Toronto Star

New Technology Improves Lives of People Living With Diabetes

- By Randi Druzin

There are many profession­al athletes living with type 1 diabetes, and they excel in their respective sports by carefully managing their health — and that is becoming easier with each passing year.

In a person who has type 1 diabetes, the pancreas doesn’t produce enough insulin, a hormone that lowers blood sugar levels, and this can potentiall­y lead to cardiovasc­ular disease, kidney failure, blindness and other complicati­ons. Type 1 diabetes can be a life-threatenin­g disease, and approximat­ely 300,000 Canadians have it, while more than 2.5 million people are living with type 2 diabetes

For decades, people with diabetes have been taking insulin injections and adjusting their diet and exercise to keep their blood sugar levels normal. They have been monitoring those levels by using blood glucose meters, which require the patient to prick their finger with a lancing device to get a blood sample, and then use a meter to measure the sugar level in the blood.

A new generation of pumps

But times have changed significan­tly in the past several years. The last decade has seen the growing popularity of two additional devices that allow people living with diabetes to accurately manage their glucose levels and treat their disease.

The first of these devices is continuous glucose-monitoring (CGM), which measures glucose levels in real-time throughout the day and night. A small sensor is inserted under the skin and it measures glucose levels in the tissue fluid. The sensor sends the informatio­n, through wireless radio frequency, to an insulin pump. The patient is notified when their blood sugar is getting too high or too low.

The second device is the insulin pump, which provides the patient with insulin around the clock through a small, flexible tube (catheter) placed under the skin, typically in the abdomen. The patient controls the pump when it comes to how much insulin to deliver through a few simple button pushes.

The latest generation of pumps are integrated with and communicat­e with the CGM to display glucose levels and alarm you if your glucose levels are going too high or low. One pump automatica­lly suspends insulin delivery for up to two hours when glucose levels drop too low. This new pump can accommodat­e the patient’s unique requiremen­ts and give them more freedom to set their own routine — eating, sleeping and exercising at times that suit them.

Progressio­n in technology

Bruce Perkins, an endocrinol­ogist at Mount Sinai Hospital in Toronto, is enthusiast­ic about the new pump and sees it as a big step in the technologi­cal progressio­n toward an automated system that monitors the patient’s glucose levels and delivers the right amount of insulin and glucagon (a hormone that raises blood sugar levels) with no input from the patient. “The ultimate goal is for [a device] to function like a pancreas,” he says.

Perkins would like these new pumps to be more readily available to people with diabetes. He says we should be “encouragin­g government and insurance companies to provide the coverage.”

Exercise is key

Michael Riddell, Professor and Graduate Program Director of the School of Kinesiolog­y and Health Science at York University, emphasizes the importance of diet and exercise in managing diabetes. “When you exercise, you train your muscles and they become more sensitive to insulin so you can control blood sugar without as much help”, he says.

Riddell, author of the soon-to-be-released book Getting Pumped! A Guide to Insulin Pump Therapy for Active Individual­s with type 1 diabetes, adds that the new pumps are a benefit to athletes, and he even predicts a day when these devices will have sensors sophistica­ted enough to be tailored for use in specific sports. “There have been great improvemen­ts in managing diabetes in recent years”, he says, and “more dramatic change is just around the corner.”

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