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Simplifying type 1 diabetes treatment

(Southern Health News, June 2017)

New system could simplify type 1 diabetes treatment

Constantly measuring glucose levels could one day be a thing of the past for people with type 1 diabetes.

A new ground-breaking study being carried out by researchers at Southern Adelaide Local Health Network (SALHN) will trial an innovative new system that automatically monitors - and adjusts – glucose levels.

If the study is successful and the hybrid closed loop system is found to be safe, effective and cost-efficient, the ultimate aim is to make it clinically available to people with type 1diabetes in Australia.

Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. There is no cure and it cannot be prevented. People with type 1 diabetes depend on insulin every day of their lives to replace the insulin the body cannot produce. The condition is managed with insulin injections several times a day or the use of an insulin pump. People must test their blood glucose levels several times throughout the day.

The three-year study is the longest of its type and a first for South Australia. A similar separate study will be run through Womens and Childrens Hospital in a paediatric population.

Study co-investigator and Director Southern Adelaide Diabetes and Endocrine Services at Repatriation General Hospital, Associate Professor Stephen Stranks, said the study hoped to address the difficulties involved in close control of type 1diabetes with current technology.

“Blood sugar levels in people with type 1diabetes can rise and drop very quickly, which can result in reduced quality of life, high levels of anxiety and frequent hospital admissions. In the long-term, complications can include renal failure, eye disease potentially leading to blindness, nerve damage, foot ulceration, amputation and accelerated vascular disease,leading to possible heart attack and stroke. So good blood glucose control is critical for people with type 1 diabetes.”

He said overseas studies of closed loop systems similar to the one being trialled at SALHN had shown positive effects on blood glucose control and patient acceptance. “However, those trials have only run for up to three months, so we’re keen to see the results of longer-term use and in an Australian population.”

People involved in the trial will receive either continuation of their current insulin treatment (injections or pumps) or use of the hybrid closed loop system for a six-month period.

The hybrid closed loop system uses a continuous glucose monitor to frequently measure glucose levels throughout the day and night. These are fed back to automatically adjust insulin dosing through an insulin pump between meals and overnight. Users will still be required to determine their mealtime insulin doses themselves.

“This is an important study because not only does it aim to improve glucose control, hypoglycaemia risk, sleep quality, psychosocial wellbeing, cognition biochemical markers in people with type 1 diabetes, but it also will provide SALHN staff with unique knowledge and experience in this cutting edge technology,” said study co-investigator Associate Professor Morton Burt.

The study hopes to start in June this year. If you are interested in taking part in the study and have been diagnosed at least 12 months ago with type 1 diabetes; speak English; live in an area with internet and cellular phone coverage; and currently use an insulin pump or are administered at least four injections of insulin daily with HbA1C <10.5%, please phone 08 82751094for more details. The study is quite intensive and participants will receive considerable education and monitoring including periods of continuous glucose monitoring.

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