April 29, 2003 -- A wristwatch-like device that automatically monitors blood glucose levels helps people with type 1 diabetes better manage their disease. Children participating in a newly published study had better blood sugar control when they wore the GlucoWatch Biographer than when they used conventional monitoring methods.
The study is the first to show that using the GlucoWatch Biographer, which gives glucose readings as often as every 10 minutes, allows patients to better adjust their insulin levels and stay within normal ranges. The GlucoWatch Biographer appears especially useful for detecting dangerously low blood sugar during sleep. This is a common problem in diabetes management, which can lead to seizures and even death.
Boulder, Colo., teenager Mathew Cooper, 13, was one of the first diabetic people in the country to wear the special watch, and his mom, Sonia, says it has taught them a lot about his nighttime blood sugar patterns. Mathew typically wears the device several times a week while sleeping.
"When kids hit the teen years, it is a time when they have a lot of adjustments to their insulin," Sonia Cooper tells WebMD. "Insulin use tends to go way up during puberty, so it is nice to have a tool to help us identify these trends."
Roughly 1 million Americans have type 1, or insulin-dependent, diabetes. Once known as juvenile-onset diabetes because it is most often diagnosed in children and adolescents, type 1 diabetes occurs when the body fails to produce insulin.
Proper management of the disease requires careful monitoring of glucose levels, which has traditionally meant drawing blood at least four times a day. New technologies for monitoring blood sugar require less frequent fingerstick testing.
The GlucoWatch Biographer, manufactured by the Redwood City, Calif., company Cygnus Inc., uses extremely low electric current to pull glucose through the skin. An initial blood sample is needed each day to calibrate the device, but it then automatically monitors glucose levels as frequently as every 10 minutes for up to 13 hours. An alarm sounds when blood sugar levels become too high or too low.
In this study, published in the April issue of the journal Pediatrics, childhood diabetes specialist H. Peter Chase, MD, and colleagues compared disease management in diabetic children who used the GlucoWatch Biographer with those who did not. All the children had episodes of poor glucose control prior to entering the study. Twenty were asked to wear the GlucoWatch Biographer four times per week for three months and to do fingerstick blood testing if the watch alarm sounded. Twenty others used traditional monitoring methods. At the end of three months, all the children were given the watches for an additional six months.
Diabetes control was similar in both groups at the beginning of the study, but much improved for the GlucoWatch Biographer group three months later. Low blood sugar was detected more often in children when they were wearing the watch, especially at night.
"The GlucoWatch made it much easier for families to identify blood sugar patterns at different times," Chase tells WebMD. "The reality is that 95% of diabetes care in children is done by the family in the home setting, and the more they know, the better."
But the GlucoWatch Biographer is not without its problems. It must be worn for two hours before blood sugar can be read, patients have reported difficulty hearing the alarm during the night, and false alarms are not uncommon.
Pediatrician Leslie P. Plotnick, MD, who wrote an editorial accompanying the study, tells WebMD that she is confident that the technology for monitoring glucose levels will evolve rapidly.
"I'm no technology guru, but I have no doubt that the next generation of watches will be smaller and work better," she says. "Insulin pumps were awful when they first came out, but now they are wonderful."