artificial pancreas

Artificial Pancreas Will Become Reality Within 2 Years

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The “artificial pancreas,” or nearly closed-loop system, may soon become a reality for patients with type 1 diabetes, with forecasts that a product may come to market as early as this year or certainly by 2018, according to a new review by the UK National Institute for Health Research published online June 30 in Diabetologia.

Authors Hood Thabit, MB BCh, MD, PhD, and Roman Hovorka, MD, of the University of Cambridge, United Kingdom, explain that the artificial pancreas combines continuous glucose monitoring (CGM) with continuous subcutaneous insulin infusion therapy and a control algorithm. A hybrid approach also exists, which allows for bolus administration of insulin after meals.

Closed-loop systems address insulin-requirement variability — average daily variability in insulin is 20% during waking hours and 30% at night, and closed loop systems seem to perform better at night. There are also large variations in insulin requirements between individuals and, even within the same person, insulin requirements can vary by as much as one-third of the normal daily dose up to three times this, depending on factors like exercise, meal composition, and the menstrual cycle.

As such, the artificial pancreas can minimize hyperglycemia and decrease the risk of hypoglycemia related to tight glucose control.

Yet there remain a number of barriers to uptake of the technology, including user adherence and usability, even though people with type 1 diabetes have voiced high interest in the use of such systems and being able to effectively take “time off from the demands of diabetes,” say Drs Thabit and Hovorka.

“The artificial pancreas has made great leaps in the past few years, from being tested in small laboratories settings to real life in people’s homes. The level of innovation has been very vast,” Dr Hovorka told Medscape Medical News.

The progress results from intensive research and generous funding, with at least $200 million poured into the effort by funders over the past decade.

Still, some patients are refusing to wait for commercial devices: a small group of patients in the United States have become so frustrated waiting for the artificial pancreas that they have built their own closed-loop systems, as previously reported by Medscape Medical News.

Trials Successful So Far but Still Some Concerns

Randomized controlled transitional studies in diabetes camps, hotels, and outpatient settings — where participants are studied in “real-world” environments but have close monitoring — support the feasibility and efficacy of closed-loop systems in outpatient settings, as have been variously reported, note Drs Thabit and Hovorka.

And studies in free-living, unsupervised settings in children, adolescents, and adults also show better glucose control/outcomes and in some cases decreased hypoglycemia, as well as favorable user acceptance.

Home studies have also shown improvements in time spent in the target glucose range, without increased hypoglycemia. The longest randomized home study to date has lasted 3 months.

And qualitative studies have supported user acceptance, say the doctors. Issues such as “having time off from their diabetes,” less worry and fear about hypoglycemia, and other health-related quality-of-life topics are cited as positives by users.

But there is still concern over the size of devices, device connectivity, and sensor-calibration issues. Also needed are improvements in the control algorithm to control for adaptation and individualization, to improve glucose-sensing inaccuracies and pump-delivery errors. In addition, the issue of cybersecurity and secure communications protocols is of vital importance.

Another challenge is the fact that even fast-acting insulin analogues do not reach their peak levels in the bloodstream until 0.5 to 2 hours after injection, with their effects lasting 3 to 5 hours. This may not be fast enough for effective control in, for example, conditions of vigorous exercise.

Use of the even faster-acting insulin aspart analogue may remove part of this problem, as could use of other forms of insulin such as inhaled insulin, they note.

Baby Steps, but Quick Ones

From here on out, Dr Hovorka expects continued, incremental innovation, although continued investment will be needed to refine these devices, he stressed.

“What is being developed now will be surpassed by new progress,” he said.

Nevertheless, “I would expect it to be more likely than not likely that an artificial pancreas will be on the market by 2018. I give it high credentials,” he noted.

Regarding the most promising model, Dr Hovorka said, “I don’t necessarily support one name or the other. The whole industry is moving forward, although there are some front runners involved.”
Components of an artificial pancreas [Source: Diabetologia]

 

One of these is technology from Medtronic, the insulin-only hybrid closed-loop 670G system (MiniMed), slated for approval by the Food and Drug Administration this summer on the basis of pivotal research presented at the recent American Diabetes Association meeting, as reported by Medscape Medical News.

Another prospect is the iLet or “bionic pancreas,” a dual hormone system developed by Boston University biomedical engineering professor Edward R Damiano, PhD, and colleagues. The iLet, which is being trialed using both insulin alone in one of the chambers of the device as well as insulin and glucagon together, is being developed by Beta Bionics, a public-benefit corporation.

