An initial study of Abbott’s Freestyle Navigator Continuous Monitoring System by the Diabetes Research in Children Network (DirecNet) Study Group, presented last week at the Scientific Sessions of the American Diabetes Association, serendipitously found that a portion of the children studied tended to become more involved an interested in self-management of their diabetes treatment.
The study followed 30 children, from 4 to 17 years old, for 13 weeks while they wore the sensor at home. (Only the first 7 weeks of results were presented.) They were contacted about once a week by a healthcare provider.
The sensor, which penetrates the skin a few millimeters, alerts patients with an alarm if their blood sugars are predicted to become too high or too low within 20 minutes. The research team developed an algorithm for each child, based on the age and historical blood sugar levels, that calculated optimal insulin doses, which were communicated to the patient.
According to Dr. Bruce Buckingham, who presented the findings, “The device brings the behavioral aspects (of diabetes management) into play. Children were able to see when to change what they’re eating and to adjust insulin accordingly…Some of the kids got to be pretty good at it. The ones who watched the closest really got it.”1
Overall, subjects using the device improved their treatment self-management.
Commentary
It certainly seems possible that children and adolescents who take their disease management seriously and those who appreciate challenges and competitiveness could benefit from this continuous glucose monitor. While I’m not privy to the original reasoning behind the tactic, I think it may have been key that the researchers apparently had the children make their own predictions of the insulin dose needed, which was then compared with the algorithm-calculated dose; 59 percent of the time these numbers were different.
Of course, 7 weeks of results from a study with an N of 30 does not establish a clinical certainty. And, other explanations, especially Hawthorne Effect, for the kids’ increased involvement abound.
Still, it is an intriguing possibility and one that deserves further investigation.
__________- Martha Kerr, Sugar monitor gets kids involved in diabetes care. Reuters. June 15, 2006.↩