THIRUVANANTHAPURAM: A ground-breaking multi-centre study, which included patients from Thiruvananthapuram, holds promise for parents concerned about Type 1 diabetes (T1D) in their children. The study found that an advanced automated insulin delivery system can significantly improve outcomes for children with the condition, potentially saving lives that would otherwise be lost 15 years after diagnosis.
In Kerala, where there are 4,500 children with TiD, two children die every month due to complications from inadequate insulin management. Because blood-glucose levels can fluctuate unpredictably and dangerously, parents often stay up all night administering insulin or giving sweets to stabilise their child’s glucose levels. Despite their best efforts, it’s not uncommon for children to pass away in their sleep or while en route to the hospital as the very management of optimal levels of glucose in TiD patients is challenging.
The study, led by Dr Jothydev Kesavadev in Thiruvananthapuram, Dr Manoj Chawla in Mumbai, and Dr Banshi Saboo in Ahmedabad, involved nearly 40 children with T1D. It found that using the Advanced Hybrid Closed Loop (AHCL) system for at least 60 days helped maintain glucose levels within the safe range (70-180 mg/dL) 76% of the time, or more than 17 hours a day. To prevent complications, at least 70% time in range (TIR) is essential, with an ideal target of 85%.
This is a significant improvement, as the widely used insulin pump with a continuous glucose monitor only guarantees 45-50% of TIR. Achieving proper glucose control is essential to preventing long-term complications, such as damage to the eyes, kidneys, heart, and nerves, and reducing the risk of premature death.
“The findings highlight the potential of automated insulin delivery technology in revolutionising T1D management, improving glycemic control and lowering the risk of severe complications. It holds promise for patients to lead normal lives,” said Dr Jothydev, a research diabetologist at Jothydev’s Diabetes Research Centre.
Cost poses challenge
Despite the promising results, the advanced system presents challenges for patients. The machine costs Rs 6 lakh, with monthly accessory costs coming to Rs 20,000.
Health experts are urging governments to adopt this new technology for T1D management and make the devices available free of charge. “Many of the children with T1D come from economically disadvantaged backgrounds. We should also explore manufacturing the devices under the ‘Make in India’ initiative. Domestic production could bring the initial cost down to Rs 50,000,” Dr Jothydev said.
According to Breakthrough T1D, a global research and advocacy organisation, individuals with T1D in India lose an estimated 45 healthy years of life due to ill-health, disability, or premature death.