Smart pump will save diabetics from coma

Insulin pump of a new generation reduces the risk of hypoglycemic coma in diabetics

The threshold sensor, which supplied the insulin pump, allows in the case of low glucose to suspend the flow of insulin. The first message about the successful use of such a system was made by American scientists.

Type I diabetes mellitus is characterized by high blood glucose levels, and patients need constant insulin injection to control it. But if the dosage of insulin is exceeded or the supply of carbohydrates is exhausted in the body (this happens, for example, because the person forgot to eat), hypoglycemia develops – the glucose level decreases too much.

This condition is dangerous primarily for the brain, its complication is hypoglycemic coma.

Therefore, people with diabetes, despite the diet, have to carry with them a piece of candy, which may be necessary if the glucose level is too low. Especially dangerous night hypoglycemia, which develops during sleep. The situation is complicated by the fact that a sleeping person is not able to take active steps to avoid coma.

An insulin pump — a computerized device no larger than a cell phone — is a convenient, but not expensive, alternative to tedious insulin injections. It can automatically supply the body of a person suffering from diabetes with a microdose of the drug. On the one hand, it makes everyday life easier and reduces the risk of complications of the disease (such as loss of vision, kidney damage, and even amputation). A person can care less about when to eat food and in what quantity. He can go to bed late without worrying about having forgotten to inject insulin. But the insulin pump does not work by itself: you need to check the blood sugar level several times a day using a glucometer and calculate additional doses of insulin taking into account what you eat (carbohydrates).

Not so long ago, insulin pumps with an integrated system for continuous monitoring of glucose, comparable in effectiveness to a conventional glucometer, appeared on the market . However, the report that was made on   73rd Scientific Session of the American Diabetes Association in Chicago   Medtronic scientists of the company – is   The first message about the successful use of a system that can not only measure, but also act – in the case of a low glucose level, suspend insulin delivery.

When the sensor detects a low glucose level, the integrated system automatically stops insulin delivery for two hours.

A person does not have long-term complications caused by this condition, as can be judged by the HbA1c test. The level of glycated hemoglobin HbA1C is an important indicator characterizing the average blood sugar level over a period of 2-3 months.

A new insulin pump was tested on 247 patients with type I diabetes suffering from nocturnal hypoglycemia. The study lasted three months, the participants in the experiment were selected at random. For three months, scientists measured and calculated HbA1C. The duration and intensity of nocturnal hypoglycemia in a number of quantitative parameters in the subjects was 37.5% lower than in the control group. For those who used a pump equipped with a sensor, the total number of hypoglycemic states (day and day) decreased by 31.4%. HbA1C remained unchanged in both groups. There were no serious adverse events associated with the disease among the subjects. The results of the study were the other day   published in New England Journal of Medicine

The developers believe that this is an important step towards the development of a fully automated artificial pancreas for people whose lifestyle diabetes makes significant adjustments. At the same time, the US Food and Drug Administration (FDA) has not yet allowed mass use of this system. The FDA does not approve the use of insulin pumps with automatic disabling functions until a large, carefully controlled study is conducted that demonstrates their complete safety. Since diabetes, despite an active research interest in many laboratories in the world, is a condition that has not yet been sufficiently studied and is accompanied by serious complications associated with both low and high blood glucose levels.

A few years ago, in the US, it was necessary to quickly stop a study in which, due to attempts to push diabetics to reduce HbA1C below 6% with medications and lifestyle changes, the risk of death among them increased by 22% compared with those were treated according to the standard scheme.

In Europe, are similar developments. For example, the British firm Cambridge Consultants in partnership with the Institute for Metabolism at Addenbrooke Hospital in Cambridge   came up with a similar system, but more cumbersome (consisting of several devices). The glucose level is measured using a sensor implanted under the skin.

A continuous blood glucose meter can not only measure glucose levels every 1–5 minutes, but also transmit messages via Bluetooth autonomously to a smartphone or tablet.

Here, the signal is algorithmically processed by a special program, which, based on the measurement result, calculates the amount of insulin needed for the injection, and sends this information to the insulin pump. The pump, receiving a signal via Bluetooth from the computer, automatically enters the required amount of insulin. Scientists believe that such an artificial pancreas, as well as the development of American scientists, will allow patients with type 1 diabetes to feel more independent. These devices have already been tested in the clinic and at home, but, according to experts, it takes a longer period of time to make final conclusions about their effectiveness.

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