Yale Physician To Lead National Group On Juvenile Diabetes

A Yale expert on juvenile diabetes is heading a national group that will be testing the most advanced blood sugar sensing technology for children with type 1 diabetes, research that hopefully may lead to the first artificial pancreas.

The project involving five centers around the country is sponsored by the National Institute of Child Health and Human Development. In addition to Yale, the centers are at the University of Colorado, Stanford University, the University of Iowa, and a diabetes center in Jacksonville, Fla.

“The research relates to advances we have seen in the last couple of years in glucose sensor systems,” said William Tamborlane, M.D., professor and section chief of pediatric endocrinology at Yale School of Medicine. “Over the last 20 years we have tried to regulate diabetes by having patients prick their fingers four times a day and measure glucose levels. Now there are two U.S. Food and Drug Administration-approved continuous glucose monitoring devices available.”

Tamborlane said the institute solicited applications from institutions that are researching type 1 diabetes, which is a more severe form of diabetes that affects children. Type 2 diabetes generally is diagnosed in adults.

“The NIH felt it would be important to put together a group of leading centers in the country to study, in a scientifically rigorous and unbiased way, how these glucose monitoring systems could be used in children with type 1 diabetes,” said Tamborlane, principal investigator for the Yale study and chair of the group’s steering committee.

He said diabetes remains an extremely difficult disease to manage, particularly in young patients. Although physicians have succeeded in lowering blood sugar levels, Tamborlane said the continuing major obstacle is the increased frequency of severe hypoglycemic reactions that lead to seizures and coma.

“Sensor technology could be a major breakthrough to better adjust our therapy to reduce some of the risk of treatment,” he said. “If the sensors work reliably over six months to a year, then, with continuous subcutaneous insulin infusion therapy (CSII), this could be an important first step in the development of an artificial pancreas.”

He said the first study the centers will undertake is validating the accuracy of the two available glucose sensors and how they work under varying conditions, such as during exercise or after eating different meals.