A recent study used a computer algorithm that analyzed children’s blood glucose levels and recommended adjustments to their insulin doses while they were asleep.

The goal of this research, conducted by the University of Cambridge, was to monitor hypoglycemia [very low blood sugar] while children with Type 1 Juvenile Diabetes were sleeping.

The research stated no children who used the computer-assisted system experienced very low blood sugar overnight, while nine children using standard treatment experienced low blood sugar.

“Diabetes is a chronic disease and entails many aspects of the person’s life,” Denise Wilson, associate professor and nurse practitioner of the Mennonite College of Nursing, said. “Eating a healthy diet, getting exercise, having regular follow-up visits with a health care provider, monitoring blood sugars and taking medications properly are all important aspects of care.

“Those on insulin injections are usually checking their blood sugars at least four times a day. Normal fasting blood sugar [before eating in the morning] is 70 to 99, and less than 140 two hours after eating for people who do not have diabetes. These values are allowed to be a bit higher for persons with diabetes,” she explained.

“Hypoglycemia is most concerning if it occurs when the person is asleep and unaware of the problem. Having the ability to have continuous glucose monitoring connected to the insulin pump and the pump being able to automatically adjust based on the glucose readings would be the ideal way to avoid the hypoglycemia,” she said.

“It simulates the feedback mechanism which naturally occurs in the person who does not have diabetes … We also have to deal with trying to prevent complications of diabetes, such as heart attack, stroke, eye problems, kidney problems and nerve problems in the extremities.

“For Type 1 Diabetes, insulin is the treatment … whether that is delivered in multiple injections throughout the day or the use of the pump is a decision made between the person and their health care provider,” she said. “Type 2 Diabetes can be treated through diet and exercise alone, with oral medications and/or insulin.”

Though the study was successful in treating hypoglycemia during the night, it did not show benefits in diabetes control during the day.

“The main problem that I see is that the pump would not know the user’s intention regarding exercise and food intake and so could not make anticipatory adjustments, just reactionary adjustments once glucose levels rise. I assume that is why the study did not show a benefit during the daytime,” Linda Moorhead, staff physician at Student Health Services, said.

 “Although the insulin pump does a great job of providing the person with a continuous source of insulin, it still requires the person to make manual adjustments in the dosage based on glucose levels obtained via the glucose meter. For example, if the blood glucose level is high, the insulin dose can be increased; likewise if the glucose is low, the dose needs to be decreased,” Wilson said.

Historically, the treatment of diabetes has come a long way in the last 50 years, explained Moorhead.

“At some point prior to the 1970s there was the development of urine strips and Clinitest tablets for home use to determine how much glucose was in the urine. By the 1980s, home glucose monitoring had been developed, allowing diabetics to measure their own blood sugar, far superior than urine glucose for diabetes management,” she said.

“In the past 20 years these devices have been improved to be much smaller and easier to carry around, and are much faster, most now take about five seconds instead of the several minutes that the earlier ones required.

“The most recent technology involves glucose sensing devices and software to advise on insulin delivery doses based on the detected glucose levels. Closing the loop by letting the software and devices do all the work and not requiring any input by the user would be the ultimate ‘artificial pancreas.’

“Ultimately, I believe a biological treatment may be found to treat Type 1 Diabetics right after diagnosis to prevent the loss of the remaining functional insulin producing cells. This would help new diabetics but not established diabetics,” Moorhead said.