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Review on Communication Security Issues in IoT Medical Devices
Published in B.K. Tripathy, J. Anuradha, Internet of Things (IoT), 2017
R. Somasundaram, Mythili Thirugnanam
Wireless medical device usage in hospitals and other medical application areas have become common place. In this digital era, medical devices and RFID tags connected with Internet escalate new security vulnerabilities. In this section, we discuss the various incidents that have occurred with wireless medical devices in recent times. In the United States of America, there was a recommendation from Food and Drug Administration (FDA) (Alexandra 2015) that medical device manufacturers and health care facilities should ensure security against different kinds of attacks. The major reason behind these recommendations is the security vulnerability presented when using insulin pumps in the medical field. Insulin pumps are used to control and monitor the insulin level in patients. In order to operate the insulin pump, the doctor uses wireless devices like smart phone, smart watches, and personal digital assistant (PDAs). In case, an attacker observed the serial number of an insulin pump, then it is possible that the attacker can hack the control of the device from a few feet away. This scenario becomes worse when these kinds of devices are connected to the Internet. A few years back, Barnaby Jack a security researcher from McAfee (Dan 2011) hacked Medtronic insulin pumps on 25 October 2011 using a special software and antenna designed by Jack. This permitted him to find and seize overall control of any device around 300 feet of the antenna without knowing the serial number. In this context, the FDA has been working closely with other government organizations and device manufacturers to mitigate vulnerabilities and incidents. These incidents help create awareness in the secure usage of medical devices. In the next section, recent case studies are discussed.
Closed-loop insulin delivery: update on the state of the field and emerging technologies
Published in Expert Review of Medical Devices, 2022
Continuous subcutaneous insulin infusion (CSII) therapy is administered via insulin pumps, which are programmable, battery-operated devices with the ability to deliver rapid or ultra-rapid acting insulin into the subcutaneous tissue via teflon or steel catheters at pre-programmed rates with user-initiated meal-time boluses [39]. Insulin pumps are able to deliver very small amounts of insulin (as little as 0.01 units), enabling the user to give a bolus for small snacks without the need for additional injections, and allowing for greater dosing flexibility in the event of changing insulin sensitivity seen with exercise, illness or early morning insulin resistance [39]. A wide variety of pumps are commercially available, with tethered pumps using a separate cannula and tubing for insulin infusion in contrast to patch pumps, where infusion sets are embedded in the pump itself. Since the early 2000s insulin pump use has increased exponentially, and roughly 50% of people with type 1 diabetes in Germany and Austria and just over 60% in the USA are using pump therapy, with even higher numbers in the youngest age-groups [40]. Insulin pump use is associated with improvements in glycemic control compared to multiple daily injections [41], however management burden remains high.
MiniMed 670G hybrid closed loop artificial pancreas system for the treatment of type 1 diabetes mellitus: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2019
Aria Saunders, Laurel H. Messer, Gregory P. Forlenza
Treatment for T1D can be varied, but always requires continuous replacement of insulin. Multiple daily injections (MDI) is one way that insulin is given. A long-acting insulin dose given once or twice per day provides the background insulin necessary for cellular metabolism of glucose, while rapid-acting insulin is given for each meal to cover carbohydrate intake and correct elevated glucose values. Insulin pumps are another way to deliver exogenous insulin. Insulin pumps are small, external devices that continuously deliver small amounts of rapid-acting insulin and, therefore, replace the need for multiple daily needle injections. The insulin is contained in a reservoir and infused through a cannula that is placed in the subcutaneous tissue and secured with adhesive – creating what is referred to as an infusion site. Many insulin pumps contain tubing that connects the reservoir to the infusion site, while other pumps, called patch pumps, have no tubing, and sits directly on the skin. The infusion site is not surgically placed, and it must be removed and replaced every 3 days by the patient or a caregiver to prevent skin infection, lipohypertrophy, or scar tissue [4].
MiniMedTM780G Insulin pump system with smartphone connectivity for the treatment of type 1 diabetes: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Jennifer McVean, Joshua Miller
Insulin pump or Continuous subcutaneous insulin infusion (CSII) therapy has been available to individuals living with T1D since the 1980s [4]. Earliest advances in pump technology allowed many benefits over insulin injection therapy including the ability to customize basal infusion rates and meal boluses to mimic physiologic pancreatic insulin secretion more closely [5]. Over time, insulin pumps have continued to evolve with improvements in micro-dosing, user interface, shareable data and wear ability. Insulin pumps have also been shown to decrease the risk of severe hypoglycemia [6].