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Sugar sensors and insulin pumps for diabetic people

There are around 4.7 million people with diabetes (irrespective of type) in the UK, which is equal to almost 7% of diabetics in the British population. The life expectancy with diabetes is severely reduced, e.g. type 2 and 1 diabetes reduces lifespan in average by  10 and 20 years, respectively. The reduction in lifespan is partially explained by the fact that diabetes makes other diseases of aging more severe (e.g. atherosclerosis which leads to heart attack). NHS spends around 10 billion pounds on diabetes treatment and gives 1 in 6 beds in hospitals to diabetic people. 

Diabetes commonly appears as we age, reduces the quality of life and steals years of life.  Since I have diabetic grandparents, I am aware of blood sugar sensors and insulin pumps. These sensors are amazing technology which continuously monitor sugar and can provide important information, such as what happens with sugar during the day and night. This information is helpful to improve the insulin regiment, change eating habits and choose better most suitable physical activity. Sensors are convenient (no finger pricking, no mobile phone is necessary). However, they can be improved by informing the person about high or low sugar levels by e.g. beeping. 

Insulin pumps inject insulin into the person when the sugar is higher than the normal level. It is convenient (no needles needed, it corrects sugar when you asleep, etc.). However, it is prone to be blocked by blood clots. Moreover, since the pump keeps sugar at normal level, an older person can get dangerous hypoglucaemia when they exercise vigorously. 

I strongly believe that if sugar sensors and insulin pumps are improved, then the older people will be less likely to hospitalised due to complications of uncontrolled diabetes (e.g. kidney failure, vision loss, gangrene, or diabetic coma). Moreover, people will be able to have higher quality of life, more years to live, and NHS can save millions of pounds. 

I hope that other people can share their experiences with blood sugar sensors and insulin pumps, and suggest other ideas how to improve them. 

 

Statistics was obtained from Diabetes UK "Facts and stats" report published on Jan 2019.

edited on Oct 23, 2020 by Miroslava Katsur
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Georgie Cade 11 months ago

This is a really interesting idea! Have you spoken to your diabetic grandparents about what they think is the most important aspect to improve?

Does anyone else here have any experiences with blood sugar sensors or insulin pumps they could contribute?

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Catalina Romila 11 months ago

@Miroslava Katsur super interesting post, thanks for sharing this. I definitely agree that with improved medical devices things like blood sugar levels could massively improve the lives of millions of diabetic patients.

The good news is that many healthcare providers are aware of some of these challenges, and innovation together with technology try to rise to these challenges. One good example of this is the Apple watch; not only these are now helping in monitoring health in many ways but the new generation is taking this to a whole new level where in addition to blood pressure and ECG/EKG which can spot signs of atrial fibrillation, it will also aim to keep an eye on blood O2 levels and even be able to detect falls. The latter is particularly important and relevant to the elderly where falls are common which often are the cause of many more health problems, and being able to alert others would make such a difference.

I suppose the main challenge with this is bridging the technology gap where many elderly already feel at a disadvantage, and only through better communication and wider implementation we can start closing off this gap, ultimately helping those that are more vulnerable enjoy a better quality of life.

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Miroslava Katsur 11 months ago

@GeorgieCade Thank you! I have talked to my family yesterday and they mentioned several things.
1. They said that one of the biggest issues is that they need to constantly think about their sugar levels, which results in anxiety and depression.
2. Pumps supply insulin at basal rate to keep sugar stable during the day, and people need to enter the amount of insulin on the pump which needs to be additionally injected after each meal. They also said it is possible to switch the pump off before an exercise to prevent the dangerously low sugar levels.

