Helping to Steady the Balancing Act of Diabetes

The five teenagers who went rock climbing at City Climb in New Haven, Connecticut were typical high school students who lead busy, active lives. What sets them apart is that they were taking part in a pioneering clinical trial to test a system for treating their type 1 diabetes, which can be complicated to manage. “Everything in my life basically revolves around it,” said Jacob Conte, 15.

The standard treatment for children and teenagers with type 1 diabetes is either multiple daily insulin injections or the use of an insulin pump. All of the teens in the study use the pump, first tested at Yale in 1979, to deliver the insulin that helps control their blood sugar. While the pump has advanced diabetes treatment tremendously, it must be operated manually to deliver the correct doses of insulin.

Yale doctors have worked with industry partners to develop what many refer to as an “artificial pancreas,” an insulin pump that works with a continuous glucose sensor to automatically adjust insulin delivery in response to the body’s demand. This closed-loop system, in which the sensor controls the pump on a minute-by-minute basis, would be a major advance for patients with diabetes.

“The ability of the system to self adjust automatically in the background while patients go about their daily lives would really be transformative in the lives of people with diabetes,” said Stuart Weinzimer, MD, who led the study.

During the clinical trial, the teens spent four days round-the-clock with a team of Yale doctors and nurses who monitored their blood sugar levels while they took part in activities that included hiking, playing laser tag, and climbing a rock wall. The idea was to challenge the system to “keep up with kids acting like kids,” said Dr. Weinzimer. The Yale medical team also monitored the teens remotely, even when they were asleep. Blood sugar levels can fluctuate at night when patients aren’t monitoring themselves, causing some parents to stay up to repeatedly check on their children.

Both Jacob Conte and Jacob Liedke, also 15, have mothers with type 1 diabetes who have also participated in clinical research and are all too aware of the challenges their children face. “There’s never been any question in my mind about having him participate in a study,” said Nicole Liedke. “His diabetes control during this study was better than it’s ever been at home.”

For the boys and the other teens who participated in the study, it was an opportunity to learn more about the disease and play a part in finding ways to more easily manage their diabetes.  “I really want to see a cure in my lifetime, so I’m helping to find one,” said Jacob Conte. “That’s the coolest thing ever.”

    “To me, this is the mechanical cure for diabetes that I’ve been waiting for my whole life,” said his mom.  “He’s making history. For him and for our family, this was an unexpected opportunity of a lifetime.”

He’s making history. For him and for our family, this was an unexpected opportunity of a lifetime.