Could new diabetes device cut low blood sugar risk?
NEW YORK – A handheld tool that provides diabetics with automated feedback — from average blood sugar levels to early signs of a treatment’s side effects — may help certain patients better manage the disease, hints a new study.
Researchers from the University of Virginia, Charlottesville, concluded that the biofeedback system could make it easier to walk the fine line between controlling blood sugar levels in order to minimize the condition’s chronic complications and risking those levels falling too low, a state called hypoglycemia.
Although such episodes can be quickly fixed by eating or drinking a sugar-rich food, failing to treat them may lead to confusion, seizures, or even death, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
«We’re undergoing a transition from just monitoring a patient to giving that person feedback to improve their diabetes symptoms,» lead researcher and inventor of the device, Boris Kovatchev, told Reuters Health.
However, one other expert is not yet convinced that the device – which is not yet FDA-approved nor available for sale — will benefit diabetics any more than tools already on the market.
It is easy to reduce average blood sugar levels simply by using more insulin, but this is «almost inevitably accompanied by an increased risk for hypoglycemia,» he added.
To test the biofeedback device’s ability to address both issues simultaneously, Kovatchev and his colleagues studied 120 adults with diabetes that required insulin. All of the subjects received three different levels of feedback, in varying orders, with each level continuing for 3 months.
Level one provided basic blood sugar monitoring alone, while levels two and three added long-term averages and measures of variability, as well as estimated risks for hypoglycemia based on blood sugar values and the patient’s symptoms.
Each participant received a commercially available blood sugar meter with test strips, as well as the handheld device necessary for levels two and three, and were asked to use them four to five times every day. (LifeScan, Inc., which has worked with the University of Virginia on the development of the technology, helped fund the research and provided the blood sugar meters.)
As expected, level one’s blood sugar monitoring was generally enough to keep average levels from rising too high. The more sophisticated feedback with the new device offered no additional benefit.
To keep blood sugar from falling too low, however, the researchers found that information from levels two and three was helpful. With only the blood sugar monitoring, the risk of hypoglycemia actually rose slightly, albeit insignificantly.
But after adding in the new biofeedback features, the estimated cases of severe hypoglycemia dropped significantly, from more than two per patient annually to fewer than one in four patients experiencing an episode every year.
Participants with the least initial awareness about hypoglycemia, as well as those who had a history of this common side effect of diabetes treatment, experienced the greatest reductions in risk.
Overall, patients who already had their blood sugar more or less under control before the study saw little improvement with the new tool, noted Kovatchev.
«We can speculate that people who had good control to begin with may just need that type of feedback for maintenance, or maybe they don’t need it at all,» he said.
Kovatchev said he did not have a suggested price for the device yet, but believes that the requirements for the hardware would not be any more than that of a modern monitor.
«This technology is intended for implementation in any contemporary meter out there,» he said. «It would make for a very smart meter.»
Dr. Brian Frier of the Royal Infirmary in Edinburgh, Scotland, noted that the more information that people with diabetes receive about their blood sugar, the more likely they are to attempt to improve the overall control of their diabetes, provided that they have been instructed on how to effectively modify their therapy and diet.
Still, he was unsure what the new device would add.
«An automated system that is user-friendly may have a role in assisting those with impaired awareness of hypoglycemia, but many with this problem already rely on very frequent blood glucose testing,» Frier told Reuters Health by e-mail, referring to already available real-time monitors that warn patients if their blood sugar falls too low.
Frier, who was not involved in the current study, also expressed concern that participants were recruited through advertising, which means they may have been more apt to stick to treatment modifications and see a benefit.