LONDON, Jan 31, (RTRS): Scientists have shown how an “artificial pancreas” can help pregnant women with type 1 diabetes and say their finding could significantly reduce cases of stillbirth and death among diabetic expectant mothers.
British researchers used a so-called “closed-loop insulin delivery system” or artificial pancreas, in 10 pregnant women with Type 1 diabetes and found it provided the right amount of insulin at the right time, maintained near normal blood sugar, and prevented dangerous drops in blood sugar levels at night.
“To discover an artificial pancreas can help maintain near-normal glucose levels in these women is very promising,” said Helen Murphy of Cambridge University, who led the study.
The experimental artificial pancreas was created by combining a continuous glucose monitor, or CGM, with an insulin pump, both of which are already used separately by many people with type 1 diabetes.
Previous trials in children with the condition found that using an artificial pancreas system at night improved blood glucose control and reduced hypoglycaemia — when the level of glucose in the blood falls too low.
The bodies of type 1 diabetes sufferers become unable to properly break down sugar and if untreated, blood vessels and nerves are destroyed, organs fail and patients can die.
Pregnancy can be particularly risky for women with diabetes as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night.
As a result of high blood glucose levels, babies of women with diabetes are five times as likely to be stillborn, three times as likely to die in their first months of life and twice as likely to have a major deformity, the researchers said.
Data from previous studies suggest that pregnant women with type 1 diabetes spend an average of ten hours a day with glucose levels outside recommended targets, said Murphy, whose findings were published in the journal Diabetes Care.
This increases the risk of birth defects, stillbirth, neonatal death, preterm delivery, oversized babies and other complications.
Type 1 diabetes, an autoimmune disease in which the body destroys its own ability to make insulin, accounts for around 10 percent of all people with diabetes. The more common type 2 diabetes is often linked to bad diet and lack of exercise.

Immunization: Older Hispanics who prefer to speak Spanish or who live in communities where little English is spoken may be more likely to miss their pneumonia or seasonal flu vaccinations, suggests a large new study.
The consequences can be severe for seniors, a population known to be at high risk of serious complications from both pneumonia and influenza. Experts recommend that seniors get the seasonal flu vaccine every year and the pneumonia vaccine once after the age of 65, with a booster 5 years later if they are at particularly high risk.
“Immunizations are so important for seniors. They save lives,” Amelia Haviland of the RAND Corp., in Santa Monica, California, told Reuters Health. “And any group that has a lower take-up rate of immunizations poses a public health risk, particularly for their communities, but also for everyone.”
Hispanic seniors are known to be more likely than their white peers to miss immunizations. Their low vaccination and high infection rates during the 2009 H1N1 flu epidemic, and the more recent whooping cough outbreak in California, are cases in point. But it’s been several years since estimates of immunization rates have been made — and no prior research has looked into differences in rates among different subgroups of Hispanic seniors, according to Haviland.
“They’re a very diverse group, so this information could be really useful for targeting efforts,” she added.
In the new study, Haviland and her colleagues looked at data from a Medicare survey of nearly 250,000 Hispanic and non-Hispanic seniors (aged 65 or older) across the U.S.
They found that pneumonia immunization rates varied substantially among the groups — from 74 percent among whites to 40 percent among Spanish-speaking Hispanics. Hispanics who preferred to speak English faired in the middle at 56 percent.
Rates of flu immunizations were also lower among Spanish- and English-speaking Hispanics — 64 percent and 68 percent, respectively — compared to 76 percent of whites, the researchers reported in the Archives of Internal Medicine.
For seniors on Medicare, the flu and pneumonia vaccines are free. This year in the U.S., popular drug store chains have been offering flu shots for about $30. The cost of a pneumonia vaccine can be twice that, or more — but experts point out that the price is still much less than what it would cost to be hospitalized with severe complications of the infection.
But even after the researchers took factors such as income, health, and education into account, there were still differences between the groups, although not as large.
Further, disparities in flu shot rates appeared higher in “linguistically isolated” areas, where a large proportion of the residents have limited English skills, as well as in “new destination” communities, such as agricultural areas in the southeast that lack a historic Hispanic population.
