JDRF - Juvenile Diabetes Research Foundation

A Western Australian study has found that rates of severe hypoglycaemia declined dramatically in the past decade.

The study out of the Department of Endocrinology and Diabetes at the Princess Margaret Hospital in Perth, found that rates of severe hypoglycaemia in children with Type 1 diabetes declined two thirds between 2000 and 2009.

The study also showed that glycaemic control stayed the same in that time, with the link between glycaemia and risk of hypos growing weaker. There was also no longer an increased risk of severe hypoglycaemia in children under six years old.

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People affected by type 1 diabetes live with constant fear about night-time hypos and there is now technology with the potential to relieve some of those fears.

The HypoMon® is described as the world’s first non-invasive system to detect and alert users of sleep-time hypoglycaemia.

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Results from one of the largest studies of new diabetes management systems shows that using a combination of insulin pump and continuous glucose monitor results in significantly better long term blood glucose control compared to people using insulin injections alone.

Whilst it has long been known that insulin pump therapy can provide both a physical and psychological benefit to users, results from the recent Sensor-Augmented Pump Therapy for A1C Reduction trial (otherwise known as STAR 3) have shown that using an insulin pump in combination with a continuous glucose monitor can significantly reduce blood sugar fluctuations.

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A South Australian woman has become the first person to receive an islet transplant at Queen Elizabeth Hospital in Adelaide.

Margaret Harrigan, a teacher from Adelaide, is producing her own insulin for the first time since being diagnosed with type 1 diabetes 36 years ago after receiving an islet transplant in January.

Margaret had spent years living with hypoglycemia unawareness – severe and uncontrollable blood glucose fluctuations that made day-to-day living almost impossible. Four weeks after the transplant, Margaret has almost halved her insulin requirement and is free of dangerous low blood sugar attacks.

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Tassie Mum Leah calls to her son while she is on the phone to JDRF. “Cooper, come and have some more sandwich! He’s actually on his way to a hypo right now,” she says.

Cooper is a bright, active, “beautiful” seven year old boy who has had type 1 diabetes since he was three. Back then, while visiting a sick brother in hospital, Cooper picked up a virus. Leah says he never really recovered.

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JDRF funded trails at Cambridge University have shown that an artificial pancreas dramatically reduces the risk of potentially deadly hypoglycemia.

Published today in the respected journal The Lancet, JDRF-funded researchers developed and successfully tested an automated management system, which was able to predict and prevent blood sugar fluctuations. Dramatic blood sugar drops, or hypoglycemia, have immediate and often devastating consequences and have an enormous impact on both individuals and families living with type 1 diabetes.

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A move towards individualised insulin therapy targets

After extensive discussion in Australia and overseas, Australian diabetes health professionals have released a new position statement on blood sugar targets for people with type 1 diabetes. Following the results of the Diabetes Control and Complications trial, the ideal target of a HbA1c of 7% was set across the board.

Recent research has suggested that one size may not fit all and to address this, the Australian Diabetes Society now officially recommends that people with severe hypoglycemia or hypoglycemia unawareness should set their HbA1c targets at 8% or less.

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Two major JDRF-funded studies in the US have shown that continuous glucose monitors (CGMs) deliver better diabetes control with regular use for all age groups, while also reducing the frequency of hypoglycemia, or dangerously low blood glucose levels that can lead to coma or death.

The first study showed that regular use of CGMs is the main factor in achieving better diabetes control, rather than the age of people using the monitors, or other demographic, clinical, or psychosocial factors.  The second study showed that people using CGMs were able to achieve good diabetes control while at the same time actually lowering the incidence of hypoglycemia.

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A JDRF trial shows that continuous glucose monitor (CGM) devices help to maintain tight blood sugar levels whilst lowering the risk of dangerously low blood sugar.

There is extensive research to show that tight blood glucose control is the best way to prevent the onset of type 1 diabetes complications such as kidney failure, retinopathy and heart disease. According to results from the Diabetes Complications and Control Trial, every one point reduction in HbA1C reduces the risk of long-term complications by approximately 40%.

Unfortunately, research has also shown that one of the hurdles to tight blood sugar control is the risk of hypoglycemia – both real and perceived.

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People with type 1 diabetes who have already been successful in achieving recommended blood sugar goals can further benefit from using continuous glucose monitoring (CGM) devices, according to results of a major multi-center clinical trial by the Juvenile Diabetes Research Foundation. Findings of the study were published online by the journal Diabetes Care, available at http://care.diabetesjournals.org/content/early/recent.

According to the JDRF study, using CGM devices enables people who have achieved excellent control (with HbA1c levels below 7 percent) to continue to tightly manage their diabetes while cutting down on the frequency of low blood sugars, called hypoglycemia. Research has shown that good blood sugar control is a key factor in reducing the risk of the devastating long-term complications of type 1 diabetes, such as blindness and kidney disease — but that the fear of low blood sugar emergencies often prevents many people from achieving tight control, and remains a constant concern for those who manage their type 1 diabetes well. The landmark Diabetes Control and Complications Trial (DCCT) showed that with intensive insulin therapy, excellent blood glucose control was obtained, but at the expense of a considerable increase in hypoglycemia. Today, the JDRF study has shown that, with CGM, hypoglycemia can be reduced while maintaining excellent blood sugar control.

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