Implantable, Continuous Sensor Reduced Glucose Fluctuations in Type 1 Diabetes

Main Category: Diabetes
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Article Date: 05 Mar 2004 - 0:00 PDT

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Adults with type 1 diabetes experienced decreased periods of high or low blood sugar when using a long-term implantable, continuous glucose sensor, according to a study in the March issue of the journal Diabetes Care. Researchers at the University of Colorado Health Sciences Center's Barbara Davis Center for Childhood Diabetes conducted this first study of the sensor and its affects on glucose excursions, or periods of hypo- or hyperglycemia.

The study showed that when participants observed data from the implanted continuous glucose monitor, they experienced 47 percent less time in hypoglycemia, a state of low or below normal blood sugar levels. The participants also spent 25 percent less time in hyperglycemic states, or states of high blood sugar.

Researchers believe this improvement in excursions from normal glucose levels is a direct result of the patients' ability to continuously see their glucose data.

'The availability of continuous glucose data allowed patients to predict hypo- or hyperglycemia and take necessary action by eating a snack or by taking additional insulin,' explained Dr. Satish Garg, a professor at the center and lead author of the study.

The sensor, made by privately held DexCom Inc. of San Diego, Calif., is about the size and shape of an AA battery. It was implanted for six months just under the skin in the abdomen of 15 adults with type 1 diabetes. The participants then used an externally-worn, pager-sized receiver that received wireless-transmitted information.

The sensor device was not only capable of providing study participants continuous glucose level data, but it could also provide auditory or vibratory alerts when glucose levels were high, or above 11.1 mmol/l (more than 200 mg/dl), or low, or below 5.6 mmol/l (less than 100 mg/dl).

For the first phase of the study, both the study participants and the doctors were blinded from the data, and the data was simply monitored and stored by the sensor.

For the second phase, the data was made available to the participants and their healthcare providers. During this time, the high and low blood sugar alerts were also activated.

During both periods, participants made changes to their insulin dosages or diets as needed. Participants also routinely checked their blood sugar using finger-stick glucose monitors to assure their implanted sensors were working correctly.

At the conclusion of this observation, the research team found the patients were more successful in maintaining normal sugar levels, or euglycemia, when they had continuous access to the data.

'This is particularly important because the biggest hurdle in diabetes management is that patients dislike poking themselves in the finger even more than giving themselves their injections,' Dr. Garg said.

'Doctors ask people with diabetes to monitor themselves as often as possible, and now this less painful and less stressful continuous monitoring seems to make their sugar management more successful. Also, continuous glucose data may make implementation of intensive diabetes management more acceptable.'

According to the Centers for Disease Control and Prevention, types 1 and 2 diabetes affects approximately 18.2 million individuals in the United States. It is estimated diabetes costs the United States $132 billion a year because of intensive treatment, education, monitoring, hospital stays and long-term complications.

The Barbara Davis Center is the largest center dedicated to type 1 diabetes in the United States, caring for more than 5,000 children and young adults with the disease from all over the world. The center is an important component of TrialNet, a major NIH initiative devoted to the prevention of type 1diabetes, and the NIH Immune Tolerance Network. The center is one of the most funded diabetes research centers in the country.

The University of Colorado Health Sciences Center is one of four campuses in the University of Colorado system. Located in Denver and Aurora, Colo., the center includes schools of medicine, nursing, pharmacy, and dentistry, a graduate school and a teaching hospital. For more information, visit the Web site at www.uchsc.edu.

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http://www.diabetesnews.com

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