DRC & Research News

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Could Insulin Management be Controlled with an App?

Determining the appropriate amount of insulin to administer in response to drops in blood sugar can be challenging, but it is something that individuals with type 1 diabetes must do daily in order to manage their health. If left untreated, low blood sugar (or hypoglycemia) can be potentially fatal.

A team of researchers and physicians at Oregon Health & Science University (OHSU) are looking to improve diabetes management through a new app called DailyDose. While there are similar types of apps that exist, what sets DailyDose apart is that has demonstrated statistically relevant outcomes through multiple clinical studies. The AI algorithm for the app was originally developed entirely through a mathematical simulator, but when real-world data was used, the recommendations generated by the app aligned with recommendations provided by physicians, or were still considered safe, more than 99% of the time. In addition, improved glucose control was achieved. This was determined after 100 weeks of testing conducted in four-week trials.

Each trial involved 16 patients with type 1 diabetes and combined information from a continuous glucose monitor or wireless insulin pen with the app. Nearly 68% of the time, the recommendations generated agreed with those of physicians.

These findings are important because they show that the app may be effective in supporting individuals with type 1 diabetes in reducing risk of hypoglycemia by better managing insulin administration and blood glucose levels between appointments with their endocrinologist. Larger clinical trials are needed over longer periods of time to further determine the accuracy and effectiveness of the app in relation to other treatment strategies.

Technology is becoming increasingly more popular and advanced in terms of managing type 1 diabetes. There are numerous devices and apps already available and more in the works. This gives individuals with type 1 diabetes a wider variety of options in order to determine what works best for their needs and lifestyle.

Though not involved with this study, the Diabetes Research Connection (DRC) strives to continue growing understanding of type 1 diabetes and improving prevention and treatment methods as well as one day finding a cure. Early-career scientists can receive critical funding through the DRC to pursue novel research studies around T1D. Learn more about current projects and how to support these efforts at http://diabetesresearchconnection.org.

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Leveraging the Power of Light to Manage Type 1 Diabetes

A common problem in managing type 1 diabetes is maintaining relatively stable blood glucose levels. By the time a person realizes their blood sugar is rising or falling and begins to treat it, they may already experience spikes. This can be tough on the body and lead to over- or undertreatment in an effort to curb the highs or lows. Though technology has made it faster and easier to track blood glucose levels and more accurately administer insulin, it’s still not a perfect system.

A recent study reveals that researchers may have come up with a way to manage blood sugar without manually administering insulin. They engineered pancreatic beta cells to be responsive to exposure to blue light. By introducing a photoactivatable adenylate cyclase (PAC) enzyme into the cells, they produce a molecule that increases insulin production in response to high levels of glucose in the blood.

The molecule is turned on or off by blue light and can generate two to three times the typical amount of insulin produced by cells. However, it does not boost production when glucose levels in the blood are low. Furthermore, the cells do not require more oxygen than normal cells, which helps alleviate the common issue of oxygen starvation in transplanted cells.

The study was conducted on diabetic mice, so more research is needed to determine whether the process will be as effective in humans. If it is, this could mean that individuals with type 1 diabetes may have an option for controlling blood sugar levels without pharmacological intervention. When paired with a continuous glucose monitor (CGM) or other device as well as a source of blue light, it could create a closed loop model of managing the disease by functioning as a bioartificial pancreas.

This could be potentially life changing for individuals living with type 1 diabetes, and Diabetes Research Connection (DRC) is excited to see how the study progresses. Though not involved with this project, the DRC supports advancement of type 1 diabetes research and treatment options by providing critical funding for early career scientists pursuing novel research projects. Learn more by visiting http://diabetesresearchconnection.org.

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Could Closed-Loop Systems Improve Blood Glucose Management?

One of the latest technologies being tested for managing type 1 diabetes is a closed-loop system. This system uses a continuous glucose monitor (CGM) to measure blood glucose levels. When blood sugar begins to rise outside of the target range, it sends information to an insulin pump to automatically administer insulin. When blood sugar begins to fall, insulin is not administered. It is a closed loop because the patient is not deciding when to inject insulin or how much, but rather the system does so automatically.

