Consensus recommendations for the use of automated insulin delivery technologies in clinical practice

The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past 6 years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage

Measuring ecosystem function: consequences arising from variation in biomass-productivity relationships

Species diversity loss is expected to alter ecosystem function, but previous work has demonstrated inconsistent relationships between these two factors. Productivity is the most common measure of ecosystem function, but given the difficulty in measuring productivity, standing biomass or change in biomass are frequently used as proxy measures. A review of the recent ecosystem-function literature revealed that 93% of studies measure productivity as biomass, thereby assuming a strong positive relationship between these two variables. We tested this assumption by measuring biomass and productivity in seagrass beds in the Gulf of Mexico. We found that the relationship between standing biomass and productivity could be positive or negative, depending on site. Change in biomass over months inconsistently underestimated short-term productivity. The relationship between biomass and productivity may depend on plant age, successional stage, or site-specific rates of tissue loss to herbivory, senescence, or disturbance. Our results suggest that if biomass continues to be used as a measure of productivity without justification, highly productive communities that typically show little change in biomass, such as healthy climax communities, will not be interpreted as such. The conflicting results of previous studies investigating the relationship between diversity and productivity may be due to differences in the inherently variable relationship between biomass and productivity at different sites and scales.C.P. terHorst, and P. Mungui