Better Care for Type 1 Diabetes Patients

Insulin pumps with blood sugar sensors might reduce the frequency of low blood sugar events

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Patients with type 1 diabetes must constantly monitor their blood sugar to make sure it isn't too high or too low. Sometimes, though, even the most attentive patients can experience low blood sugar, especially when they are sleeping.

A new study looked at whether an insulin pump with a blood sugar sensor could prevent incidents of severe and moderate low blood sugar, which can be a serious health problem for people with type 1 diabetes.

The study found that people who used insulin pumps with sensors were less likely to have dangerously low blood sugar compared to people who used normal insulin pumps.

According to the researchers, this study showed that insulin pumps with alerts and sensors could help prevent incidences of low blood sugar, especially in young patients who may be less aware of their blood sugar level.

"Keep a close eye on your blood sugar if you have type 1 diabetes."

Trang Ly, MBBS, DCH, FRACP, of the Princess Margaret Hospital for Children, led this study to see if an insulin pump with a sensor could prevent hypoglycemia in diabetes patients.

For patients with type 1 diabetes, hypoglycemia, or low blood sugar, is a serious concern. Type 1 diabetes prevents the body from producing enough insulin, which regulates blood sugar and the metabolism. Without enough supplemented insulin, a diabetes patient can experience high blood sugar.

Many type 1 diabetes patients use an insulin pump, or a device that automatically delivers insulin to the body, in order to regulate their blood sugar levels. However, in some cases, the amount of insulin dispensed is too much given the patient's current blood sugar level.

When diabetes patients receive too much insulin, their blood sugar can fall too low. Low blood sugar can prevent the brain from functioning normally and lead to seizures and unconsciousness.

This study sought to find out if an insulin pump with a blood sugar sensor would reduce the number of hypoglycemic incidents in diabetes patients.

The new pump involved in the trial tested the wearer's blood sugar level before delivering insulin, and if the wearer's blood sugar was already low, the pump would emit an alarm. If the patient did not respond to the alarm, insulin would be suspended for two hours.

To test the pump, the researchers used 95 participants who had been diagnosed with type 1 diabetes at least one year prior and used insulin pumps.

On average, the patients were 18 years old and had been using an insulin pump for four years. The researchers also used a questionnaire to ensure that each of the patients had relatively low awareness of hypoglycemia.

A total of 49 patients were assigned to use a normal pump without a sensor, and 46 used the pump with the blood sugar sensor.

The patients attended a screening visit three times during the study: three months before receiving the pump and three and six months after. During these visits, the researchers measured blood sugar from several previous days.

The researchers found that after six months of use, patients using the sensor pump had a significant reduction in moderate and severe hypoglycemia events compared to patients using the regular pump.

Patients using the normal pump experienced 34.2 moderate to severe blood sugar events per 100 patient-months, while patients with the sensor pump experienced only 9.5 incidences per 100 patient-months.

The reduction was especially significant for patients younger than 12 years old, who may be particularly unaware of their blood sugar levels.

Additionally, the study found that patients with the sensor pumps had many fewer hypoglycemic events at night, when they most frequently happen among children.

The researchers concluded that in this study, automated insulin pumps with blood sugar sensors helped to reduce the rate of severe and moderate hypoglycemic events for diabetes patients.

"Insulin pumps with sensors seem to help patients with type 1 diabetes to better control their blood sugar levels, and possibly assist in reaching A1c target goals  (the average of on-going blood sugar measurements for the last 2 to 3 months)," Govind Koka, DO, Co-Medical Director of Advanced Urgent Care in Las Vegas, Nevada, told dailyRx News. "This results in not only better day-to-day control, but also reduces the potential of long-term complications from diabetes." 

They noted, however, that a pump with an alarm is not sufficient to avoid all hypoglycemic events, and awareness on behalf of the patient is also necessary.

In an editorial accompanying the article, Pratik Choudhary, MBBS, MRCP, MD, wrote that this and other studies "...demonstrate the ability of sensor-augmented insulin pumps with threshold suspension function to provide a significant reduction in severe hypoglycemia."

This study was published in JAMA on September 24.

The research was funded by the Juvenile Diabetes Research Foundation and Medtronic. One of the authors disclosed that he was supported by the Juvenile Diabetes Research Foundation. Another author received honoraria for lectures from Medtronic and other pharmaceutical companies.

Review Date: 
September 24, 2013
Last Updated:
September 25, 2013