New Devices May Free Diabetics From Constant Monitoring
Sunday, April 23, 2006
When Casey Burkhalter, 12, was diagnosed with diabetes 2 1/2 years ago, her parents started waking up repeatedly at night to test her blood sugar, typical of the exhausting tasks many of the nation's 21 million diabetics go through to extend their lives.
But no more. For four months the Jacksonville, Fla., girl has been wearing an experimental gadget that provides a continuous reading of her blood sugar and wakes the family if it falls dangerously low. The Burkhalters can sleep now, confident that their youngest child will be alive when the sun comes up. "My parents -- it's just been a cinderblock off their backs, not having to get up at night," Casey said.
The technique she's helping test is called continuous glucose monitoring, and it's a goal researchers have chased for nearly 50 years. Now, they say, they can finally see the finish line. Sophisticated monitoring devices that promise diabetics a new measure of freedom are just coming to market and are expected to be widely available in the United States by late this summer.
The monitors aren't perfect yet -- they're not as accurate as blood tests, and they're slow to discern the rapid changes in blood sugar that can accompany activities such as exercise. At least for now, patients who wear them are urged to draw blood periodically for comparison. But researchers hope that within a year or two, the devices will allow diabetics to go for long stretches, possibly days, without using the hated finger lances that are the bane of their existence.
People who have used the monitors say that, despite the limitations, they work without much discomfort. More importantly, initial research suggests the devices could improve the control of blood sugar, a task at which diabetics do poorly on average. That would offer a new way to cut the nation's $100-billion-a-year bill from diabetes complications and reduce the suffering -- heart disease, stroke, amputations, blindness, impotence, kidney failure -- associated with the disease.
"I want to tell the world about this," said Leslie Burkhalter, Casey's mother and a jewelry saleswoman in Jacksonville. "It's going to add years to people's lives. All these things going on right now -- amputations, heart disease -- it's all going to be stopped."
Few doctors are ready to go that far yet, but they are paying attention. "The idea that there are devices that are marketable is a big breakthrough," said William V. Tamborlane, a diabetes researcher at Yale University.
The devices from different manufacturers resemble one another. A patch worn on the abdomen carries a tiny wire that pokes through the skin to measure glucose in cellular fluid. The patch hurts a bit going on but is comfortable afterward, patients say. The patch is worn for several days, wirelessly transmitting information to a receiver the size of a mobile phone, before it is replaced with a new one.
The Juvenile Diabetes Research Foundation, a principal advocacy group for people with the most serious form of diabetes, has gone into overdrive in recent months as its officers concluded that the new devices could represent a big improvement in care.
"I think this signals a new era where we can take diabetes by the horns and really start to control it aggressively," said Aaron J. Kowalski, the group's director of strategic research. "Diabetics have been waiting a long, long time for this."
With money raised from bake sales and diabetes marches across the country, the foundation is launching a series of independent studies designed to test manufacturer claims about the new devices and provide information on their worth. Among the big questions are how much they can cut rates of hospitalization, car accidents caused by drivers with low blood sugar and the many other problems attributable to diabetes.
The group is also pushing to mate the glucose sensors with insulin pumps, which have been on the market for years, to create automated systems that might be able to control diabetes for days with minimal intervention. That technique has been tested on a small scale recently at Yale University, and the creation of a commercial system was recently designated a priority by the Food and Drug Administration.