As @CatalinaRomila mentioned, there are already both awareness of the problem, plus the development of better sugar monitors. There are already technologies like FitBit watch which can monitor the physical activity and calorie burn, sensors to monitor blood sugar and insulin pump which constantly supplies insulin to the body. My family thinks it could improve the health and mental wellbeing of diabetic people if these technologies could be combined. It is incredibly challenging for the person to decide on their own how much insulin to inject, because:

1. You don't always know how many carbohydrates you eat. For example, you eat out or at your friends house, or you simply forget to count carbohydrates (memory problems), or you calculated carbohydrates incorrectly.
2. You don't always know how much sugar will be burned in the next hours. For example, you may suddenly realise you need to go to shop, or you walk a bit faster today - it is not possible to predict well how each activity will affect your sugar.
3. Stress and illness (e.g. flu) increase sugar levels, and it is almost impossible to guess how much insulin a person needs to inject per unit of carbs.
4. There are cases that even with very controlled lifestyle the pump may overinject insulin (e.g. user error, when one estimates insulin needed for a meal is incorrect).
5. If you oversleep, you miss increase in blood sugar levels, which can climb dangerously high. I guess when the morning comes, the body starts to produce glucagon to ensure the person is ready for any activity. However, some older people (like my grandma) suffers from insomnia, which is common in people as they age, so she stays sometimes longer in bed. Then, she misses the spike in blood sugar, and her all day gets ruined because high blood sugar makes person very unwell.

After discussing all these points, we arrived to a conclusion that combined technologies such as those which track physical activity, a pump which supplies insulin and a blood sugar sensor would be desirable for diabetic patients. If sensor constantly feeds information to the pump, the pump would be able to adjust insulin injections based on that information, with no need for a user to guess their carbohydrates intake in various situations (walking, having flu or stressful day). Moreover, the activity sensor could help to predict further sugar changes and imrpove the dosage of insulin. The mind of an older person can be finally free of worry about sugar measuring and insulin injections, constant worries about hyper and hypoglucaemia or diabetis-related diseases. My family says that if such technology is available, they would be happy to pay higher cost for a better quality of life. However, the price of such invention should be not too high to make it as affordable for NHS/older people as possible.

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Octavio Zamudio 11 months ago

This is certainly of tremendous interest. What you describe, to some extent, has just been awarded research funds by the H2020, so it seems that this is the direction being taken for the future, this project may be of further reference:

https://cordis.europa.eu/project/id/951933

https://www.apt-norway.com


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Miroslava Katsur 11 months ago

@Octavio Zamudio Thank you for sharing these links. My boyfriend, who is type 1 diabetic and also a researcher/medical doctor, discussed these projects with me. So, the Norwegian group works on the delivery of glucagon and glucose sensing based on spectrometry. It can make pumps which would prevent not just high, but also low blood sugar. Moreover, such sensors can last a lifetime with no need of needles. These sensors can be built in a smartwatch to monitor blood sugar, convey its information to a pump which has both glucagon and insulin. The work of Norwegian group seems excting!

However, H2020-funded project is quite bold for me, who did a pharmacology degree. "Pump refilling through a weekly oral recyclable drug pill" sounds less realistic for me compared to the work of the Norwegian group. I cannot imagine how they can ensure that the drug will go straight to a pump implanted in the body, that the drug won't spill the contents on route (which would result in immediate death of a patient), and, moreover,how the drug can be recycable. I am not aware of similar technologies excisting already and I think that this project, even if successful, may take decades before being offered to patients.

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Georgie Cade 11 months ago

Status label added: Useful insight

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Bonolo Mod 11 months ago

The FreeStyle Libre flash glucose monitor (pictured above in the top right) is great because very time a person scans the results are shared with pre-registered family members and the primary care giver (doctor). This also encourages lifestyle changes around what to eat, increasing exercise and reducing stress which can help to effectively manage diabetes.

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Adrian Girling 11 months ago

I'd like to see more work being done to find out why the body loses the ability to produce insulin. In far too many examples of chronic health conditions I believe there is too much emphasis on managing the condtion than fixing it - there is no ongoing revenue from a condition cured....

See https://www.med.uio.no/klinmed/english/resear...ty-insulin.html for research moving in the right direction

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Miroslava Katsur 11 months ago

I'm happy to see this work. I suppose the reasons of type 1 diabetes are complex. I know people who got it because of some respiratory viral infection, pregnancy, or just by getting old. The cause of type 1 diabetes seems to be harder to decipher, and I would like to see a cure for it one day. I guess we need to know when to intervene in time to prevent the loss of insulin-producing cells.
With type 2 diabetes, I know that diet and physical exercise can reduce its burden or completely get rid of it.

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Georgie Cade 9 months ago

Status label removed: Useful insight

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