project on juvenile diabetes
A Yale expert on juvenile diabetes is heading a national group that will test the most advanced blood sugar sensing technology for children with Type 1 diabetes -- research that investigtors hope may lead to the first artificial pancreas.
Dr. William Tamborlane of the School of Medicine will lead the project, which involves five centers around the country and is sponsored by the National Institute of Child Health and Human Development. In addition to Yale, the centers are at the University of Colorado, Stanford University, the University of Iowa and a diabetes center in Jacksonville, Florida.
"The research relates to advances we have seen in the last couple of years in glucose sensor systems," says Tamborlane, who is professor and section chief of pediatric endocrinology. "Over the last 20 years we have tried to regulate diabetes by having patients prick their fingers four times a day and measure glucose levels. Now there are two U.S. Food and Drug Administration-approved continuous glucose monitoring devices available."
Tamborlane says all the participating institutions were already involved in research on Type 1 diabetes, which is a more severe form of diabetes that affects children. Type 2 diabetes generally is diagnosed in adults.
"The NIH felt it would be important to put together a group of leading centers in the country to study, in a scientifically rigorous and unbiased way, how these glucose monitoring systems could be used in children with Type 1 diabetes," says Tamborlane, principal investigator for the Yale study and chair of the group's steering committee.
Diabetes remains an extremely difficult disease to manage, particularly in young patients, notes the Yale physician. Although physicians have succeeded in lowering blood sugar levels, the continuing major obstacle is the increased frequency of severe hypoglycemic reactions that lead to seizures and coma, he explains.
"Sensor technology could be a major breakthrough to better adjust our therapy to reduce some of the risk of treatment," he says. "If the sensors work reliably over six months to a year, then, with continuous subcutaneous insulin infusion therapy, this could be an important first step in the development of an artificial pancreas."
The first study the centers will undertake is validating the accuracy of the two available glucose sensors and how they work under varying conditions, such as during exercise or after eating different meals.
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