Promising approach to reduce risk of hypoglycemia in diabetes shows positive results

Jun 25 2013

People with type 1 diabetes who rely on insulin injections to control their blood sugar levels are at risk for life-threatening hypoglycemic events in which their blood glucose levels drop dangerously low. A promising approach for reducing the risk of hypoglycemia in diabetes has demonstrated positive and exciting results, and it may be available in the U.S. later this year, as described in an Editorial published in Diabetes Technology & Therapeutics (DTT), a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

A sensor-augmented pump (SAP) represents a novel glycemic control approach that relies on a continuous glucose monitoring device linked to an automated insulin infusion pump. In the editorial "Reducing Hypoglycemia in Type 1 Diabetes: An Incremental Step Forward," Senior Editor Irl B. Hirsch, MD, University of Washington School of Medicine, Seattle, describes the therapeutic benefits of a "threshold suspend" strategy, in which the automated insulin delivery component of an SAP system would suspend insulin delivery during the critical first few minutes when a person is becoming hypoglycemic.

Nocturnal hypoglycemia is an especially devastating problem, and the use of modern-day, long-lasting forms of insulin may increase their risk, as insulin doses delivered around the dinnertime meal may linger into the nighttime. A recent study in New England Journal of Medicine showed that a threshold suspend SAP approach could reduce nocturnal hypoglycemia risk and events by at least 32%.

"It is exciting to see that threshold suspend with SAP is safe, does not cause rebound hyperglycemia, and is the next step for the technological holy grail of an automated closed-loop pancreas ('Bionic Pancreas')," says Dr. Hirsch.

"The diabetes community has been waiting a long time for a closed-loop system, and the ASPIRE-In-Home study clearly shows reduction in hypoglycemia without any deterioration of glucose control," says Satish Garg, MD, Editor-in-Chief of Diabetes Technology & Therapeutics and Professor of Medicine and Pediatrics at the University of Colorado Denver. "The results of this study will reinforce more providers and patients accept intensive insulin treatment using insulin pump and continuous glucose monitoring."