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Diabetes Research News
July 26, 2020

Exploring the Impact of Type 1 Diabetes on COVID-19

For the past several months, the world has been struggling to contain the spread of COVID-19 and effectively treat patients diagnosed with this disease. It is a new strain of coronavirus that researchers continue to learn more about every day. One thing that is known about the virus is that individuals with underlying health conditions are at increased risk of developing severe illness and complications.

One such underlying health condition that researchers are paying closer attention to is type 1 diabetes (T1D). Preliminary research from small studies appear to show that individuals with T1D are at increased risk of poorer health outcomes than those with type 2 diabetes (T2D) or no history of diabetes. A recent study of 64 individuals with T1D and confirmed or suspected COVID-19 in the United States found that “more than 50% of all cases reported hyperglycemia, and nearly one-third of patients experienced DKA.” Both hyperglycemia and diabetic ketoacidosis (DKA) can be life-threatening conditions if not properly treated in time.

Furthermore, research released from the United Kingdom’s National Health Service (NHS) revealed that hospitalized individuals with T1D are significantly more likely to die from COVID-19 than those with T2D. Scientists believe that hyperglycemia may enhance the immune system’s overresponse thereby exacerbating the impact of severe infections.

Being hospitalized can make it more difficult for individuals with T1D to maintain glycemic control because their body is already trying to fight off infection, and they may not have the mental clarity or ability to effectively monitor their own blood sugar. Diabetes Research Connection (DRC) sponsored a study by Addie Fortmann, Ph.D., regarding the use of continuous glucose monitors (CGMs) in hospital settings, which found that these devices were pivotal to glycemic control. As a result, Scripps deployed this technology across all of their hospitals to better support diabetes management.

But not every hospital in the United States allows patients to use their CGM while admitted, and not all staff is adequately trained in diabetes care. This can complicate things for patients struggling with T1D as well as COVID-19 and contribute to poorer health outcomes. Not only are patients fighting against the effects of COVID-19 including fever, shortness of breath, dry cough, nausea, body aches, and fatigue, if their blood sugar should go too high or too low, this can add to more symptoms and complications. In both patients with confirmed and suspected COVID-19 as well as T1D, DKA was the most prevalent adverse outcome.

It is essential that attention is given to managing underlying conditions such as diabetes in order to provide more effective treatment tailored to patient needs. Since 2012, the DRC has been providing critical funding for early-career scientists pursuing novel, peer-reviewed research related to type 1 diabetes. This work is essential to advancing understanding of the disease, improving prevention strategies and treatment options, minimizing complications, enhancing quality of life, and working toward a cure. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Diabetes Research News
July 23, 2020

Managing Blood Sugar During Exercise with Long-Acting Insulin

Engaging in regular physical activity is good for overall health. It helps with weight management, blood pressure, cardiovascular health, blood sugar, and more. Individuals with type 1 diabetes may find exercise helpful in improving insulin sensitivity and reducing the amount of insulin needed following activity. However, this can also be a challenge because they must carefully monitor their blood-glucose levels to ensure that they do not become too low or too high.

A recent study found that combining long-acting insulin (degludec) with the use of an insulin pump can be beneficial for managing glucose levels during and after exercise. Some individuals with T1D prefer to remove their insulin pump during exercise, and by administering degludec before starting exercise, they were able to remain in target range (70-180 mg/dL) for longer periods of time than when just using the insulin pump alone.

The study involved 24 physically active adults who participated in two phases of workouts that included five weeks of high- and moderate-intensity sessions. During one phase, they only used their insulin pump to control their basal insulin needs, and for the second, they used the insulin pump and the degludec. When using the insulin pump alone, they spent an average of 143 minutes (40% of the time) in target range, but when using the degludec, this time in range increased to 230 minutes (64% of the time).

The researchers found that “this was down to a significant 87-minute reduction in time spent in hyperglycemia, with no difference seen for hypoglycemia” as well. In addition, when using the hybrid insulin approach, blood sugar rose just 14.5 mg/dL after 30 minutes following exercise, compared to an 82.9 mg/dL increase using the insulin pump alone.

More than two-thirds of participants found the hybrid insulin regimen useful, and nearly half said they were somewhat or very likely to continue using this approach while exercising in the future. The researchers are looking at moving forward with a larger study to see if these results continue to be significant when more people are involved.

This study shows that there may be more than one effective option for improving glucose control during exercise for individuals with type 1 diabetes. They do not have to rely on the insulin pump alone, and some may find administering degludec beneficial when exercising without their insulin pump.

Diabetes Research Connection (DRC) is interested to see how this study plays out in the future and if more people can benefit from the hybrid insulin regimen while exercising. It is encouraging to see more options become available to help individuals better control their diabetes while improving their health and quality of life. DRC supports early-career scientists in pursuing novel research on type 1 diabetes by providing access to funding. The goal is to one day find a cure while also improving prevention, treatment, and management of the disease. Click to learn more about current projects and provide support.

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Diabetes Research News
July 15, 2020

Could Benefits of Early Screening for Type 1 Diabetes Outweigh Costs?

Advances in science have improved the ability to identify warning signs for type 1 diabetes (T1D) early on. For instance, scientists can detect the destruction of insulin-producing beta cells before noticeable signs of diabetes emerge or conditions such as diabetic ketoacidosis (DKA) occur. They have also determined other key changes and factors that may put an individual at increased risk.

A recent study found that conducting health screenings on children can increase awareness regarding their risk of developing T1D, help prevent DKA occurrences, and encourage individuals to take better care of their health to reduce complications and impact of the disease.

Researchers at the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine created the Autoimmunity Screening for Kids (ASK) study to determine if this type of health screening is beneficial. While it can be costly to conduct widespread screenings for children between the ages of 1 and 17, they found that there are a host of benefits such as those mentioned above. In addition, the long-term cost savings can quickly make up for screening expenses because when individuals know their risk and learn how to better manage their T1D, it can reduce complications and associated healthcare costs.

Now they are looking at how to effectively implement screenings, what the practice would look like, what the age schedule for screenings should be, and who would benefit most. Early detection can play an integral role in managing T1D and improving quality (and quantity) of life.

Diabetes research occurs at all stages of the disease, from the time patients are pre-symptomatic to those with the most serious complications. It covers everything from screenings to closed-loop systems for treatment to understanding the cellular and molecular impact of the disease. Diabetes Research Connection is committed to supporting a wide range of T1D research by providing critical funding to early-career scientists. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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