Wednesday 30 July, 2014

New tools to control blood sugar work better than conventional methods

Published On: Tue, Jul 10th, 2012 | Diabetes | By BioNews

Newer technologies designed to help people with type 1 diabetes monitor their blood sugar levels daily work better than traditional methods and require fewer painful needle sticks, a new study has revealed.

The Johns Hopkins research findings suggest that even though these diabetic control technologies are more costly, people with diabetes who use an insulin pump are more satisfied with their treatment and quality of life than those who give themselves insulin shots many times a day.

“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,” the study’s senior author, Sherita Hill Golden, M.D., M.H.S., an associate professor in the division of endocrinology and metabolism at the Johns Hopkins University School of Medicine, said.

“We found that certain devices confer real benefits,” Golden said.

Roughly 5 percent to 10 percent of people with diabetes suffer from type 1, which used to be known as juvenile-onset diabetes.

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.

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. Diabetic individuals can make decisions about adjusting insulin therapy and/or activity levels based on the readouts.

These devices also sound alarms if the blood sugar level is dangerously high or low.

The researchers found that children, teens and adults 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 (hyperglycemia). Both methods worked equally well to control hypoglycemia, the condition that results when blood sugar levels are too low.

The insulin pumps provide insulin around the clock, as needed. People with diabetes can either program the device with the push of a button based on finger stick glucose measurements or link the pump to the continuous monitor.

The latter is called a “sensor-augmented pump.”

While there was little difference in blood sugar control in those who give themselves multiple insulin shots a day versus those who used insulin pumps, those with type 1 diabetes who used the sensor-augmented pumps, pumps that include real-time continuous glucose monitoring devices, did much better controlling blood sugar than those who used finger stick testing and shots.

“Those who use the devices as prescribed do the best at maintaining blood sugar control,” she said.

“Adherence is the key to effectiveness.”

Golden said that her study was unable to determine whether people over 65 benefit specifically from using the device.

The study was published online in the July 10 issue of the Annals of Internal Medicine.

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