Artificial pancreas “safe and effective” for extended use at home, research finds
A closed-loop artificial pancreas system is effective and save for use at home in adults with type 1 diabetes, according to a new study.
The research, conducted at the Academic Medical Center at the University of Amsterdam, observed the blood glucose levels of participants over a period of eight weeks while they used a closed-loop artificial pancreas system. The results were compared to the use of an insulin pump only.
The researchers found that blood glucose control improved during artificial pancreas use, compared to insulin pump use.
“This study is the first in which glucose control was investigated over a prolonged period and not just overnight, and included the difficult post-dinner period,” said Jort Kropff, MD, lead author of the study.
“Although mean glucose concentration during the event was not different between the closed-loop and [pump therapy] period, the use of closed-loop control significantly reduced the time spent below the target range in this period.”
The study was conducted using data from 32 adults with type 1 diabetes who were using insulin pump therapy between April and December 2014. Patients who had experienced severe hypoglycemia or diabetic ketoacidosis in the past year were excluded. Three of the participants had used continuous glucose monitoring (CGM) before the study.
Each participant was given a closed-loop artificial pancreas system, to be used over a period of eight weeks. The system was comprised of a Dexcom G4 Platinum CGM and Accu-Chek Spirit Combo insulin pump connected to a smartphone with a control algorithm. The participants used the system from dinner until they woke up; during the day they used insulin pump therapy.
Patients spent less time with both hypoglycemia and hyperglycemia while using the artificial pancreas system, indicating better blood glucose control generally.
The study strongly indicates that the artificial pancreas system is suitable for extended home us. It was, however, a small study, and it was only conducted over an eight week period. For the idea to gain serious traction, larger, longer-term studies will be needed.
Laurent Legault, endocrinologist at Montreal Children’s Hospital, wrote an accompanying commentary. In it, Legault writes: “it remains to be seen if the use of this technology leads to substantial improvements in HbA1c concentrations over three months or more. Studies to answer this question are presently underway.”
The findings are published in The Lancet Diabetes and Endocrinology.
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