Alia, right, with her sister. She was one of the first cohort of young patients to use the hybrid closed-loop pump
Doha: Sidra Medicine, a member of Qatar Foundation, has successfully established its Type 1 diabetes (T1D) treatment protocol for children and young people as a best practice model.
The protocol is based on the effective use of an insulin pump. The pump, which is a hybrid closed-loop system, acts as an artificial pancreas to help children and young people with T1D control their insulin dosage, without the need for multiple daily injections. Based on an initiation schedule developed in-house at Sidra Medicine, the protocol also allows for remote follow-up care.
The protocol was launched two years ago as a pilot program by Prof. Goran Petrovski an attending physician of pediatric endocrinology and his team at the Diabetes Clinic at Sidra Medicine. It follows a step by step process and initiation schedule for the hybrid closed-loop, provided by a multidisciplinary team of endocrinologists, nurse educators, dietitians and nurses. Since its implementation, it has fast tracked the treatment process of nearly 100 children and teenagers with T1D being cared for at the hospital’s diabetes clinic.
The first step of the protocol involves the children and teenagers (between the ages of 7-17 years) being assessed for eligibility and compatibility with the closed-loop system. They then undergo training for five consecutive days, where both patient and family are provided consistent information and support. The patient first trials the system on manual mode – before it is switched to automatic mode. The whole transfer from “injection to pump” process can be achieved in ten days.
Prof. Petrovski said: “Hospitals worldwide follow different protocols in diabetes management depending on the treatment, technologies and the ease and access to insulin. As a result of the work that was achieved in Qatar at Sidra Medicine, we are now in a position to be considered as a best practice center that showcased the most effective use of the hybrid closed-loop. Our protocol was able to prove that we are truly empowering the children to have better glycemic control and improving their quality of life, all within a matter of days. Given the current circumstances and safety measures about social distancing, the protocol is effective as we can provide remote follow up care without expecting families to come in to the clinic.”
“We recently published the results of our protocol in Acta Diabetologica and presented it at several international conferences a few months ago. We have many children’s hospitals from neighbouring countries and as far as Europe and Australia, reaching out to us to find out how they can implement the protocol. In fact, Qatar is the first Middle Eastern country to successfully show the best results in using the closed-loop system with our treatment protocol program,” continued Prof. Petrovski.
The hybrid closed loop system uses a sensor and a controller-aided insulin pump to monitor glucose levels. The device is attached to the body of the patient. The sensor reads the glucose levels in the body and sends the information to the controller in the pump which based on the reading, uses algorithms to calculate the amount of insulin that the patient needs and pumps the correct dosage. While patients still need to calculate the amount of food and to enter the number of carbohydrate grams, the pump automatically takes care of calculating the insulin dosage.
Previously, patients in Qatar had to travel abroad to the United States to be implanted with the closed-loop system, often having to wait a long time before gaining access to the device. Other drawbacks included slower international administrative processes, delays in educating parents and complex international insurance policies.
Following the success of the protocol, Sidra Medicine has established the use of the most advanced model of the hybrid closed-loop system as the preferred treatment program for many of its pediatric and teen patients with T1D (provided their compatibility with the system).
Alia is a seven year old girl who was one of the first cohort of young patients to use the hybrid closed-loop pump, which was administered at Sidra Medicine’s Diabetes clinic. Her mother said: “I am grateful that we inserted the hybrid closed-loop pump at Sidra Medicine and made the life-changing decision for our daughter Alia, as both the transition and the transformation were visible in such a short span of time.”