However, Dr Hovorka believes that “significant challenges” exist for the dual hormone system. Adding glucagon increases the complexity over insulin alone, which has been in use for decades, and necessitates a second pump device. And current glucagon formulations, which require replacement every 24 hours, are unstable, he explains.

Research into dual-chamber pumps and how to formulate more stable glucagon is ongoing: long-term human safety trial data are needed regarding the chronic use of subcutaneous glucagon, for example. And there may be other unknown obstacles, which is not the case for the single hormone.

“Given where we are currently, I think there’s no way the dual hormone system will make it for 2018,” Dr Hovorka said. “We will start definitely with a single hormone. I’m not against the dual hormone system, I’m just saying that’s an area for further research.”

Other companies involved in developing closed-loop systems are Animas and Tandem, which is partnering with Dexcom.

Acceptance by Doctors and Widening Patient Base and Reimbursement

In the review, Drs Thabit and Hovorka note that other barriers may come in the form of front-line healthcare professionals themselves: there is a question as to how quickly they will adopt and prescribe any such closed-loop device.

As such, structured education about the use of the device will be key, along with reassuring them that communications remain secure and not vulnerable to cybersecurity threats, unauthorized data retrieval, and interference with wireless protocols.

Another issue will be how to expand the user base to a wider population, including those patients who are not currently using insulin pumps.

“Increasing the user base is really critical for further development,” Dr Hovorka commented.

More research is also needed into quality-of-life issues and which populations will benefit most from this new technology.

How will user issues vary among the very young, pregnant women, and those with inpatient hyperglycemia, for example?

And cost-effectiveness data and reimbursement policies will be key.

“The current speculation is that an artificial pancreas should not be more expensive than the combination of sensor and a pump, but the price is to be determined,” Dr Hovorka concluded.

Extended home use of artificial pancreas safe, effective for adults with type 1 diabetes

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Adults with type 1 diabetes using a closed-loop artificial pancreas system for 8 weeks maintained better overnight glucose control vs. adults who used sensor-augmented pump therapy alone, according to research in The Lancet Diabetes & Endocrinology.

In a crossover, randomized study conducted in France, Italy and the Netherlands assessing at-home use of a single-hormone artificial pancreas during the evening and overnight, researchers also found that incidents of overnight hypoglycemia were significantly reduced for adults assigned to the closed-loop control system.

“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,” Jort Kropff, MD, of the Academic Medical Center at University of Amsterdam, and colleagues wrote. “Although mean glucose concentration during the evening was not different between the closed-loop and [sensor-augmented pump] period, the use of closed-loop control significantly reduced the time spent below the target range in this period.”

Kropff and colleagues analyzed data from 32 adults with type 1 diabetes using insulin pump therapy (mean age, 47 years; 18 men; mean BMI, 25.1 kg/m²; mean HbA1c, 8.2%; mean duration of diabetes, 28.6 years) between April and December 2014. Three patients in the cohort were using continuous glucose monitoring (CGM) before the start of the study; patients with severe hypoglycemia or ketoacidosis in the past year were excluded.

During two 8-week study periods, adults were assigned an artificial pancreas system (Dexcom G4 Platinum CGM and Accu-Chek Spirit Combo insulin pump connected to a modified smartphone with a model predictive control algorithm) to be used from dinner until wake time, plus sensor-augmented pump therapy during the day, or assigned sensor-augmented pump therapy only, both in free-living conditions. All participants used both therapies; the order of the two sessions were randomly assigned. Participants had no restrictions on their daily activities.

Researchers found that participants spent more time in the target range while using the artificial pancreas than sensor-augmented pump therapy alone (66.7% vs. 58.1%; paired difference, 8.6%) through reductions of mean time spent in both hyperglycemia and hypoglycemia. There was a significantly greater decrease in HbA1c while participants used the artificial pancreas vs. sensor-augmented pump alone (–0.3% vs. –0.2%; paired difference, –0.2%).

There were no serious adverse events during the study period; mild to moderate adverse events were determined to be unrelated to the study.

In commentary accompanying the study, Laurent Legault, MD, FRCP, an endocrinologist at Montreal Children’s Hospital, said the study proves the artificial pancreas is safe and efficient for the in-home setting, and longer-term studies are needed.

