‘GlucoWatch’ may be useful in diabetic tots

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A wristwatch-like monitor that checks blood sugar without a needle may be useful for managing Diabetes in young children, new research suggests.

The study looked at the feasibility of using the monitor, sold as the GlucoWatch G2 Biographer, in toddlers and young children with type 1 diabetes, a disease in which the immune system mistakenly destroys pancreatic cells that make the hormone insulin.

Insulin is needed to move the sugar digested from foods out of the blood and into cells to be used for energy. People with type 1 diabetes must take injections of synthetic insulin every day in order to survive; they also have to check their blood sugar levels several times a day with a finger-prick test.

The GlucoWatch device, which can be worn like a watch or around the ankle, continuously monitors blood sugar levels throughout the day or overnight. It cannot replace finger-prick tests, but is instead intended to give diabetics a better idea of how their blood sugar fluctuates throughout the day. In addition, an alarm goes off when blood sugar drops below a certain level or soars too high.

The monitor is approved for use only in adults and children older than 7, but younger children and toddlers could potentially benefit, according to the authors of the new study, because they are often unable to tell their parents when they have symptoms of low blood sugar.

“They don’t express the symptoms like older children do,” said lead author Dr. Eba Hathout, director of the Pediatric Diabetes Center at Loma Linda University in California.

The fact that the monitor appears “tolerable and usable” among young children is promising, Hathout told Reuters Health, because good blood-sugar control is essential for reducing the long-term risks of diabetes—which include damage to the kidneys, heart, eyes and nerves.

People who develop diabetes early in life are at greatest risk of such complications, Hathout said, so finding ways to better manage young children’s blood sugar is particularly important.

For their study, she and her colleagues followed 46 children with type 1 diabetes --15 of whom were younger than 7—for three months. Families were instructed to use the GlucoWatch monitor for two daytime and two nighttime periods each week over the course of the study.

Overall, Hathout’s team found, the monitor accurately sounded an alarm to signal steep blood-sugar drops about three-quarters of the time.

The findings are published in the March issue of the journal Pediatrics. Some of the study co-authors are with Redwood City, California-based Cygnus Inc., which developed the monitor.

The GlucoWatch device works via a low electrical current that pulls glucose (sugar) through the skin, from the fluids that exist between body cells and tissue. Sugar levels in these fluids have been shown to reflect sugar levels in the blood.

The main side effect of the monitor is skin irritation, and about one-third of the children in the study dropped out, in part, because of irritation or restlessness caused by the alarm going off—particularly at night.

However, Hathout said, it’s similarly tough for families to comply with finger-stick testing, and the study’s drop-out rate can be seen as a “reflection of real life.”

Still, the GlucoWatch monitor is not for everyone, Hathout added, and more research is needed to refine such non-invasive technology.

“We need improved devices, and that’s in the works,” she said.

The researchers did not find clear improvements in the children’s blood sugar control over the study period. However, Hathout noted that a previous study of children with type 1 diabetes did find that the device aided long-term blood sugar control.

SOURCE: Pediatrics, March 2005.

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