Insulin study could lead to new dosage devices

February 8, 2010, 4:04pm

The results of a new study on managing juvenile diabetes may give hope to millions of parents in this country and abroad who typically wake up several times a night to make sure their children’s blood sugar levels have not dropped into the danger zone. Researchers are trying to pair such systems with automated glucose testing.

And the research, published Friday in The Lancet, a British medical journal, could help spur medical device companies to more quickly develop technology based on the study’s underlying concept.

The study reported that a novel computer algorithm that analyzed children’s glucose levels and recommended frequent adjustments in their insulin doses was better at preventing very low glucose overnight than a standard diabetes management system.

That standard system involved a continuous glucose monitor that operated separately from a preprogrammed insulin pump — an approach now used by many of the estimated three million people nationwide who have Type 1 diabetes. Type 1 diabetes, also known as juvenile diabetes, is a disease that often develops early in life and is separate from Type 2 diabetes, which often stems from obesity.

Very low glucose, called hypoglycemia, is a condition that poses risks for people with either form of diabetes, potentially causing shakiness, dizziness, seizures, coma or even death. But it is a particular concern among children on insulin because their blood sugar levels tend to fluctuate more widely, researchers said.

No children in the study who were treated with the computer-assisted system experienced very low blood sugar overnight. But there were nine instances of very low blood sugar among children who had the standard treatment, according to the study, conducted by researchers in Britain at the University of Cambridge.

“This is an important step in diabetes control because it shows that, with this system, people can sleep safely with minimized risk of hypoglycemia,” said Dr. Eric Renard, a professor of diabetology at Montpellier University Hospital in Montpellier, France.

Dr. Renard, whose commentary accompanied the study in The Lancet, has been a consultant and speaker for several makers of diabetic products, he said.

Industry analysts have estimated that 10 to 15 percent of Americans with Type 1 diabetes — perhaps 400,000 of them — use either a continuous glucose monitor or an insulin pump, or in some cases both.

Over the last decade, the makers of medical devices have developed techniques that have widened diabetes management options beyond pricking the finger several times a day to test blood glucose levels. Companies like DexCom in San Diego now make small continuous glucose monitors whose sensors can be embedded in the skin. And Animas, a division of Johnson & Johnson, makes programmable pumps the size of a cellphone that administer insulin doses through a tiny implantable catheter. (NYT)

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