“It remains to be seen if the use of this technology leads to substantial improvements in HbA1c concentrations over 3 months or more,” Legault said. “Studies to answer this question are presently underway.” – by Regina Schaffer

Adding Glucagon to Artificial Pancreas May Cut Hypoglycemia

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Possible reduction in hypoglycemia in pooled small outpatient studies

 Using both a glucagon and insulin pump integrated with continuous glucose monitoring could reduce nighttime hypoglycemia in type 1 diabetes, a combined analysis of two small outpatient studies suggested.

Overnight use of the dual-hormone system was associated with less time spent in the hypoglycemic range under 72 mg/dL, at 1.0% compared with 3.1% with the single-hormone system and 5.1% with conventional insulin pump therapy, Ahmad Haidar, PhD, of McGill University in Montreal, and colleagues found.

The difference was almost entirely accounted for during the first half of the night, the time when glucagon was administered, whereas insulin delivery was otherwise similar between the two artificial pancreas systems.

Those were the findings from two randomized open-label crossover trials, one with 21 adults and seven children in a home setting using Medtronic pumps and sensors for two nights per intervention and the other with 33 children in a camp setting using Dexcom sensors and Roche pumps for 3 nights per intervention.

Combined analysis was reported here at the American Diabetes Association annual meeting, along with simultaneous publication of the pediatric camp study online inLancet Diabetes and Endocrinology.

The two artificial pancreas systems yielded similar overall glucose levels, both averaging 122 mg/dL compared with 140 mg/dL with conventional pump therapy.

Time spent at night in the hyperglycemic range over 144 mg/dL was 21% with the dual system, 23% with the single-hormone system, and 48% with conventional pump therapy.

The difference in nocturnal hypoglycemia was not significant in the pediatric study on its own, given the higher bar for statistical significance with multiple looks.

That study used a research-level set-up, with the kids’ continuous glucose monitors reading out to a sensor set outside the camp tent every 10 minutes, which was then entered manually by study staff into a tablet computer to run a dosing algorithm for the artificial pancreas systems that was then used to manually deliver the medications via remote control.

The researchers suggested that their findings warrant larger, longer studies with the goal of a fully integrated system.

Such a system would be more complex and more expensive, Jessica R. Castle, MD, of the Oregon Health & Science University in Portland, cautioned in an editorial accompanying the Lancet paper.

“Many advancements are needed to make a dual-hormonal automated system commercially viable,” she wrote, “including the approval of a stable glucagon formulation, a dual-chamber pump for combined storage and delivery of insulin and glucagon, and preferably a specialized infusion set that allows for combined delivery through a single insertion site.

“Despite these hurdles, the ongoing development of dual-hormonal systems is needed. Until a truly ultra-rapid insulin is available, an insulin-only system will be suboptimal, particularly in situations where insulin needs drop rapidly, such as during exercise.”

This four-year-old is the first person to receive an artificial pancreas .

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A four-year-old boy from Perth, Australia, has become the first person outside of clinical trials to be fitted with an artificial pancreas in order to help him manage his blood sugar levels.

An insulin pump that acts like an artificial pancreas could help a four-year-old Perth boy better manage his blood sugar levels and avoid hypoglycaemia, which can cause seizures, coma or even death.

Xavier Hames suffers from type 1 diabetes, an autoimmune disease that stops the body from being able to produce insulin, the hormone that regulates blood sugar levels, properly.

Usually diabetics need to continuously test and manage their blood sugar with finger pricks and insulin injections, but Xavier may be able to control his condition more easily thanks to his new artificial pancreas.

According to researchers from the Princess Margaret Hospital for Children in Perth, who created and installed the device, the pump can predict and prevent a hypoglycaemic attack around 30 minutes before it happens.

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The majority of these attacks happen during the night, which makes them particularly dangerous.

“Most parents have to get up two or three times a night to check glucose levels and this might make them feel a little safer at night time if they know they’ve got this automated system that’s going to prevent low glucose,” Tim Jones, a professor at the hospital, told Charlotte Hamlyn for ABC News.

While the actual pump machine stay outside of the body, the insulin is delivered via a plastic tube pushed under the skin, which can last for four years before needing to be replaced.

The device is now commercially available for A$10,000, as Hamlyn reports, but the price is predicted to decrease as the technology becomes more accessible. It can also be used by any age group.

