Artificial pancreas trumps insulin pump therapy in trials
The artificial pancreas has reached another important step towards becoming a reality for the public after success in a clinical trial which compared two different types of artificial pancreas against conventional insulin pump therapy.
The pumps and artificial pancreas systems used
One of the artificial pancreases used in the trial was one that combines an insulin pump with a continuous glucose monitor. As glucose levels rise rise, more insulin is secreted and as glucose levels fall too low insulin delivery is ceased to prevent sugar levels decreasing much lower. This system is referred to as a single hormone artificial pancreas.
The other artificial pancreas used is one in which the insulin pump also is able to deliver glucagon, so when blood sugar levels rise, insulin is released and when sugar levels go too low, glucagon is released which raises sugar levels. This system is referred to as a dual hormone artificial pancreas.
The conventional insulin pump therapy relied upon participants’ decision making as to when to increase and decrease insulin delivery.
How the study was run
Participants, who were 12 years or older and had type 1 diabetes, were put onto each
of the therapies in random order. Each participant attended a research facility, at the University of Montreal, three times for 24 hours to test out each of the therapies.
The researchers reviewed the success of each system by analysing how much time participants spent in target blood glucose windows and by how many times participants experienced too low blood glucose levels (hypoglycemia).
The target ranges were as follows:
- 72-180 mg/dl (4—10 mmol/l) within 2 hours after meals
- 72-144 mg/dl (4-8 mmol/l) at any other time
Hypoglycemia was recorded, for the purpose of the study, as any blood glucose result under 60 mg/dl (with symptoms) or otherwise any result under 54 mg/dl.
The results were as follows:
|Treatment system||Time spent in target range||Number of hypos||Number of nocturnal hypos|
|Dual hormone artificial pancreas||63%||9||0|
|Single hormone artificial pancreas||62%||13||0|
|Conventional insulin pump||51%||52||13|
The results show that the both single and dual hormone artificial pancreas systems improved the time spent in the target blood glucose window and greatly reduced the number of hypos. The artificial pancreas systems showed particular success in eliminating over night hypos.
In addition, the results showed the single hormone artificial pancreas system to be a close match for the dual hormone system.
Larger trials still required
Whilst the trial showed significant success for the artificial pancreas systems, larger scale research studies will be required to prve safety and effectiveness. It is expected to be at least 5 years before an artificial pancreas system is ready for public use.
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