – in the measurement and interpretation of results – although much remains to be done, especially as regards the sensors’ accuracy and reliability. Some very important studies (RealTrend, Eurythmics, ONSET, SWITCH, STAR 3, INTERPRET) have confirmed that continuous glucose monitoring contributes added value to insulin therapy, especially when an insulin pump is used, to achieve therapeutic goals. For almost ten years now it has been possible to combine the pump with a blood glucose sensor, giving what is known as sensor-augmented insulin pump therapy. In the last two years, the findings from other studies have been published, with important updates on blood glucose monitoring implemented with automatic suspension of the insulin infusion as soon as a predetermined threshold is achieved (ASPIRE) or even in relation to the expectation that the threshold will soon be reached (PILGRIM).