The hospital is now working on making a more sophisticated device that constantly monitors blood sugar and adjust the level of insulin delivered accordingly, which could potentially eliminate the need for finger prick testing altogether.

Over in the US, scientists are already working on a similar device, which is controlled by a smart phone. And a team of researchers have also created atemporary tattoo that monitors a patient’s blood sugar levels in real time.

While all of these devices are currently going through testing, it’s looking pretty hopeful that in the next decade, diabetics will have a range of options to help them better manage their condition.

The artificial pancreas shown to improve the treatment of type 1 diabetes

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The world’s first clinical trial comparing three alternative treatments for type 1 diabetes was conducted in Montreal by researchers at the IRCM and the University of Montreal, led by endocrinologist Dr. Remi Rabasa-Lhoret. The study confirms that the external artificial pancreas improves glucose control and reduces the risk of hypoglycemia compared to conventional diabetes treatment. The results, published today in the scientific journal The Lancet Diabetes & Endocrinology, could have a significant impact on the treatment of type 1 diabetes, a chronic disease that can cause vision loss and cardiovascular diseases. Credit: IRCM

The world’s first clinical trial comparing three alternative treatments for type 1 diabetes was conducted in Montréal by researchers at the IRCM and the University of Montreal, led by endocrinologist Dr. Rémi Rabasa-Lhoret. The study confirms that the external artificial pancreas improves glucose control and reduces the risk of hypoglycemia compared to conventional diabetes treatment. The results, published today in the scientific journal The Lancet Diabetes & Endocrinology, could have a significant impact on the treatment of type 1 diabetes, a chronic disease that can cause vision loss and cardiovascular diseases.

An emerging technology to treat type 1 diabetes, the external artificial pancreas is an automated system that simulates the normal pancreas by continuously adapting insulin delivery based on changes in glucose levels. Two configurations exist: the single-hormone artificial pancreas that delivers insulin alone and the dual-hormone artificial pancreas that delivers both insulin and glucagon. While insulin lowers blood glucose levels, glucagon has the opposite effect and raises glucose levels.

“Our clinical trial was the first to compare these two configurations of the artificial pancreas with the conventional diabetes treatment using an insulin pump,” says Dr. Rabasa-Lhoret, Director of the Obesity, Metabolism and Diabetes research clinic at the IRCM and professor at the University of Montreal’s Department of Nutrition. “We wanted to determine the usefulness of glucagon in the artificial pancreas, especially to prevent , which remains the major barrier to reaching glycemic targets.”

People living with type 1 diabetes must carefully manage their blood glucose levels to ensure they remain within a target range in order to prevent serious long-term complications related to high glucose levels (such as blindness or kidney failure) and reduce the risk of hypoglycemia (dangerously low blood glucose that can lead to confusion, disorientation and, if severe, loss of consciousness, coma and seizure).

“Our study confirms that both artificial pancreas systems improve and reduce the risk of hypoglycemia compared to conventional pump therapy,” explains engineer Ahmad Haidar, first author of the study and postdoctoral fellow in Dr. Rabasa-Lhoret’s research unit at the IRCM. “In addition, we found that the dual-hormone artificial pancreas provides additional reduction in hypoglycemia compared to the single-hormone system.”

“Given that low blood glucose remains very frequent during the night, the fear of severe nocturnal hypoglycemia is a major source or stress and anxiety, especially for parents with young diabetic children,” adds Dr. Laurent Legault, paediatric at the Montreal Children’s Hospital, and co-author of the study. “The artificial pancreas has the potential to substantially improve the management of diabetes and the quality of life for patients and their families.”

IRCM researchers are pursuing clinical on the artificial pancreas to test the system for longer periods and with larger patient cohorts. The technology should be available commercially within the next five to seven years, with early generations focusing on overnight glucose control.

According to the Canadian Diabetes Association, an estimated 285 million people worldwide are affected by diabetes, approximately 10 per cent of which have type 1 diabetes. With a further 7 million people developing diabetes each year, this number is expected to hit 438 million by 2030, making it a global epidemic. Today, more than nine million Canadians – or one if four – are living with or prediabetes.

The randomized controlled trial compared the dual-hormone artificial pancreas, the single-hormone and the conventional insulin pump therapy in 30 adult and adolescent patients with, who had been using an insulin pump for at least three months. Patients were admitted to the IRCM’s clinical research facility three times. Each visit included three meals, chosen social activities, an evening exercise, a bedtime snack and an overnight stay, throughout which blood glucose levels were monitored.

