The use of technology to reduce hypoglycemia.

For children as well as adults with diabetes, hypoglycemia and the fear it generates limit attainment of glycemic targets. In this paper we discuss advances in technology that have the potential to prevent or limit exposure to hypoglycemia. Improvements in insulin delivery, different types of boluses and bolus advisors assisting patients in deciding doses, software data downloads to observe patterns and continuous glucose sensors with hypoglycemia alarms warning of impending hypoglycemia may all be able to reduce hypoglycemia burden and are now available for clinical use. Advances in the integration of continuous glucose monitoring and insulin pumps already allow automated suspension of insulin delivery during hypoglycemia to limit its severity and duration. Current developments include overnight and hybrid closed loop insulin delivery systems, dual hormone delivery and other modifications to existing therapies that offer the potential to reduce the risk of hypoglycemia for people with diabetes.