Diabetes: Better quality of life through AI

According to experts, type 1 diabetes is the most common metabolic disease in childhood and adolescence. In Germany, around 32,500 children and young people aged up to 19 are affected. When young children suffer from diabetes, it is an enormous burden not only for them but also for their parents. Researchers are now reporting that artificial intelligence (AI) can help improve the quality of life of those affected.

As in a current Message In other words, the diagnosis of type 1 diabetes in preschool children poses major challenges for parents. A “closed-loop system” implemented by the University of Cambridge (Great Britain) – glucose management via mobile phone app, glucose sensor and insulin pump – can make everyday life much easier for those affected and improve the children’s blood sugar control safely and effectively. These are the results of the recently completed EU project KidsAP, in which the Medical Universities of Vienna, Graz and Innsbruck were also involved. In the specialist magazine “New England Journal of Medicine‘ is reported about the project.

Elaborate treatment

The treatment of type 1 diabetes in young children is complex and often robs parents of their sleep in the truest sense of the word. It is not only during the day that the blood sugar has to be measured and, depending on the carbohydrate intake, the corresponding insulin dose has to be calculated and given. Repeated blood sugar checks and, if necessary, insulin or carbohydrate intake are also required at night.

According to the information, young children have pronounced blood sugar fluctuations, a very regular need for insulin and unpredictable eating and exercise behavior and are therefore at risk of having dangerously low blood sugar levels (hypoglycaemia) and high blood sugar levels (hyperglycaemia).

If the blood sugar drops too sharply and suddenly, this can lead to unconsciousness and seizures. If the blood sugar level is too high for a long time, the risk of acute severe metabolic disorders and the development of life-threatening diabetic ketoacidosis is increased.

Reduce high parental stress

In conjunction with artificial intelligence (AI), an algorithm for controlling the so-called “closed-loop system”, the high burden on parents can be reduced and glucose management significantly improved. This is the result of the recently completed international EU project KidsAP, which was coordinated by the University of Cambridge and in which the medical universities of Innsbruck, Graz and Vienna played a key role alongside other European study centers.

This system, which was tested in seven study centers (Cambridge, Leeds, Luxembourg, Leipzig, Graz, Innsbruck, Vienna) on a total of 74 children between the ages of 1 and 7, works with an app (CamAPS FX) run by Roman Hovorka at the University of Cambridge. , which is being studied in combination with a glucose sensor and an insulin pump as an artificial pancreas.

As explained in the notification, the amount of insulin delivered will be automatically adjusted based on predicted or real-time glucose readings. The child’s caregiver only has to administer insulin at mealtimes to ensure that glucose and insulin requirements are continuously adjusted; at all other times, the algorithm works by itself to keep the programmed glucose target (usually 100 mg/dl) at and stable. The frequency of bloody measured values ​​can thus be significantly reduced.

Improving glucose control

To evaluate the safety and effectiveness of the closed-loop system versus sensor-assisted insulin pump therapy, participating children used the app-controlled system for 16 weeks, followed by control therapy with conventional sensor-assisted insulin pump therapy for 16 weeks.

The evaluation of the data showed that the time in the glucose target range (70-180 mg/dl) could be increased significantly, so that the children were in the target range an additional 125 minutes per day. This resulted in a 0.7 percent reduction in the HbA1c value in young patients who were already very well adjusted. This laboratory value provides information about the setting of the metabolism: the lower, the better the prognosis and the lower the risk of late complications caused by diabetes.

In addition to this improvement, the time with elevated blood glucose levels was also reduced by nine percentage points using the closed-loop system. According to the experts, this improvement in glucose control could occur without an increase in hypoglycaemia. In both studies, the risk of hypoglycaemia was equally low.

In addition, the heads of the three Austrian study centers Innsbruck (Sabine E. Hofer, University Clinic for Pediatrics I), Graz (Elke Fröhlich-Reiterer, University Clinic for Pediatrics and Adolescent Medicine and Julia Mader, University Clinic for Internal Medicine) and Vienna (Birgit Rami-Merhar, University Hospital for Paediatrics) from parents who rate the closed-loop system as “enormous relief both during the day and at night”. (Display)