Artificial pancreas informed by heart rate may reduce hypoglycemia risk during exercise.

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In patients with type 1 diabetes, an artificial pancreas closed-loop system that includes a heart rate signal may confer additional protection against hypoglycemia both during and immediately after exercise, according to recent findings.

  • In the clinical trial, researchers evaluated 12 patients with type 1 diabetes who were enrolled in a randomized crossover study at the University of Virginia Clinical Research Unit. The patients (median age, 38 years) had a glycated hemoglobin level of 6.9±0.2% and had type 1 diabetes for 23.6±4.4 years. The study participants were randomly allocated to a control-to-range (CTR) artificial pancreas system hospital admission, or a CTR system plus heart rate (HR) information (CTR+HR).  The admissions were up to 26 hours in duration and entailed a mild bout of afternoon exercise.

The patients were instructed in the use of the DiAs portable artificial pancreas platform, which ran on an Android (Google, Mountainview, Calif.) smartphone and was programmed with the CTR and CTR +HR algorithms.

The plasma glucose of the participants was measured at least every 30 minutes using a model YSI 2300/2700 from Yellow Springs Instruments (Yellow Springs, Ohio). Hypoglycemia was defined as YSI reading below 70 mg/dL or appearance of hypoglycemic symptoms.

The researchers assessed low blood glucose (BG) index (LGBI), number of hypoglycemic events and overall control of glucose.

They found that the addition of HR to the CTR system significantly decreased the BG decrease during exercise (P=.022), yielded a slightly lower LGBI (P=.03) and led to fewer hypoglycemic incidence during the bout of exercise (zero vs. two events, P=.16). Additionally, the CT+HR algorithm resulted in an overall higher amount of time in the target range (81% vs. 75%, P=.2).

According to the researchers, these findings would need to be confirmed in patients with heart conditions, those with significant cardiovascular conditions, and at various levels of exercise intensity. Nonetheless, they acknowledged that the results show promise for adding heart rate to an artificial pancreas algorithm.

“HR has been used for the first time to inform the AP system, slowing the rate of glycemic decline associated with exercise, and possibly indicating a reduced risk and improved protection against hypoglycemia during and after exercise,” the researchers wrote.

Artificial pancreas, algorithm yield nighttime glucose stability in type 1 diabetes.

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An artificial pancreas using a predictive rule-based algorithm achieves normal nocturnal concentrations of blood glucose in patients with type 1 diabetes, according to study findings.

“This study shows that the [predictive rule-based algorithm] is a new, more physiological, and highly precise controller that achieves a significant increase in overnight normoglycemia and glucose stability in patients with a previously acceptable metabolic control,” the researchers wrote.

The randomized crossover study evaluated 10 adult participants with type 1 diabetes and previously treated with continuous subcutaneous insulin infusion (CSII). All participants were aged at least 18 years, had diabetes for at least 3 years, and had received CSII treatment for more than 1 year.

The study participants spent two non-consecutive nights at the Diabetes Day Care Center, Parc Tauli Sabadell University Hospital in Barcelona, Spain. On one of the nights, the participants underwent their usual CSII therapy (open-loop night), and one night entailed the use of the predictive rule-based algorithm (closed-loop night). Each night involved the evaluation of two patients, one for each treatment approach. The closed-loop treatment duration was between 10 p.m. and 10 a.m., and included overnight control and breakfast control. Blood glucose was evaluated through samples collected every 20 minutes.

The researchers found that the percent of normoglycemic time sustained during the nocturnal period (from midnight to 8 a.m.) increased from 66.6% with open loop to 95.8% using the closed-loop algorithm (P<.05). The median time in which patients were hypoglycemic decreased from 4.2% in the open-loop night to 0% on the closed-loop algorithm night (P<.05). The open-loop night was associated with nine hypoglycemic events vs. one using the closed-loop algorithm. Post-meal glycemic deviation was not lower with the closed-loop system vs. conventional insulin pump therapy.

Source: Endocrine Today

New FDA Guidelines for Testing Artificial Pancreas

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Agency Gives Industry Greater Flexibility to Develop Artificial Pancreas for Type 1 Diabetes

 

human pancreas

The FDA today released new guidelines for the development and testing of artificial pancreas devices for the treatment of type 1 diabetes.

