Innsbruck-based diabetologist is involved in a study with small children – an app evaluates measurement data in “closed-loop” systems and controls insulin delivery – more precisely and safer than humans
The treatment of type 1 diabetes is time-consuming and particularly challenging the parents of affected small children. Glucose sensors and insulin pumps are already helping with therapy – in future, they will be linked by artificial intelligence. Sabine Hofer, Head of the Diabetes Outpatient Clinic at Innsbruck University Clinic for Pediatrics 1, is involved in a European study of the “closed loop” system. In the APA interview, she reported “impressive” results.
“Parents of diabetic toddlers face enormous challenges in everyday life,” explained Hofer. “The blood sugar content has to be determined six to ten times a day. The children have to be injected with insulin four to six times a day”. Type 1 diabetes is an autoimmune disease that causes the insulin-producing cells in the pancreas to be destroyed. Although the disease can be treated well, it intervenes massively in the everyday life of those affected, Hofer described. Parents are constantly worried: “An undisturbed night’s sleep is hardly possible”. If the blood sugar drops too sharply and suddenly, this can lead to unconsciousness and seizures.
Technical aids are already helping to keep control over the sugar level. In so-called “closed-loop” systems, the glucose sensor and insulin pump are linked by an algorithm, the Innsbruck diabetologist described the latest technology. The algorithm is controlled and monitored using a smartphone app.
In a study sponsored by the European Union, the suitability of this method for small children will be examined by the end of the month. 71 children under eight years of age have participated in the study since autumn 2019, in which, in addition to the Medical University of Innsbruck, study centers in Vienna, Graz, Cambridge, Leeds, Luxembourg and Leipzig were also involved. The studies of this “particularly vulnerable” group would show the influence of artificial intelligence-based therapies on “the quality of life and development of small children” despite their diabetes, explained Hofer.
A pilot study was previously carried out in which 20 small children took part. The study was completed in 2019, and the recruitment of participants for the main study would have started immediately afterwards. At that time it was shown that the system “can be used very safely – both at night and during the day”. It is “incredibly impressive” how “calm and stable the nightly glucose levels are”, emphasized Hofer, “it is no longer the doctor, but the algorithm that determines the precise dosage of insulin supply. Artificial intelligence is simply ahead of us in some respects”.
“But the person is still the boss,” added the doctor, adding that one does not give up all control. In this case, however, technology could help with fine-tuning, and corrective measures by parents would “largely be omitted”. The parents had reported enormous relief after the pilot phase. The quality of sleep has improved enormously. “A mother told us that there were suddenly moments when she was allowed to forget that her child had diabetes,” said Hofer, adding that it was a “moving moment”.
90 percent of the parents participating in the pilot study would recommend the “closed loop” system, three quarters of all participants from Innsbruck would like to continue using the system over the long term. It has already been shown that the system is suitable for everyday use; the data will be statistically processed from March onwards. “I’m sure the data will be convincing,” said Hofer, now it is a matter of showing “measurable improvements”.
The closed-loop system is not yet commercially available, but it is already CE-certified. Hofer hoped that it would “make the leap into everyday treatment” within the next one to three years. It is important that there is a “rethinking of the health and insurance companies”, stated the doctor. “These costs must be refunded”. Medical apps will play an increasingly important role in the future.