Managing diabetes in a ‘flash’

Exploring a novel glucose monitoring system among adolescents with poorly controlled type-1 diabetes.

Dr Ben Wheeler
University of Otago, Dunedin

What is the problem and who does it affect?

Type 1 diabetes is an autoimmune disease often presenting in early adolescence. The immune system mistakenly attacks insulin-producing cells in the pancreas, leaving these cells incapable of producing insulin. As insulin is a critical hormone in the process of controlling glucose levels in the blood, when the body fails to effectively produce it, people with the disease are left vulnerable to serious blood glucose fluctuations which can be extremely dangerous.

There are approximately 2500 children and youth, aged 0 – 18, living with type 1 diabetes (T1D) in New Zealand. While T1D is currently incurable, there are treatments available, but unfortunately all have a considerable impact on a person’s day-to-day life. These treatments also require considerable precision, routine, and vigilance; traits not usually found in abundance in teens.

Current treatment requires children and young people to prick their finger to obtain a blood sample several times a day. This is painful, and can be embarrassing for teenagers when they have to do it among their peers. As a result, adherence to regular testing is a significant issue among teens, and can lead to the worsening of one’s condition, pathing the way for further complications, such as hypoglycaemia.

 

What is this project hoping to achieve?

Dr Ben Wheeler from the University of Otago, will trial the use of a ‘flash continuous glucose monitoring’ (FGM) in a high-risk (low compliance) group of adolescents. FGM requires no pricking of the finger, while still offering accurate and timely glucose information allowing correct levels of insulin to be administered.

The trial will recruit 64 teens, aged 13 – 18, half of which will be randomly allocated to receive the FGM, while the other half will act as a control, and be monitored at similar rates. The objectives of the study are to improve glucose control, increase glucose monitoring behaviour, and to improve the quality of life of patients.

There is little evidence of FGM’s effectiveness in adolescent populations; especially those deemed high risk. If improved outcomes result from this trial, it could reduce the burden of management on T1D young people and improve short-term and long-term health outcomes in this high-risk group.

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