New Way to Monitor Overnight Glucose in Type 1 Diabetes
A new way to monitor overnight glucose levels in people with type 1 diabetes to help avoid hypoglycemic episodes and seizures has been developed. In the near future, people with type 1 diabetes may be able to get a better night’s sleep and feel safer throughout the night.
If you are the parent of a child with type 1 diabetes, you may be getting up several times a night to check on your son’s or daughter’s blood sugar levels. If you are an adult with type 1 diabetes, significant drops in overnight blood sugar levels are a concern as well. One major hazard is the risk of diabetic seizures, 75 percent of which occur during the night when blood sugar levels drop too low and are not detected.
Help may be on the way. A Stanford University School of Medicine study, published in Diabetes Care, reports that use of a new glucose sensor (Medtronic Inc) that is implanted under the skin and coupled with an insulin pump can significantly prevent potentially lethal hypoglycemic episodes overnight.
In the trial, 45 individuals (ages 15-45 years) with type 1 diabetes who used an insulin pump were fitted with the under-the-skin glucose sensor. The sensor and pump were connected wirelessly to a bedside computer that was programmed to temporarily stop the delivery of insulin when the individual’s blood sugar level dropped lower than 80 ml/dl. The subjects participated for about 42 nights, stayed in their own homes, and never knew on which the nights the program was active and when it was not, as this was randomly chosen by the computer program.
Here are some highlights of the study:
- The process did not wake the patients
- The temporary shut-down of insulin delivery reduced the total time that patients spent with low blood glucose while asleep by 81 percent
- Nighttime glucose levels showed only a minimal increase with use of the new sensor, but levels were still within a safe range in nearly every case
- In only 9 of 977 (0.9%) intervention mornings, fasting blood sugar levels were 300 mg/dL or higher
- The system shut down the insulin pumps at least once during 76 percent of the treatment nights
Previous study of a glucose sensor
The New England Journal of Medicine published a report last year on the results after using the Medtronic sensor along with an insulin pump in individuals with type 1 diabetes. Participants were randomly assigned to wear the sensor (121) or not (126) for three months.
That study also yielded impressive results. For example, individuals who used the new glucose sensor and pump combination had nearly 32 percent fewer hypoglycemic episodes during the night and day than patients who did not have the sensor. In addition, similar to the newer study, use of the new technology did not have an impact on blood sugar levels between the two groups of patients.
The newer study’s authors are continuing their research and using a larger population of patients, including children as young as 3 years old. Since type 1 diabetes is especially challenging for young children and their parents, availability of this new way to monitor blood glucose will be most welcome.
Beck RW et al. Frequency or morning ketosis after overnight insulin suspension using an automated nocturnal predictive low glucose suspend system. Diabetes Care 2014 May; 37:1224-29