Sleeping soundly (and safely) with diabetes: Technology points the way
June 3, 2014—Nighttime holds hazards for people with type 1 diabetes, as blood sugar (glucose) levels can dip dangerously low, causing loss of consciousness, seizures or even death. Unfortunately, people with diabetes who use insulin pumps might sleep through their system’s alarm and be unable to respond to a glucose fall at night by turning off their pumps.
A study published in Diabetes Care may hold the answers. Researchers used computer programs to track and automatically manage nighttime glucose levels in people with type 1 diabetes who use insulin pumps. This technology is novel, and it’s not right for everyone, but it could point the way to better control for people with diabetes.
About the study
The study lasted for 42 nights. There were 45 participants, all of whom were between the ages of 15 and 45 and had type 1 diabetes. They slept in their own homes, but each night, they wore an under-the-skin glucose sensor that was attached to an insulin pump. That pump had a wireless connection to a bedside computer.
On some nights the computer was on, and as the people slept, the computer monitored their blood sugar levels and used a mathematical model to predict when the glucose numbers might fall. If the program spotted an impending dip below 80 mg/dL, the computer turned off the participant’s insulin pump until blood sugar levels began to rise—all without waking the participant.
Other nights the computer didn’t do anything at all, and the pumps remained on all night long without doing anything unusual.
The sleepers had no way of knowing whether the computer was working or not.
On treatment nights, the researchers found that:
- Insulin pumps were turned off at least once on 76 percent of these nights.
- Incidents of low blood sugar levels lasting two hours or more were reduced by 74 percent.
- Blood sugar did not rise to an unsafe level, as measured by morning blood and urine tests, indicating that insulin was not kept from patients who needed it.
Researchers are expanding the study to include children ages 3 to 15 in hopes of helping parents who must get up throughout the night to monitor a child’s blood sugar.
Read the entire study here.
|The take-home message|
|Although this study is promising, researchers are still investigating the use of computer programs like this. And sadly, while nighttime glucose monitors do exist, they often use audible alarms that are easy to sleep through, particularly for people who are feeling ill due to low blood sugar.
If you have type 1 diabetes, you can take steps to reduce episodes of low blood sugar by keeping close watch over your levels. The American Diabetes Association (ADA) recommends keeping a log of your results and regularly sharing those notes with your doctor. The ADA provides both an online tool and a printable log for that purpose.
Keep in mind that numbers are individualized, so what’s normal for you will not be the same as for someone else, and numbers can change due to stress or diet. The key is to gather data and keep it all in one place. That way, you and your doctor can see changes over time, and you might connect those variations to specific foods or activities.
If you’d like to know more about why tight control is so important, visit this slideshow about the impact of diabetes on various parts of your body.