Clinical researchers at Cambridge University have been testing the effectiveness of combining commercial continuous glucose monitors with insulin pumps via a proprietary closed-loop algorithm developed by the researchers.. The study, performed on type 1 diabetic pediatric patients using pumps and meters from Smiths Medical, Medtronic, and Abbott, has demonstrated a significant overnight glucose management improvement over continuous drip pumps.
In the new study, 17 children and teenagers aged between 5 and 18 with type 1 diabetes were studied during 54 nights at Addenbrooke’s Hospital. The team measured how well the artificial pancreas system controlled glucose levels compared with the children’s regular continuous subcutaneous insulin infusion (CSII) pump, which delivers insulin at preselected rates.
The study included nights when the children went to bed after eating a large evening meal or having done early evening exercise. Both are challenging to manage, a large evening meal because it can lead to so-called “insulin stacking” and, as a result, a potentially dangerous drop in blood glucose levels later in the night, and late afternoon or early evening exercise because it increases the body’s need for glucose in the early morning and can therefore increase the risk of night time hypoglycaemia.
The pooled results showed the artificial pancreas kept blood glucose levels in the normal range for 60% of the time, compared with 40% for the CSII. The artificial pancreas halved the time that blood glucose levels fell below 3.9mmol/l – the level considered as mild hypoglycaemia. It also prevented blood glucose falling below 3.0mmol/l, which is defined as significant hypoglycaemia, compared with nine hypoglycaemia events in the control studies.
More from the study abstract in The Lancet: Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial
Press release: ‘Artificial pancreas’ a step nearer for children with type 1 diabetes
Image: Medtronic’s Paradigm Veo Wireless Insulin Pump Helps Prevent Hypoglycemia
