Four patients (and their families), eager to finally take advantage of a technology that will radically change their daily life as diabetic children: in mid-February, the pediatric diabetology department of the Hyères hospital equipped these adolescents suffering from a type 1 diabetes (1) of the first closed-loop insulin treatment system (read elsewhere) accessible to children, and reimbursed since last October by health insurance.
This technology (Minimed 780G) combines a blood glucose sensor attached to the child’s skin, connected to a transmitter, and an insulin pump, all controlled by a complex algorithm.
A better quality of life
“Thanks to the algorithm, this system allows the insulin pump to adjust the delivery of insulin in real time, depending on the child’s glucose level which is measured by the sensor placed on his skin and transmitted to the pump via the transmitter” summarizes Dr. Jamel Khoury, head of the pediatric diabetology unit. “The algorithm constantly strives to bring blood glucose – the blood sugar level – closer to a predefined target value, while avoiding hypoglycemia, in other words the drop in blood sugar level.
The doctor, like the families, do not hesitate to speak of revolution: “The closed loop dramatically improves the quality of life of eligible patients and their families. Day-to-day management of the disease involves constant monitoring, including at night, with consequences for sleep. This system also reduces complications over the long term, by making it possible to target the predefined glucose level more regularly. We have patients who are up to 90/95% of the time at the target level, explains the doctor, knowing that beyond 70% is already good.”
A structured course of therapeutic education
If the imperatives related to the daily management of diabetes are considerably reduced, the child and the family must however be able to respond to the demands of the algorithm. “We must inform him regarding the quantity of carbohydrates ingested at mealtimes and we must also announce in advance the physical activity sessions which affect blood sugar since the body consumes glucose during exercise” perfectly sums up Océane, a 15-year-old patient, diabetic since the age of 10. “We had carb counting training and if we have any doubts, there is a Gluci-Chek app to help us” says his mother, Lauriane.
To benefit from these first closed loops, the four young people from Var and their families followed a structured course of therapeutic patient education (TPE).
“We start with a specific preparation and education phase three months before the closed loop. And in the three months following the commissioning of the pump, six follow-up appointments and tele-consultations are scheduled, according to specifications set by decree and by the Francophone Society of Diabetes” indicate Dr Khoury and the two pediatricians in charge of the ETP, Marie-Aude Léon and Mégane Graziussi.
In Hyères, these pathways are organized thanks to nursing time for therapeutic education, the intervention of self-employed nurses from the Var Educ Santé association (via a partnership agreement with the Hyères hospital center) but also and above all thanks to “to the specific and targeted training in this technology of the diabetology team, associated with its great motivation” welcomes the management of the hospital.
In addition to these four young patients, eight other diabetic children over the age of six will benefit from this technology by June.
1 – Type 1 diabetes is due to a lack of insulin secretion by the pancreas, while type 2 diabetes results from poor use of insulin by the body’s cells.