The guidelines are designed to give researchers and industry a great deal of flexibility in order to get a safe and effective device to patients as quickly as possible.

“Flexibility is one of the most important hallmarks of this guidance,” Charles “Chip” L. Zimliki, PhD, leader of the FDA’s Artificial Pancreas Working Groups and Critical Path Initiative, told reporters at a news conference today.

A primary goal, Zimliki says, is to move clinical trials to an outpatient setting to see how they function in a “real world setting.”

While Zimliki referred to the device as an artificial pancreas, it does not actually replace that organ, which is responsible for the production of insulin. Instead, a two-part device — combining an insulin pump and a continuous glucose monitor — would take over that function, constantly monitoring blood sugar levels via a sensor placed under the skin.

The insulin pump and continuous glucose monitor would work together in controlling blood sugar (glucose) levels. If blood sugar levels were to become too high or low, the insulin pump would be programmed to make adjustments in insulin-dosing to bring blood sugar levels back to a normal level.

The devices, if approved, have the potential to vastly improve the lives of the approximately 3 million people in the U.S. who have type 1 diabetes. These patients must constantly monitor their blood sugar levels throughout the day and inject insulin when needed.

 What Is Type 1 Diabetes?

Type 1 diabetes, which often starts in childhood or early adulthood, is a chronic autoimmune disease in which the immune system attacks the insulin-producing beta cells in the pancreas. Its causes are unknown and there is no known cure.

Zimliki says there are currently more than 20 studies of various devices underway. He says the data he has seen so far are encouraging.

“Hopefully it [approval for one or more device] will happen sooner rather than later,” Zimliki says. “As a person with type 1 diabetes, I hope it happens tomorrow.”

While the guidelines released today include recommendations on how to proceed during testing, the FDA says it is flexible in terms of specific study goals, the number of patients involved in studies, and the length of the studies. They also encourage researchers and manufacturers to discuss with them alternative means of testing devices.

“If a company would like to find a way to do it differently, we encourage them to approach the agency,” Zimliki says.

He says the guidelines are “pretty novel — one of the few written before a device has gone through the regulatory process.”

The flexibility of the guidelines, Zimliki says, takes into account the fact that the devices are constantly being “changed, updated, modified” as they are tested. “We have recommendations that we would encourage industry to follow in this process,” said Zimliki, “but because this is an innovative device, we realize we don’t have all the answers and need to be open to new ideas. … We want these devices on the market as quickly as possible.”

source:FDA

Artificial pancreas may improve overnight control of diabetes in adults

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Data from two randomized trials suggest that an artificial pancreas may improve overnight blood glucose control and reduce the risk for nocturnal hypoglycemia in adults with type 1 diabetes.

Previous studies have demonstrated the efficacy of an artificial pancreas in children and adolescents, but the effects of such a system have remained unknown in adult populations. Researchers at the University of Cambridge conducted two small studies to compare the safety and efficacy of overnight closed-loop insulin delivery with conventional insulin pump therapy in 24 adults with type 1 diabetes. Participants were aged 18 to 65 years and had used insulin pump therapy for at least 3 months.

In the first study, half of participants were monitored twice overnight after consuming a medium-sized meal (60 g carbohydrates) at 7 p.m. They were randomly assigned to an artificial pancreas or conventional insulin pump therapy and then, on a night 1 to 3 weeks later, they used the other delivery method, according to a press release. In the second study, the other 12 participants were monitored twice overnight after consuming a larger meal (100 g carbohydrate) accompanied by alcohol at 8:30 p.m. They were also assigned to one of the two insulin delivery methods.

During overnight-loop insulin delivery, the time spent with blood glucose levels in the target range increased by up to 28%. Closed-loop delivery also lowered glucose variability overnight and significantly reduced the time spent hyperglycemic, according to the release.

The researchers said their findings provide further evidence that overnight closed-loop delivery can operate safely, effectively and consistently across different age groups, insulin sensitivities and lifestyle conditions. In addition, an artificial pancreas may allow for more flexible lifestyles and improved glycemic control for people with type 1 diabetes in the future.

In an accompanying editorial, Boris Kovatchev, PhD, of the University of Virginia, said that closed-loop control shows promise in a research setting. However, further development and system miniaturization is needed in practice to really improve the health and lives of people with type 1 diabetes.

source: Endocrine today