A recent study involving 168 individuals with type 1 diabetes between the ages of 14 and 71 were part of a six-month trial using a closed-loop system. One hundred and twelve people were randomly assigned to the closed-loop group while the remaining 56 people used a sensor-augmented pump and were considered the control group. All 168 participants completed the trial. There were no incidences of hypoglycemia and only one incidence of diabetic ketoacidosis, which occurred in the closed-loop group.

The results showed that the closed-loop group remained in the target range for glucose levels (70-180 mg/dL) a greater percentage of time than those in the control group. On average, their time in the target range increased from 61% to 71%, while the control group remained around 59%. In addition, the closed-loop group spent less time with glucose levels above 180 mg/dL or below 70 mg/dL. Throughout the duration of the six-month trial, participants in the closed loop group remained in closed-loop mode (with the system automatically managing glucose monitoring and insulin administration) a median of 90% of the time.

While the closed-loop system is not perfect, these findings show that it improved time spent in the target glucose range, which is desirable in diabetes management. It also reduces the manual tracking and input from individuals with type 1 diabetes in managing the disease. While more research and testing are needed, it is a step in the right direction toward developing what many refer to as an “artificial pancreas.”

Diabetes Research Connection (DRC) is interested to see how this system will continue to advance and improve diabetes management in the future and continues to follow its progress.  These types of devices play an integral role in supporting individuals with T1D and helping them to maintain more normal blood glucose levels. The DRC supports early career scientists in pursing novel research studies geared toward improving understanding, diagnosis, and treatment of T1D with the goal of one day finding a cure. Learn more about these efforts and how to help by visiting http://diabetesresearchconnection.org.

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Could Real-Time Continuous Glucose Monitoring Reduce Incidences of Hypoglycemia?

Managing type 1 diabetes can be tricky. Many people rely on self-monitoring throughout the day by periodically testing their blood sugar and administering the proper dose of insulin as needed. Individuals with T1D often inject themselves with insulin multiple times per day. However, food, beverages, physical activity, illness, and other factors can all impact blood sugar levels making them more difficult to effectively manage.

But with advances in technology, continuous glucose monitoring (CGM) devices are now available to help those with T1D track and manage their blood sugar. These devices have a tiny sensor that is inserted under the skin which automatically measures blood glucose levels and transmits the information to a monitoring device. The system can also alert when blood sugar becomes too high or falls below a specified level allowing individuals to respond accordingly.

A recent study conducted across 12 diabetes centers in Germany aimed to determine whether the use of real-time CGM (rtCGM) systems could reduce the number and severity of incidences of hypoglycemia in patients with T1D who had a history of impaired hypoglycemia awareness or severe hypoglycemia within the previous 12 months. The study involved 149 participants, and 141 successfully completed the trial in its entirety.

All participants wore a masked rtCGM system for 28 days before being randomly assigned to one of two groups: the first group wore an unmasked rtCGM system for the next 26 weeks, and the second group was a control group that self-monitored blood glucose levels during this time. The results of the study found that the group that wore the rtCGM system had a 72% decrease in the number of hypoglycemic events (10.8 to 3.5 per 28 days), while the control group saw no significant reduction (14.4 to 13.7 per 28 days). Therefore, the rtCGM system was able to reduce the number of hypoglycemic events that occurred in individuals with a history of severe hypoglycemia or impaired hypoglycemia awareness.

The Diabetes Research Connection (DRC) is encouraged to see the difference these types of devices can make in the lives of individuals living with type 1 diabetes. It is through innovative research studies and technology development that these advances are possible. The DRC supports early career scientists in pursuing novel research geared toward diagnosing, treating, or curing T1D, as well as improving quality of life for those living with the disease. Learn more about the incredible projects that are taking place and find out how you can be a part of supporting these initiatives by visiting http://diabetesresearchconnection.org.

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