Looking at future of diabetes treatment

Diabetics may one day rely on artificial pancreas that would free them from worry over rising and falling blood-sugar levels and decisions about how much insulin to take.

The dashboard in their cars could double as a blood-sugar monitor.

These and other developments on the horizon were among the topics discussed at a conference on current technology and research for diabetes care hosted Tuesday for health care professionals by Altru Health System in Grand Forks.

But even before those advances become reality, health care providers said patients already have an array of options that make diabetes care more manageable, efficient and effective.

Diabetes and its complications are the leading causes of chronic diseases, said James Brosseau, director of the Altru Diabetes Center and a conference organizer. "And the problem only seems to grow worse."

Worldwide, diabetes has reached epidemic proportions, he said. In the United States, 10 percent of adults have diabetes mellitus and at least 35 percent are at risk for the disease, he said.

"Diabetes mellitus is one of the most complex conditions you could ever imagine," he said. "It affects the kidneys, eyes, central nervous system and circulation to the limbs."

He has seen diabetes in newborns as well as patients over 90 years old.

Recent advances

In the past decade, new technological developments have produced sensors for blood-sugar monitoring and an assortment of pens and pumps for insulin injection.

More than 20 companies produce 70 different glucose, or blood sugar, meters, Brosseau said. There are eight different insulin pen devices and 16 types of insulin on the market, replacing the animal-source insulin that was the only option in the past, he said.

Sensors that continuously monitor blood sugar provide a reading every five minutes, alerting the patient to dips or increases that may need response.

This small tool, about the size of a quarter, captures data that can be downloaded to a computer and shared with a physician who can work with the patient on an individualized care plan.

Blood-sugar monitoring is critical to keep levels within normal ranges. If blood-sugar levels are too high or too low, severe reactions, such as loss of consciousness, can result.

Insulin pumps, about the size of a deck of cards, deliver a steady stream of insulin under the skin.

Pumps and sensors are worn externally and pierce the skin with needles so fine they are painless, Brosseau said.

Hundreds of smart phone applications, many free, capture blood glucose readings and trend data. Others provide nutrition facts and track carbohydrate intake and total calories, fat, sugar, protein and fiber.

Conquering diabetes

Diabetes requires ongoing attention, Brosseau said, and can be frustrating even for people who feel they are doing everything right.

"People with diabetes may get discouraged and depressed," he said. "There are so many variables to deal with."

To that, Stephen Smith, a Mayo Clinic endocrinologist and conference speaker, said, "Remember that conquering is at least as good as curing."

"I can't think of another disease that has had more advancement in terms of impact," Smith said. A continuing commitment to innovation in research, care and prevention of diabetes bodes well for health care in general, he said.

"If we get it right for diabetes," he said, "it can serve as a model for other diseases as well."

Reach Knudson at (701) 780-1107; (800) 477-6572, ext. 107; or send e-mail to pknudson@gfherald.com .