Apparently for the first time in the world, a recent research study on children with type 1 (insulin-dependent, juvenile- onset) diabetes aimed at creating an effective artificial pancreas to produce insulin was held not in a hospital but in a hotel.The clinical trial was conducted by specialists at the Schneider Children’s Medical Center (SCMC) at the Kibbutz Ma’aleh Hahamisha Hotel outside Jerusalem. The prospective, crossover study, in which the whole group receive the treatment but at different times, was part of the three-day DREAM (Diabetes wireless Artificial pancreas consortium) Camp for Children with Diabetes.ISRAELI GAYS ‘COME OUT’ EARLIER The number of Israeli lesbian, gay and bisexual teens who identify their sexual leanings and “come out” to their family and friends has grown dramatically in the past two decades, with the average age dropping from 25 in 1991 to 16 in 2010, according to Tel Aviv University researchers.In a new study published in the journal Family Relations on the stress factors and the mental health of sexual minorities, Dr. Guy Shilo of TAU’s Bob Shapell School of Social Work reported that family support and acceptance is becoming increasingly essential for LGB youth. “Family support is a crucial variable in the mental health of young LGBs, higher than peer support,” wrote Shilo, noting that it is difficult for LGB teens to separate themselves from unsupportive families because they are still dependent on them for their welfare.Shilo and his colleague Prof. Riki Savaya conducted a study of 461 self-identified LGB youth aged 16 to 23 to examine how stress related to being part of a minority group was impacting their mental health. To determine stress levels, the researchers questioned participants on how they felt about their family, friends and peer support, as well as their connection to the LGB community for emotional support. Participants were evaluated for mental distress and feelings of well-being – the polar negative and positive of mental health.While peer support certainly had an impact on the mental health of participants, the researchers discovered that family support was more central to their sense of well-being.A lack of family support was found to significantly heighten mental distress among the study participants, which can lead to depression.In addition, they found that family acceptance had the strongest positive impact on self-acceptance of sexual orientation.Adult LGBs who lack the support of their families, explained Shilo, often react by leaving their families behind. They build separate lives that can include “families of choice,” where peer groups – mainly from the LGB community – form an alternative family structure and give each other the same emotional support and sense of belonging that a family is meant to provide. But this is not always a viable option at a younger age.Today, more adolescents are open about their sexual orientation – and the younger they are, the more important family connections tend to be, wrote Shilo, who works with Beit Dror, a shelter for runaway LGB youth in central Tel Aviv supported by the municipality and the Welfare and Social Services Ministry and the Israel Gay Youth Organization.The average 16-year-old is still in school and depends on family for financial support, food and shelter. “They can’t just get up and go.”The tendency of LGBs to come out earlier in life derives from social and cultural progress, concluded Shilo. Most adult LGBs knew they were homosexual or bisexual at the age of nine or 10, he maintained. “The increasing respect and recognition of the rights of sexual minorities have provided the encouragement to ‘come out’ at an earlier age,” he wrote.It consisted of 18 kids aged 12 to 15 years; nine of them were were connected to the artificial pancreas system on the first night of the camp, while eight were connected on the second night. The benefit of being in a hotel rather than a hospital ward was that the more pleasant, non-threatening environment made the results more accurate.The MD-Logic Artificial Pancreas, developed at the SCMS’s Institute for Endocrinology and Diabetes, consists of an off-the-shelf subcutaneous glucose sensor that monitors glucose levels, and an insulin pump. The sensor and pump are connected to a computer that programs the information and stipulates the amount of insulin that should be released to the body in order to maintain blood glucose balance.This innovation “closes the loop” between the sensor and the pump and relieves the patients with diabetes from the daily burden of dealing with their diabetes and has the potential to significantly improve the quality of life of patients with diabetes.The Schneider team collaborated with colleagues at the department of pediatric endocrinology and diabetes at Kinderkrankenhaus auf der Bult in Hannover, Germany, and the department of pediatric endocrinology, diabetes and metabolism at University Children’s Hospital in Ljubljana, Slovenia.Monitoring the night-time glucose levels is extremely important since most cases of severe hypoglycemia occur then, and bloodsugar levels are not within the desired range in many patients during sleep. The team of engineers and medical staffers stayed both nights in a specially set up control room, from where they were able to remotely supervise the trial and monitor the children’s glucose levels.Within the framework of the camp, social activities with counselors and the Institute for Endocrinology and Diabetes team took place: the children enjoyed swimming in the pool, sports, watching movies and other fun activities.The experimental artificial pancreas is aimed at providing a real solution for patients with type 1 diabetes, which usually begins in early childhood. The research is being carried out at the Shaffer Institute for Endocrinology and Diabetes at the Petah Tikva hospital’s National Center of Childhood Diabetes. The project is headed by institute director Prof. Moshe Phillip and Dr. Revital.Following the successful trial, Phillip said: “I am proud to head and be a part of the pioneering team working for a number of years to find a technological solution that will significantly improve the lives of millions of diabetics around the world. The MD-Logic Artificial Pancreas and the DREAM Projects will enable patients to be relieved of the continuous need to check glucose levels and inject insulin, while ensuring long-term balance which significantly reduces the chance of complications from diabetes. The entire staff in the Institute is excited to be part of this important historic project.”“This is a significant landmark in research,” he added. “This is, to the best of our knowledge, the first time in the world that such a trial project has been taken outside the hospital, illustrating a normal life for youngsters with diabetes, while using an automatic insulin delivery system during the night.” The overall success of the research represents genuine good news to millions of patients with diabetes in Israel and the world, he said.About 5000 children and adolescents in Israel have been diagnosed with childhood diabetes and thousands more youngsters and adults in the country have other types of diabetes.Diabetes requires constant vigilance concerning nutrition and blood glucose levels and requires that patients with diabetes inject insulin throughout the day in order to compensate impaired function of the pancreas.