Artificial pancreas better than existing treatment for type 1 diabetes, study finds

Posted on 03 October 2018

JDRF-funded artificial pancreas trial

The artificial pancreas is better at helping people to manage their glucose levels than the best currently available technology, a JDRF-funded trial found.

People who used the artificial pancreas spent 65% of time with glucose levels in range, compared with 54% of time for people using a continuous glucose monitor and an insulin pump.

In addition, people on the system experienced greater reductions in HbA1c over the three months of the trial.

You can read the full report in The Lancet here.

These findings bring us one step closer to making the artificial pancreas a reality for people living with type 1 diabetes in the UK.

The artificial pancreas, also known as a closed-loop system, consists of three pieces of technology – a continuous glucose monitor (CGM), an insulin pump, and a computer programme – that work together to automatically deliver precise amounts of background insulin, as and when needed.

This differs from using a CGM and an insulin pump together, where the two pieces of technology do not communicate with each other.

Why did they do this trial?

JDRF has been supporting Professor Roman Hovorka at the University of Cambridge since 2006 to develop an artificial pancreas for adults and children living with type 1 diabetes.

New technology has to be tested thoroughly for safety and effectiveness before it can be approved for use. This trial is the latest in a series designed to test the closed-loop system in increasing numbers of adults and children.

What did they do?

86 adults and children over the age of six took part in the trial. Half of the participants used the artificial pancreas for three months, while the other half used CGMs and insulin pumps, for comparison.

Importantly, the participants spent the three months of the trial living at home and carrying out their lives as usual. This helps us to see whether new technology is effective when used under normal living conditions.

What did they find?

The artificial pancreas was safe to use and effective in helping people with type 1 diabetes to manage their glucose levels.

People who used the closed-loop system spent more time with glucose levels in range, and less time hypo than those using pumps and sensors alone. The researchers defined the target glucose range as 3.9 – 10 mmol/L.

Participants on the experimental system also experienced greater drops in HbA1c, on average from 8.0% to 7.4% after the study, compared with 7.8% to 7.7% for the comparison group.

None of the participants experienced severe hypos during the trial, although there was one case of diabetic ketoacidosis (DKA) in the artificial pancreas group due to an infusion set failure. The infusion set is the part of the pump that is inserted into the skin to allow the insulin into the body.

What does this mean for type 1?

These results provide clear evidence that the artificial pancreas could become another effective treatment tool for people living with type 1 diabetes.

Rachel Connor, Director of Research Partnerships at JDRF in the UK, said:

“These are great results, and I congratulate Professor Hovorka on the vital work he is doing. Type 1 diabetes is a challenging condition, but these results take us a step closer to changing the lives of the 400,000 people that live with the condition in the UK.”

In their paper, the researchers say that the evidence to date backs the use of artificial pancreas technology:

“Results from our study together with those from previous studies support the adoption of closed-loop technology in clinical practice across all age groups.”

What’s the next step?

The research team will continue to gather evidence so that closed-loop systems can be approved for use in the UK. Professor Hovorka also indicated that they would be looking to commercialise their computer programme so that people could use it with any pump and any CGM to make an artificial pancreas.

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