“This suggests that when there is a long-standing community, they are able to build up better access and better resources for Hispanics in the area,” said Haviland, noting that well-established communities may, for example, have greater opportunities to recruit Spanish-speaking doctors.
Newer communities may also lack continuity of care, or providers who care for their patients over a number of years and would know if a 68-year-old senior had received his or her pneumonia vaccine yet, she added.

Nearsightedness: For many children in poor nations, a simple pair of glasses can be out of reach. But a new study suggests relatively cheap specs that people can adjust themselves hold some promise.
The study, reported in the journal Ophthalmology, looked at the usefulness of “self-refracting” glasses for adolescents with vision problems, mostly nearsightedness.
The glasses are designed so that the wearer can adjust them to the right strength without the need for eye professionals, who are scarce in developing parts of the world. In parts of sub-Saharan Africa, for example, there is just one optometrist for every 1 million people.
Made under the name Adspecs, the glasses are already in use. About 30,000 adults in developing nations have received them so far, according to the Center for Vision in the Developing World — a group directed by Adspecs inventor Dr Joshua D. Silver, a physicist at Oxford University in the UK.
But it hadn’t been clear whether children and teenagers could feasibly use the specs. So in the new study, Silver and colleagues in China, the UK and US had 554 Chinese students aged 12 to 17 years try them out.
The researchers compared the students’ ability to self-correct their vision — under the supervision of their teachers, who had been shown how to use the glasses — against the results of a professional eye exam.
The adjustable glasses work via special lenses made of a clear membrane filled with silicon oil and held between two plastic discs. The wearer can change the amount of oil in the lenses using a removable syringe and dial that attach to the glasses’ frame. Adding or removing oil changes the curvature of the lenses, which alters their strength.
Among kids in the current study, just over 92 percent were able to correct their nearsightedness using the glasses. That compared with a nearly 100-percent rate when the students were given professional eye exams.
“What we have proven is the basic principle,” said Silver in an e-mail to Reuters Health. “The large majority of teenaged children in an area where poor vision from uncorrected refractive error is common can achieve vision sufficient to meet the demands of the classroom.”
But many questions remain, the researchers say — including how well the glasses would work for children in the real world, over the long term.
The specs also have their limits. For example, they cannot correct astigmatism, a common eye problem that is usually mild but can cause blurred vision in some cases. Nor are they known for their stylish looks: They are large, round, thick-framed and vaguely Harry Potter-esque — although Silver’s Center for Vision says the aesthetics should improve as the technology does.
And that is a major barrier to the glasses being put into wide use for now, according to Dr Thomas S. Shane, an eye doctor with Bascom Palmer Eye Institute in Miami who was not involved in the study.
“The obstacle we’d have is getting kids to wear them,” Shane said. “They’re big, they’re bulky, they’re not stylish.”
For the adjustable glasses to become everyday specs, they will need to be made considerably lighter and more attractive, according to Shane, who has been involved in projects to get vision screening and inexpensive, ready-made eyeglasses to people in Haiti and Belize.
However, Shane told Reuters Health, the adjustable glasses could offer a simple, cheap way to assess kids’ vision and determine the level of correction they need. Right now, one way of doing that in the developing world is with portable devices called auto-refractors.
But auto-refractors are expensive and require someone trained in using them. Adspecs, by contrast, are $19 per pair, and can apparently be used by kids as young as 12.
“I think the best thing to come from this study is that it’s feasible for kids to use these as a sort of ‘field refractor,’” Shane said.
He and his colleagues at Bascom are beginning a study where they will have people use the adjustable glasses to self-correct their own vision, then give them inexpensive ready-made glasses based on those measurements.
While many people in wealthier nations see eyeglasses as a basic commodity, they are scarce in other parts of the world.
It’s estimated that about 150 million people worldwide have impaired vision but no access to glasses. And 90 percent of those people live in developing nations, Shane noted. (Impaired vision means vision poor enough that, in the US, you could not drive without corrective lenses.)
Silver has said his goal is to get the Adspecs price down to $1 a pair, and distribute 1 billion pairs worldwide by 2020.
“A key part of further work will be the creation and test of designs which are appealing to kids and well-suited to the rough-and-tumble of daily life,” he said.