Researchers in the United States are testing easier ways for younger children with type 1 diabetes to get the doses of insulin they need using an artificial pancreas.
They are undertaking clinical trials of a closed loop system which modulates insulin delivery based on glucose sensor readings measured every five minutes which they believe could be an historic advance for young people with the conditions.
The system, commonly referred to as an artificial pancreas, works by wirelessly linking an insulin pump and a glucose monitor. While some of the testing and blood sugar adjustments can be made by the system, patients must still perform these tasks themselves prior to eating.
One person who is taking part in the study is Jamie Kurtzig from California who was diagnosed with type 1 diabetes at the age of 19 months. For the last 10 years her parents have woken up every three hours during the night to prick their daughter’s finger so they could check her blood glucose level.
If her blood glucose was too low, they gave her food to avoid seizures or a loss of consciousness. If it was too high, they gave her an insulin injection to bring the level down to a normal range.
But for the past year, they’ve been able to sleep through most nights. That’s because Jamie started using a hybrid closed loop insulin delivery system in 2016 as part of the clinical trial at Lucile Packard Children’s Hospital Stanford and Stanford University’s School of Medicine that is assessing the system’s use in children aged seven to 14.
‘When the system is in auto mode, it monitors my blood sugar every five minutes and keeps up the proper basal rate of insulin. Now I only have to check blood sugar four times a day. In the past, I had to check it a lot more, even up to 12 times a day,’ Jamie explained.
‘The closed loop system has completely changed our lives. It took me a month to trust it, but now I can go to bed at 11 pm and wake up at 6.30 am almost every day,’ said Jamie’s mother Sara.
Bruce Buckingham, professor of paediatric endocrinology who is directing the clinical trials, explained that patients can achieve very reliable and safe overnight glucose control, mitigating overnight highs and lows with minimal manual intervention
He pointed out that that the improved glucose control dramatically decreases the risk for overnight seizures and long term complications associated with type 1 diabetes.
‘We are not yet to the point where these systems have been tested in all age groups or where they truly mimic all functions of a human pancreas, so there is more work to do,’ added Buckingham.
Among the challenges the researchers are working on it that the current hybrid closed loop systems still require patients to assess the amount of food (carbohydrates) they are eating and to deliver an insulin dose through their pump before meals.
Buckingham and his team at Stanford continue to work toward improving the system. Their efforts include testing and adapting these devices for younger children as well as testing systems with different user interfaces and different methodologies that adjust for exercise and insulin delivery at meals.
Korey Hood, professor of paediatrics and of psychiatry and behavioural sciences at the Stanford School of Medicine, is also working on the study, investigating how to best help children and their families use these systems.
‘Part of our mission is to ensure that the system will be used properly by young patients, meaning that it has the desired impact on both a patient’s health and quality of life. To that end, we evaluate the user experience by administering surveys and focus groups, and then we use those responses to generate new strategies and solutions to help the closed loop system user,’ Hood said.
The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.