Artificial system

‘artificial pancreas’ may help children with type 1 diabetes | Health, Medicine and Fitness

Amy Norton

THURSDAY, Jan. 20, 2022 (HealthDay News) — Having a child with type 1 diabetes can be a difficult health issue for parents to manage, but new research suggests an “artificial pancreas” system could beat the treatment. standard for controlling blood sugar disease in young children.

Forms of the technology – which automatically monitors and regulates blood sugar levels – are already available for adults and children with type 1 diabetes. The systems have been shown to improve blood sugar control and make life easier for people with of the disease.

Until recently, most research on artificial pancreas systems has focused on adults or older children, although one system is approved in the United States for children ages 2 to 6.

The new study, published on January 20 in the New England Journal of Medicineadds to the evidence that the technology is safe for toddlers and preschoolers – and can better control their illness.

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Type 1 diabetes is much less common than type 2 diabetes, which typically strikes in adulthood and is often associated with obesity.

The type 1 form is caused by a misguided attack by the immune system on the body’s insulin-producing cells. Insulin is a hormone that regulates blood sugar, and people with type 1 diabetes need to take synthetic insulin daily.

Traditionally, this meant taking several “finger pricks” each day to measure blood sugar, then injecting the correct amount of insulin.

Some advances have made it easier: instead of injections, people can opt for a “pump” that delivers doses of insulin throughout the day through a small tube just under the skin. And an alternative to finger pricks is the continuous glucometer – a device that tracks blood sugar around the clock, via a sensor placed under the skin.

Even with these technologies, however, managing type 1 diabetes remains daunting, especially in young children, experts said.

Parents still need to calculate how much insulin the pump should deliver and make frequent changes, day and night, said lead researcher Dr Julia Ware.

The artificial pancreas – also called a closed-loop hybrid system – connects the insulin pump and the glucose monitor into a single automated system. The man in the middle is a computer algorithm that analyzes glucose readings from the monitor and automatically adjusts insulin doses from the pump.

“This automation greatly reduces the burden on parents, especially at night,” said Ware, of the Wellcome Trust-MRC Institute of Metabolic Science at the University of Cambridge, England.

This point was echoed by Sanjoy Dutta, vice president of research for the nonprofit JDRF (formerly Juvenile Diabetes Research Foundation), which helped fund the study.

“Now parents can sleep through the night,” Dutta said.

Beyond that, better blood sugar control from an early age is key, he added. Over the years, chronically high blood sugar can damage blood vessels and nerves throughout the body. Better control can reduce the risk of long-term complications like heart, kidney and eye disease, Dutta said.

Extremes in blood sugar – very high or very low – can also cause immediate problems with thinking, attention and other mental abilities. And young children are especially vulnerable to this, said Dr. Meredith Wilkes, medical director of the Pediatric Diabetes Center at Mount Sinai, New York.

Wilkes, who was not involved in the trial, agreed that managing diabetes in young children is particularly difficult: they often cannot feel the symptoms of blood sugar extremes and rely on their parents and other caregivers. for monitoring.

“The hope is that new technologies, especially artificial pancreas systems, will not only improve [diabetes] control, but also make management easier for caregivers,” Wilkes said.

The new trial included 74 children aged 2 to 7 years. Each spent 16 weeks using a traditional glucometer and insulin pump, and 16 weeks using an artificial pancreas system developed by the Cambridge researchers.

On average, the study found that the children spent around 72% of the day in a normal blood sugar range when using the artificial pancreas, just over two hours longer than the standard treatment.

The system also reduced instances of very high blood sugar, without increasing potentially dangerous blood sugar drops.

“Right now, closed-loop hybrid systems are the best treatment we have,” Dutta said.

In the United States, Medtronic’s MiniMed 770G is approved for children as young as 2 years old. And other systems are being studied in very young children, Dutta noted.

The technology is not cheap and there is an ongoing cost of glucose monitor and pump supplies. Even with insurance coverage, Dutta noted, cost can be a barrier for some families.

The US National Institute of Diabetes and Digestive and Kidney Diseases has more on artificial pancreas systems.

SOURCES: Julia Ware, MD, clinical research associate, Institute of Metabolic Sciences, University of Cambridge, UK; Sanjoy Dutta, PhD, vice president, research, JDRF, New York; Meredith Wilkes, MD, medical director, Pediatric Diabetes Center, Icahn School of Medicine at Mount Sinai, New York City; New England Journal of MedicineJanuary 20, 2022

This article was originally published on Content Exchange