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 The experimental system linked to an implanted
monitor may help people with type 1 diabetes avoid nighttime
seizures and other complications brought on by prolonged periods of
low blood glucose, or hypoglycemia, according to the study’s lead
author.
“The goal of this study was to have the system work in the
background, without generating unnecessary alarm, so people can get
a good night’s sleep and not be at risk for prolonged low blood
glucose,” Dr. Bruce Buckingham, one of the study's authors, said.
Buckingham is a specialist in pediatric endocrinology at the
Stanford University School of Medicine in Stanford, California.
The system wirelessly connects through a bedside computer to a blood
sugar monitor implanted under the skin and a wearable insulin
delivery pump. The program analyzes data from the monitor and shuts
off the insulin pump when it predicts that a person’s blood sugar is
going to dip too low.
Type 1 diabetes, previously known as juvenile diabetes, typically
strikes children whose immune systems have killed off
insulin-producing cells in the pancreas. The body needs insulin to
remove sugar from the blood to use for energy.
Diabetics can control their blood sugar during the day by regulating
their insulin use and food intake. But at night, an automatic
insulin pump may drive blood sugar levels too low.
Buckingham and his colleagues write in Diabetes Care that past
research shows about 9 percent of people with type 1 diabetes
experience hypoglycemia at night.
The researchers recruited 45 people with diabetes between the ages
of 15 and 45 to use the system for 42 nights.
The system randomly selected half of the nights to run its
calculations and the other half to remain dormant for comparison.
The system shut off the insulin pump when it predicted that a
person’s blood sugar would fall below 80 milligrams per deciliter
(mg/dL) of blood in the next 30 minutes. A person starts to be at
risk from complications of low blood sugar at 60 mg/dL.
The pump was shut off until the person’s blood sugar began to rise.
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The researchers found that a blood sugar reading of 60 mg/dL was
recorded on 21 percent of the nights the system was active, compared
to 33 percent of the nights when it was dormant.
Overall, the researchers found the average time people spent with
low blood sugar was reduced by 81 percent during the nights the
system was active, compared to when it was inactive.
The participants’ blood sugar readings tended to be higher after
nights when the system was active, but did not reach dangerously
high levels, the researchers write.
“This technology can work,” Buckingham said. “It can decrease the
risk of having a prolonged low at night and there seems to be
minimal downside.”
He added that studies like this one are the first step toward
creating artificial pancreases, which would be able to reliably stop
and start delivering insulin around the clock.
“This is just demonstrating that if used properly . . . what they’re
able to do is prevent hypoglycemia, which is one of the two biggest
issues with diabetes safety,” Dr. Steven Willi told Reuters Health.
Willi, who was not involved in the new study, directs the Diabetes
Center for Children at The Children’s Hospital of Philadelphia.
“This is a ripe target, but it’s just a step along the road to
having a fully automated device,” he said.
SOURCE: http://bit.ly/Qm7cFx Diabetes Care, online May 7, 2014.
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