New Insulin Pump Cuts Odds of Overnight Hypoglycemia

Sensor device may ease patient fear of dangerously low blood sugar levels during sleep, experts say

By Steven Reinberg

HealthDay Reporter

SATURDAY, June 22 (HealthDay News) -- A new sensor attached to an insulin pump helps prevent dangerously low blood sugar levels in patients with type 1 diabetes while they sleep, a new study finds.

The new pump automatically stops delivering insulin when the sensor finds blood sugar levels have reached a pre-set low level, and it reduced overnight episodes of low blood sugar (hypoglycemia) by a third, the researchers report.

"After years of hoping for a way to achieve our goal of getting good blood sugar control without a lot of low blood sugar, we are finally, with this new technology, getting close to our goal," said study lead author Dr. Richard Bergenstal, executive director of the International Diabetes Center at Park Nicollet in Minneapolis.

"Hypoglycemia has all of a sudden become an important topic," he said. "Now that we are able to keep blood sugar down, we are running up against hypoglycemia as being our biggest barrier to achieving the blood sugar control we want to get to prevent eye disease, kidney disease and amputations and heart disease."

The effects of hypoglycemia can range from dizziness to seizures to coma and death, according to Bergenstal. "Patients are scared to death saying, 'Am I going to go to sleep tonight and am I going to wake up tomorrow morning, or am I going to have a major problem in the night,'" he said.

This may also be another step to creating a so-called "artificial pancreas" for people with type 1 diabetes, who cannot make insulin on their own, Bergenstal added. "This is the first step that shows that the artificial pancreas can actually work," he said.

Although this device has been used in Europe, the new study is a move toward getting the device approved by the U.S. Food and Drug Administration.

The study was funded by Medtronic Inc., the maker of the device. The results of the study were published June 22 online in the New England Journal of Medicine, to coincide with a scheduled presentation at the American Diabetes Association annual meeting in Chicago.

"This is a very real difference for people with type 1 diabetes, because these patients often go to bed in fear of low blood sugar," said Dr. Ronald Tamler, director of the Mount Sinai Diabetes Center in New York City. He was not involved in the new study.

But he added that it remains to be seen whether patients are agreeable to wearing a sensor along with an insulin pump and whether they can trust the technology.

"Some patients may not be willing to wear a sensor in addition to an insulin pump and entrust themselves to devices that need to work accurately and in harmony to succeed," he said. "It's a matter of practically and trust."

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work overnight shifts

Hello buddies.. I'm new with Calorie Count. I ve been promoted to my position about 2 years ago and gained 25lbs!! I work overnight shifts (11pm-7am) and I'm having a hard time trying to figure out what time I start and end my calorie count. I've been exercising 5 days a week and kind of feel a difference in my clothing. I cut back a lot of my Calorie intake. But it's so hard to try to figure out when to count my calories. Can some one help?

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Artificial Pancreas Worked Overnight on Kids With Type 1 Diabetes

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Feb. 27 (HealthDay News) -- The artificial pancreas -- a treatment that's been called the closest thing to a possible cure for type 1 diabetes -- may be another step closer to becoming a reality.

Israeli researchers just released the findings from an overnight trial of their artificial pancreas system at three different camps for youngsters with type 1 diabetes. The artificial pancreas system was able to maintain better blood sugar levels, and helped prevent dangerous overnight drops in blood sugar levels, compared to an insulin pump and a continuous glucose monitor, according to the study.

"There is hope for better control without the fear of [low blood sugar levels], and therefore improvement in quality of life is coming soon," said study author Dr. Moshe Phillip.

Philip is director of the Institute for Endocrinology and Diabetes at the National Center for Childhood Diabetes at the Schneider Children's Medical Center of Israel, in Tel Aviv. The findings appear in the Feb. 28 issue of the New England Journal of Medicine.

Type 1 diabetes is an autoimmune disease in which the body's immune system turns against healthy cells. In type 1 diabetes, the immune system attacks beta cells in the pancreas, effectively destroying the body's ability to produce the hormone insulin. Insulin helps metabolize carbohydrates from food and fuels the body's cells.

Insulin can't be replaced with a pill. It must be injected with a shot or delivered by a pump that uses a tiny catheter inserted under the skin. This catheter must be changed every few days. The problem with both techniques is that people have to estimate how much insulin they'll need based on the foods they eat and how much activity they'll be doing.

Too much insulin can result in low blood sugar levels (hypoglycemia), which makes a person with diabetes feel awful, and if left untreated, can cause a person to pass out. Low blood sugar levels can even lead to death. Too little insulin leads to high blood sugar levels (hyperglycemia), which over time can cause serious complications, such as heart disease and kidney and eye problems.

An artificial pancreas could potentially solve those problems by taking over the decision-making process and applying sophisticated computer algorithms to decide how much insulin is needed at any given moment.

But developing such a device isn't easy. It has to be able to continuously detect patients' blood sugar levels and know whether the levels are trending up or down. There also has to be a piece of the device that holds and delivers insulin. Right now, most artificial pancreas devices, including the one tested in this study, use already-available insulin pumps and continuous glucose monitors. Such monitors measure blood sugar levels every few minutes with a sensor that's inserted under the skin, and send the results to a transmitter.

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New security balance for overnight workers

2 December 2012, an international team of researchers from the Italian world's first screening tool to help reduce sleep-related accidents and diseases, including cardiovascular disease and cancer, caused by shift work developed.

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Published in the journal sleep, the new tool can healthcare professionals and industry to better understand individual vulnerability to the health and safety effects of shift work.

This questionnaire screening for a condition known as shift work disorder (SWD) is developed by researchers at Monash University, and our partners, Harvard Medical School, Brigham and women hospital, and Henry Ford hospital.

At least 15% of workers in Australia, the USA and the United Kingdom, and about 23 percent of employees in Japan estimated to work outside normal working hours, causing significant disruption of their natural sleep-wake schedules. SWD, characterized by extreme sleepiness and/or insomnia, is thought to affect about 10 percent of workers in different shifts.

Shantha Rajaratnam of Monash and associate professor, Harvard University, said that the prevalence of shift work is unknown due to the lack of accurate evaluation tools.

"Shift work is a reality of modern economies, but research has shown that there are very real health risks associated with work outside normal hours are" Associate Professor Rajaratnam said.

"In addition to the associated health problems, shift workers are considerably more risk of accidents at the workplace. The workers most affected by disruption of sleep--who with SWD--good for a significant part of this risk and should be adopted. "

Shift work, especially at night, is linked to a higher rate of car crashes, industrial accidents, actual and near-miss quality control errors and injuries on the job.

Secondary health problems associated with shift work include cancer, cardiovascular diseases, diabetes, gastrointestinal disease and mood disorders, including depression.

"This questionnaire is an important step in better understanding causes of vulnerability to shifting work, and focused on interventions to those who need them the most," said Associate Professor Rajaratnam.

"But this is only a first step and further tests of actual impairment by lack of sleep should be developed for implementation in professional settings."

"More cooperation between researchers, industry and Government partners is necessary for this important challenges and shift work as safe and productive as possible."

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