SUNDAY, June 27 (HealthDay News) -- New research suggests that
artificial pancreas technology can help diabetics gain greater
blood sugar control overnight, even when they have eaten a big meal
or had wine for dinner.
The promise of this emerging technology is to free diabetics
from the need to constantly monitor their blood sugar levels by
letting a computer program do the job -- constantly adjusting
glucose and insulin levels as needed. Using this technology is
still seen as a stopgap, however, while a biological solution to
diabetes is sought.
"We have pioneered the development of a closed-loop artificial pancreas because we believe it will significantly impact the lives of individuals with both type 1 and type 2 diabetes, by providing exquisite control of blood sugar," Dr. Richard A. Insel, executive vice president for research at the Juvenile Diabetes Research Foundation (JDRF), said during a noon teleconference Saturday.
A symposium on advances in the technology -- co-sponsored by the
American Diabetes Association and the JDRF -- is slated for Sunday
as part of the American Diabetes Association's annual meeting, in
For people with type 1 diabetes, controlling their blood sugar
levels is a full-time job. Too much insulin can cause low blood
sugar (hypoglycemia), which can be life-threatening, while too
little causes the serious damage of diabetes such as kidney, vision
and circulation problems.
"The promise in the near term of these technologies is not only to help us reduce significantly the risk of long-term diabetic complications, but also to reduce the risk of having a catastrophic hypoglycemic event, and further help people with diabetes live easier," Aaron Kowalski, research director of the JDRF's Artificial Pancreas Project, said during the teleconference.
"This will help keep people healthy while we drive toward a biological approach, which will take longer," he said.
In the first report, Dr. Roman Hovorka, a principal research
associate in the department of pediatrics at the University of
Cambridge, reported that the technology can significantly improve
overnight blood sugar control in adults without the fear of
developing hypoglycemia. With the technology, patients maintained
their blood sugar levels within the target range for 70 percent of
the time, compared to 47 percent of the time among those not using
Moreover, glucose control was demonstrated in real-life
situations such as after a large meal and having a glass of white
"We let them consume about three-quarters of a bottle of wine to simulate what happens after a large meal," Hovorka said during Saturday's teleconference. "What has been shown is that drinking alcohol in the evening causes hypoglycemia early in the morning."
These results were similar to findings in children where the
system extended the amount of time spent at target blood sugar
levels, he added. "We reduced hypoglycemia by half," he said.
"Our plan is to move into home studies, which hopefully will happen later on this year," Hovorka said.
Meanwhile, Marilyn Ritholz, a senior psychologist at the Joslin
Diabetes Center and an assistant professor of psychology at the
Harvard Medical School, reported on a study on psychological
barriers to continuous blood sugar monitoring.
"So far, studies have not shown which factors predict which factors are associated with successful or unsuccessful continuous glucose monitoring [CGM]," she said during the teleconference.
Ritholz's team found that people who were better at coping with
the frustration of using the device were more successful at keeping
their blood sugar under control.
Frustrations included warning alarms and problems at the
insertion point of the device. "We found that the people who did
well used a more problem-solving approach and persisted in trying
to learn how to use the CGM," she said.
People who were not successful used "emotion-based coping,"
Ritholz said. "They easily became overwhelmed and they just gave
In addition, successful people had more involvement and support
from their spouse or "significant other," she added. All patients
felt self-conscious wearing the device, Ritholz noted.
"We know that CGM success or failure is as dependent on the human experience as it is on the perfection of the technology," she said.
Speaking at the Saturday teleconference, Dr. William Tamborlane,
chief of pediatric endocrinology at Yale University School of
Medicine and co-chair of the Juvenile Diabetes Research
Foundation's Continuous Glucose Monitoring Group, said the system
only works if worn almost every day.
Studies have shown that children and adults over 25 who used CGM
were able to reduce their blood sugar levels. However, teenagers
did not see a benefit, probably because they were less likely to
wear the device, Tamborlane said.
People who used the device more than six days per week saw
improvement, regardless of age, he added.
To get more people to use CGM, "the industry needs to come up
with better systems and better devices," he said.
Artificial pancreas technology combines CGM with an insulin pump
and a sophisticated computer program that controls when and how
much insulin to deliver.
The device delivers two hormones that are deficient in type 1
diabetes -- insulin, which keeps blood sugar levels from going too
high after a meal, and glucagon, a naturally occurring hormone that
prevents blood sugar levels from dropping too low.
However, the complicated computer algorithm for the pump system
is still being developed.
For more information on type 1 diabetes, visit the
American Diabetes Association.