Diabetes Patients Benefit From New Treatment Technology, Study Says
The study looked into such enhancements as insulin pumps and blood sugar sensors
Thursday, July 12, 2012
People with type 1 diabetes must carefully monitor their blood sugar levels and that usually requires regular sticks with a needle. So a report in the Annals of Internal Medicine about new research at Johns Hopkins is sure to stir some interest.
Newer technologies such as insulin pumps and blood sugar sensors, which provide an alternative to multiple daily insulin shots a day, actually work better according to the Johns Hopkins researchers.
"Our study was designed to help patients and physicians better understand the effectiveness of insulin pumps and blood sugar sensors that provide constant glucose monitoring compared to conventional approaches," said the study's senior author, Sherita Hill Golden, M.D., an associate professor in the division of endocrinology and metabolism at the Johns Hopkins University School of Medicine. "We found that certain devices confer real benefits."
When you have diabetes, your body is not able to properly regulate the level of sugar in the blood. With type 1, the body does not make insulin, which regulates the body's use of sugar. Individuals with type 1 diabetes need insulin to keep blood sugar levels even before and after meals and at all other times.
That requires frequent monitoring, usually by pricking their fingers many times a day to obtain blood and using a glucose monitor and test strips to detect blood sugar amounts. But the newer technologies allow even more frequent monitoring without having the patient take any action -- like sticking themselves with a needle.
The continuous monitoring devices track blood sugar levels all day and night, as often as every five minutes, using a sensor that is attached to the abdomen with a small needle held in place by tape. The sensor sends the results to a display that is worn on the belt.
Patients can make decisions about adjusting insulin therapy based on the readouts. While there's much less discomfort, the patients still need to prick their fingers two to four times a day to make sure the device is working properly. That's much less than as many as eight to 10 times a day for patients trying to strictly control blood sugar. These devices also sound alarms if the blood sugar level is dangerously high or low.
Without strict control of glucose, diabetic individuals will suffer serious and chronic complications, including blindness and tissue damage.
In their study, Golden and her colleagues reviewed and re-analyzed data from 33 randomized controlled trials that compared the newer technologies to conventional methods of monitoring and controlling blood sugar levels. The new technologies they looked at were primarily real-time continuous glucose monitoring devices and insulin pumps.
Researchers found that patients with type 1 diabetes who used continuous monitoring had lower blood glucose levels than those who used finger stick testing alone. They also spent less overall time with too much blood sugar, a condition known as hyperglycemia. Both methods worked equally well to control hypoglycemia, the condition that results when blood sugar levels are too low.
Unfortunately, not all insurance companies cover the new technologies. Medicare, for example, doesn't cover the real-time continuous glucose monitoring sensors. Golden says her study was unable to determine whether people over 65 benefit specifically from using the device.