Stable blood sugar? There’s almost an app for that

Technology moved a little closer to the long-sought goal of helping diabetics maintain something close to normal blood sugar levels, around the clock, without the ordeal of endless finger sticks and insulin injections.

And yes, it involves an iPhone app.

Although not yet available, researchers at Boston University reported in the New England Journal of Medicine this week they had achieved much more stable blood sugar levels with a “bionic pancreas” in two small studies of type 1 diabetics — one involving 20 adults, and the other 32 adolescents attending a diabetes camp, over the course of five days.

In type 1 diabetes, the body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. About 4 million Americans suffer from the disease.

Although insulin pumps have been around for many years, and continuous blood sugar monitors more recently, getting them to work together hasn’t been easy. In addition, there was still the serious risk of hypoglycemia — or very low blood sugar — which can lead to hospitalization and even death.

The new technology combines continuous blood sugar monitoring with a dual-action pump that injects both insulin to lower blood sugar when it’s high, and glucagon to raise it when it’s too low. The iPhone app contains an adaptive algorithm that interprets the ever-changing blood sugar level and adjusts it using insulin or glucagon. That information is sent back and forth wirelessly.

That algorithm is critical to making minor adjustments throughout the day. Any number of factors can make blood sugar levels in the blood rise and fall, including diet, physical activity, stress and illness.

Dr. Daniel Hale, a pediatric endocrinologist and professor of pediatrics at UT Health Science Center San Antonio, said the same technological advances driving improvements in every aspect of modern life are also helping diabetics.

“Technology just keeps getting better and better and smaller and smaller,” said Hale, who practices at University Health System’s Texas Diabetes Institute Children’s Center.  “And that means that you can add more and more bells and whistles — like a second pump for glucagon and additional computer power that permits more complex calculations and the integration of a continuous blood glucose monitor.”

Hale cautioned that continuous glucose monitors “still must be calibrated several times a day, and you still have to pay attention to diet and activity.”

The next step is the launch of larger trials with many more people to confirm the benefits of the device.